MHF: People with recurring depression denied key therapy

The Mental Health Foundation has called on the government to improve access to mindfulness based cognitive therapy (MBCT), after a survey found poor uptake from GPs five years after the treatment won official backing.

National Institute for Health and Clinical Excellence (NICE) guidance for the NHS has recommended MBCT for recurrent depression since 2004. But the foundation’s Be Mindful report said that just one in five GPs can access the treatment for their patients and only one in 20 prescribe MBCT regularly.

Meditation and cognitive therapy

MBCT combines cognitive therapy, which is designed to tackle negative thoughts that cause mental ill-health, with activities such as meditation. MBCT seeks to help patients recognise a deterioration in mood and prevent this carrying over into negative thoughts and depression.

Evidence suggests that MBCT can cut relapse rates by half for those who experience more than two episodes of depression. Recurrent depression is extremely common, with 50% of sufferers having more than one episode and the risk of relapse rising to 70% and 90% respectively for the second and third episodes.

The online survey of 250 GPs found that three-quarters (75%) had prescribed antidepressants for recurrent depression when they felt an alternative might be more appropriate.

Lack of alternatives

Chief among reasons given for this were waiting lists for psychological therapies (67%) and a lack of alternatives (57%).

The foundation’s report said the government could achieve the necessary expansion of training and MBCT services through its Improving Access to Psychological Therapies (IAPT) programme.

Professor Steve Field, chairman of the Royal College of General Practitioners, said: “The IAPT initiative is increasing access to psychological therapies and allows patients a greater choice of treatment.

Evidence base growing

“[MBCT] is gaining an increasing evidence-base and should be offered to people with recurrent depression according to the recently updated NICE guidelines.”

Mental Health Foundation chief executive Dr Andrew McCulloch said: “GPs spend about a third of their time dealing with mental health problems and know how common conditions like recurrent depression are.

“MBCT is an effective intervention and should be much more widely available than at present. We need to build up capacity so that every patient who might benefit has access.”

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