Times article below. Cheers. B
Counselling by computer to fight depression
By Sam Lister
Hi-tech treatment is intended to ease demand on the NHS
MILLIONS of people suffering from depression, one of the biggest burdens on the NHS, will soon be able to get counselling by computer with the expansion of a revolutionary programme for GPs surgeries.
After trials on the interactive programme, which counsels users to help them to overcome depressive tendencies, an NHS trust in Wiltshire will become the first to introduce it in all primary care services.
Such is the demand for treatment for depression a condition that affects an estimated six million Britons that the therapy is to be recommended to primary care trusts nationwide in clinical guidelines published this year.
Of the 1.3 million suffering severe depression, only 10 per cent are thought to receive adequate therapy because of a reluctance to seek help and pressure on NHS resources, with patients waiting up to a year to see a counsellor.
Unlike conventional depression treatment, based on consultations with doctors and psychotherapists and regimented courses of medication, the computer counselling, called Beating the Blues, requires a single guidance session, dramatically reducing costs and pressure on staff.
Random trials have shown that the treatment which uses cognitive behaviour the- rapy (CBT) to alter outlook and mood to be as effective as, and greatly enhance, other clinical treatments. For many patients, particularly those who fear confrontation with a clinician, it has been found to be a far quicker cure.
While private surgeries and individual GPs have tested the scheme over the past year, Swindon Primary Care Trust last week became the first trust in Britain to buy licences for Beating the Blues for all 30 of its practices, at a cost of 50,000.
Take-up by other primary care trusts, which treat 95 per cent of mental health problems, is expected to rise after the publication of depression guidelines by the National Institute of Clinical Excellence (NICE), due in November.
Sir David Goldberg, the reports lead author and a strong advocate of such forms of therapy, has described the programme as one of the most important advances in the treatment of anxious depression in the last 50 years.
The economic burden of depression has risen sharply in recent years. It costs the NHS more than 1 billion a year and accounts for a further 6 billion of lost productivity while GP consultations for depression have more than doubled in the last ten years.
The new programme, which was developed at the Institute of Psychiatry in London in conjunction with Ultrasis, an IT healthcare company, works by taking sufferers through systematic steps to help them to think differently about everyday situations that trigger anxiety from running late in a traffic jam to being stood up in a bar.
Different character case studies the middle-class housewife, the elderly widow, the single parent also offer alternative insights and emotional responses, helping to illustrate, and ultimately to teach how to control, the links between negative feelings and thoughts.
For Peter Crouch, a GP at Taw Hill Medical Practice, a flagship surgery in Swindon, the arrival of the Beating the Blues course has increased capacity more than five-fold since it was introduced last year.
From August, patients served by the primary care trust will be able to attend the course of eight one-hour sessions at any time, rather than the once-weekly psychother- apy sessions now offered by surgeries. This programme has been identified as an incredibly effective way of rolling out a vital service to everyone who wants it, said Dr Crouch, an adviser to the primary care trust.
It is a programme that helps patients realise the capa- city to help themselves. Traditional forms of counselling have often fostered a dependency on the service among patients, but they should leave this feeling a crucial sense of self-control. For doctors at the Priory, the private health clinic famed for its celebrity clientele, the programmes value has been evident since its introduction nine months ago.
According to Paul McLaren, medical director of the Priory's clinic in Ticehurst, Kent, its 400 course of computerised cognitive therapy has proved an excellent complement to anti-depressant drugs and face-to-face counselling. We were very interested in looking at new ways of delivering mental health care at a cost people could afford, he said.
We wanted to be able to give people choice, and in the public sector the options to date have been very limited. Dr McLaren said that South London and Maudsley NHS Trust, where he also works as a consultant psychiatrist, planned to bring in the programme before the end of the year. Most of the NHS service is currently overwhelmed, he said.
Recent research into depression treatment found that 80 per cent of family doctors felt that they prescribed too many anti-depressants, a trend forced on them by the lack of appropriate psychological therapies or social care on the NHS. A quarter of all GPs surveyed this month rated wider access to depression treatment as one of the health services most pressing priorities.
HAUNTED BY THE BLACK DOG
An estimated 1.3 million Britons suffer from severe depression, yet only 10 per cent receive adequate therapy. A further five million people are categorised as suffering from milder conditions of mixed depression and anxiety
Depression refers to a wide range of mental health problems characterised by the loss of interest and enjoyment in ordinary things and experiences, low moods and a range of associated emotional, physical and behavioural symptoms
As the most common psychiatric disorder, depression is ranked as the fourth biggest burden on healthcare by the World Health Organisation. It is expected to worsen over the next 20 years
One in four UK women and one in ten men are likely to suffer depression serious enough to require treatment
GP consultations for depression jumped from four million to more than nine million between 1994 and 1998
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