Patients ‘should be allowed to self-refer for psychological therapies’

By Liz Lockhart

GPs should encourage patients with mental health disorders to self-refer to psychological therapies and counselling services, according to new NICE guidelines – prompting fears that already stretched services could be overwhelmed according to ‘Pulse Today’.

The NICE guideline on common mental health disorders says that although the ‘vast majority’ of depressive and anxiety disorders that are diagnosed are treated in primary care, ‘recognition of anxiety disorders by GPs is particularly poor, and only a small minority of people who experience anxiety disorders ever receive treatment.

NICE blames this ‘in part’ on GPs’ difficulties in recognising the disorder, and calls on GPs to be alert to possible anxiety disorders as well as depression particularly in patients with a past history, possible somatic symptoms, a chronic physical health problem, or a recent traumatic event.

As we reported last week the guidance also notes patients are most often treated with psychotropic medication in primary care, ‘due to the limited availability of psychological interventions’. The guidance also recommends GPs to refer all appropriate patients with depression, generalised anxiety disorder, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder and social anxiety disorder for psychological therapies as part of a stepped model of care.

The new guideline says that in order to improve access to services, services should have a clear and explicit criteria for entry to the service focusing on entry and not exclusion criteria, and to further widen access services should have multiple means of referral to psychological therapies and counselling services ‘including self-referral’.

Dr Barbara Compitus, a GP in Bristol and member of the guideline panel said ‘Success would be building on depression detection and making sure anxiety detection is as much in GPs’ consciousness as depression. The guidance is aimed at ensuring quality and consistency – so that GPs always pick up on those areas and giving them the tools to set patients on the right path.’

The more we read these guidelines, the more the Uncovered team look forward to seeing them implemented across the country.