New prescription for mental health: read a good book
Doctors usually send patients to the pharmacy to get medication, but from tomorrow GPs in one county will be packing people
off to the library with prescriptions for self-help books.
Those with symptoms of depression, anxiety or eating disorders will be referred to clinics where they will be prescribed
books to read alongside support sessions with graduate mental health care workers.
society.guardian.co.uk 9 Jan
The scheme in Devon, which is the first of its kind in the UK, aims to cut waiting lists for more serious cases, reduce
over-prescription of drugs and offer some form of treatment for patients who may otherwise receive none.
'This is needs driven,' said Paul Farrand, a senior lecturer in health psychology at Plymouth University, who developed
the scheme. 'Nine out of 10 people with mild or moderate depression do not receive any treatment at all. Others are put on
long waiting lists or are given medication that may be unnecessary.'
Farrand said the scheme was developed following recommendations in a government report, Self-help interventions for mental
health problems. By the summer there will be 80 self-help clinics in Devon, all using books based on cognitive behavioural
therapy.
'This is not for those with chronic problems,' said Farrand. 'But it could reduce waiting lists for those patients to receive
the treatment they desperately need.'
Jan Ap-Thomas, from Derby, welcomes the move. The 53-year-old began suffering from severe depression 14 years ago. Overcoming
Depression, by Professor Paul Gilbert, was one of the books recommended in the Devon scheme and played a large part in her
recovery.
'A book doesn't go on holiday or have bad days,' she said. 'It is always there for you to pick up when you need it and
for me it was my depression bible.'
Jan used to cry all the time and would spend days in bed. She even started to lose interest in her three daughters. She
was treated by Gilbert while he wrote the book and has since used the literature regularly.
'The best thing about these books are they are full of case studies that make you realise you are not alone,' she said.
'Depression means you feel extremely isolated. [The books] also remove the stigma as you can do it in the privacy of your
home. For me, the antidepressants stopped working but the book did not and it meant I was making myself better instead of
relying on someone else.'
She now enjoys life again and is planning a holiday abroad with her family, something she would never have done before.
Dr Richard Byng, a GP based in Devon, with a special interest in mental health, will be referring patients to the scheme.
'Anything that can broaden the options that GPs have is a good thing,' he said. 'There is good evidence to support the use
of books and the graduate workers will help motivation.'
The chosen books aim to help those suffering from depression, anxiety, bereavement and eating disorders, as well as victims
of child abuse. The initiative, which has been welcomed by some charities, will begin in Devon tomorrow but is likely to spread
across the country.
'While we recognise there is often a place for medication in treatment, the NHS relies on it too heavily,' said Sophie
Cortlett, director of policy of Mind, a mental health charity. 'The self-help scheme looks like a possibly useful way of broadening
patient choice.'
GPs have been criticised for over-prescribing anti-depressants, some of which carry side-effects.
Samantha, a 24-year-old Londoner, suffered a difficult relationship breakdown two years ago. She started to experience
mood swings and felt down a lot of the time. When she went to see her GP she was immediately put on anti-depressants.
'They really helped at the time,' she said. 'But when I tried to come off them I started having panic attacks. I stayed
on them for a year longer than I needed to because I was so scared. I would have much preferred to be offered some sort of
supported self-help solution. Coming off the antidepressants was hell for me.'
Though the scheme has been welcomed by the Department of Health, others warn it could have problems.
Phillip Hodson, a fellow of the British Association for Counselling and Psychotherapy, said: 'If patients go to their GP
and are prescribed a book they feel a huge rejection because no one is giving them any time.'
Marjorie Wallace, director of the charity Sane, which campaigns on mental health issues, has written the foreword for a
self-help book, Beat Depression and Reclaim Your Life .
She said: 'Obviously we are very glad the doctors are thinking of this and there is some value in people reading self-help
books. However, I would be very worried if the government were to see this as an alternative to much-needed investment in
professional counselling.'
Way with words
Overcoming Depression by Paul Gilbert
Gilbert, professor of clinical psychology at Derby University, tried out draft chapters of this book on his patients to
check their effectiveness. The book looks at the evolution of depression and how to cope with it, and includes exercises.
'One of the common things about depression is that people feel bad about themselves and think they are weak to be depressed,'
said Gilbert. 'When people recognise they condemn themselves to depression by bullying themselves then they can start to cope
with it.'
Overcoming Binge Eating by Professor Fairburn
Fairburn is one of the world's leading experts on eating disorders. This book explains how the illness works and how to
treat it. Trials in the UK, America and Australia showed that in up to a third of cases people recovered with the help of
the book. 'Guided self-help is best,' he said.
Mind Over Mood by Dennis Greenberger and Christine Padesky
This was voted the most influential cognitive behavioural therapy book of all time in 2002 by the British Association of
Behavioural and Cognitive Therapies. It aims to build self-esteem by showing readers how to rate mood reactions, become more
balanced in their thinking and do behavioural experiments.
Self Esteem for Women by Lynda Field
Field, a well known self-esteem expert, has been a therapist for nearly 20 years and is the author of 12 self-help books
that have sold 500,000 copies. This five-step programme aims to show women how to discard negative patterns, succeed in love
and be assertive at work. 'Everyone can improve the quality of their lives,' said Field.
