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Prescribing self-help books on the NHS is an effective treatment for
depression, a study suggests.
Patients offered books, plus sessions guiding them in how to use them, had
lower levels of depression a year later than those offered usual GP care.
The effect was seen in addition to the benefits of other treatments such as
antidepressants, Scottish researchers report in the journal Plos One.
Such an approach may help the NHS tackle demand for therapy, they said.
More than 200 patients who had been diagnosed with depression by their GP took
part in the study, half of whom were also on antidepressant drugs.
Some were provided with a self-help guide dealing with different aspects of
depression, such as being assertive or overcoming sleep problems.
Patients also had three sessions with an adviser who helped them get the most
out of the books and plan what changes to make.
After four months those who had been prescribed the self-help books had
significantly lower levels of depression than those who received usual GP care.
Start Quote
Depression saps people's motivation and makes it hard to believe change is
possible
Prof Christopher Williams
A year later, those in the self-help group were more likely to be keeping on
top of their depression.
Study leader Prof Christopher Williams, from the University of Glasgow, who
also wrote the books called Overcoming Depression and Low Mood, said the guided
sessions were the key to getting people engaged.
The sessions can be delivered in general practice without referral to a
specialist, taking pressure off waiting lists.
In Scotland, a telephone support service has now been set up to help support
those using the books, which can be freely copied and disseminated, he added.
"We found this had a really significant clinical impact and the findings are
very encouraging," he said.
"Depression saps people's motivation and makes it hard to believe change is
possible."
The challenge for the NHS, where self-help books are already used in many
places, is how to implement this model so people have easy supported access in
primary care, he said.
'Worth investing in'
There has been huge investment in better treatment for depression in the UK in
recent years with the Improving Access to Psychological Therapies programme in
England set up to widen access.
It has been estimated this approach could save the NHS up to 272m and the
wider public sector 700m.
But, says Prof Williams, despite the huge levels of investment, it is just not
possible to refer everyone with depression to mental health services.
Dr Paul Blenkiron, consultant in adult psychiatry at Leeds and York Partnership
NHS Foundation Trust, said the results showed that guided self-help is
effective and is "something the NHS should be investing in".
He is currently advising on behalf of the Royal College of Psychiatrists, on a
National Books On Prescription Scheme, to be rolled out across UK public
libraries this year.
Thirty books, including the one used in the study, have been selected.
But Dr Blenkiron said self-help would not be suitable for everyone: "The key
thing is that the person is committed to doing some work."