Mental health charity Mind has warned that new guidance for the NHS on the treatment of depression could lead to cuts in counselling services.
The National Institute for Health and Clinical Excellence today issued revised clinical guidelines on the treatment of depression in adults, alongside a new guide to treating adults with depression and chronic physical health problems.
Previous guidelines on depression stated that health professionals should consider counselling as one option for people with mild or moderate depression.
Counselling not first choice
However, the revised guidance says counselling should only be used for people with persistent sub-clinical or mild or moderate depression who decline a range of other treatments, including antidepressants and cognitive behavioural therapy.
It says the evidence for using counselling – which has been defined as “a systematic process which gives individuals an opportunity to explore, discover and clarify ways of living more resourcefully” – was “very limited” in treating depression.
The guidance emphasises the importance of cognitive behavioural therapy – in which patients are guided to recognise and re-evaluate negative thoughts – for treating all forms of depression.
It says antidepressants should not be used to treat persistent sub-clinical or mild depression unless other treatments do not work, the patient has a history of moderate or severe depression or sub-clinical symptoms have persisted for at least two years.
Responding to the guidelines, Mind’s chief executive, Paul Farmer, warned: “We welcome Nice’s recommendations to promote the use of talking therapies over antidepressants, however we are concerned that the stronger focus on CBT over counselling will be interpreted by health services as an excuse to cut counselling services.”
He added: “Depression can be a complex issue and while CBT can bring huge benefits to many people, for others it isn’t always the right approach and there is no substitute for talking through long-term issues with a counsellor.”