INFORMATION RESOURCES ON MENTAL HEALTH AND WELL-BEING
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Guidance on Management of Mental Health Problems
This section brings together a collection of National Institute for Health and Clinical Excellence (NICE) guidelines and other guidance designed to support those responsible for identifying, treating and managing a range of mental health problems.
Supporting people with dementia and their carers in health and social care – clinical guideline 42
This guideline makes specific recommendations on Alzheimer's disease, dementia with Lewy bodies (DLB), frontotemporal dementia, vascular dementia and mixed dementias, as well as recommendations that apply to all types of dementia. Dementia in Parkinson's disease shares a number of similarities with DLB. Although the evidence base for dementia in Parkinson's disease was not examined specifically in the context of this guideline, the recommendations for DLB may be useful when considering treatments for dementia in Parkinson's disease.
Depression – adults
Management of depression in primary and secondary care – Clinical guideline 23 (NICE)
Depression is a broad and heterogeneous diagnostic grouping, central to which is depressed mood or loss of pleasure in most activities. Depressive symptoms are frequently accompanied by symptoms of anxiety. For the purpose of this guideline, the treatment and management of depression has been divided into four categories as defined by ICD10 – mild depression, moderate depression, severe depression and severe depression with psychotic symptoms.
This guideline, issued in December 2004, makes recommendations for the identification, treatment and management of depression for adults in primary and secondary care and draws on the best current available evidence.
The guideline makes good practice points and evidence-based recommendations that cover:
- The care people with depression can expect to receive from their GP or other healthcare professionals, whether they receive treatment in or out of hospital
- The information they can expect to receive about their problem and its treatment
- What they can expect from treatment, including psychological therapies, drug treatment and electro convulsive therapy
- The kind of services that help people with depression, including GP services, specialist mental health services and hospital care
Depression – children and young people
Depression in children and young people: identification and management in primary, community and secondary care – Clinical guideline 28 (NICE)
This guideline, issued in September 2005, makes recommendations for the identification and treatment of depression in children (5–11 years) and young people (from the age of 12 up to their 18th birthday) in primary, community and secondary care.
The guideline draws on the best currently available evidence for the identification and management of depression and covers:
- The care children and young people with depression can expect to get from their doctor, nurse or counsellor
- The information they can expect to be given
- What they can expect from treatment
- The kinds of services that can help young people and children with depression, including family doctors (general practitioner or GP), health staff at your school, and specialists in clinics or hospitals
Management of anxiety (panic disorder, with or without agoraphobia, and generalised anxiety disorder) in adults in primary, secondary and community care – Clinical guideline 22 (NICE)
If left untreated anxiety disorders are costly to both the individual and society, however:
- A range of effective interventions is available to treat anxiety disorders, including medication, psychological therapies and self-help
- Individuals do get better and remain better
- Involving individuals in an effective partnership with healthcare professionals, with all decision-making being shared, improves outcomes
- Access to information, including support groups, is a valuable part of any package of care
This guideline, issued in December 2004, makes recommendations on the management of generalised anxiety and panic disorder (with or without agoraphobia) in adults in primary, secondary and community care.
- Psychological treatments
Eating disorders: core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders – Clinical guideline 9 (NICE)
This guideline, issued in January 2004, is evidence based and makes recommendations for the identification, treatment and management of anorexia nervosa, bulimia nervosa and atypical eating disorders (including binge eating disorder) in primary, secondary and tertiary care. The guideline applies to adults, adolescents and children aged 8 years and older.
The guideline covers physical and psychological treatments, treatment with medicines, and what kinds of services best help people with eating disorders.
Computerised cognitive behaviour therapy
Depression and anxiety - computerised cognitive behavioural therapy – Technical appraisal 97 (NICE)
This technical appraisal published by NICE in February 2006 makes a number of recommendations about the use of computerised cognitive behavioural therapy (CCBT) to treat depression and anxiety. It recommends using:
- Beating the Blues for people with mild and moderate depression
- FearFighter for people with panic and phobia
There is not enough evidence to recommend COPE and Overcoming Depression for managing depression. But people can use them specifically as part of ongoing or new clinical trials.
OCFighter is not recommended for people with obsessive-compulsive disorder who are not already using it. People who are currently using OCFighter either:
- as part of their treatment, or
- as part of a clinical trial should have the option to continue with the treatment until they, their GP and/or specialist think it is right to stop
Conduct disorder in children - parent-training/education programmes
Parent-training/education programmes in the management of children with conduct disorders – Technical appraisal 102 (NICE)
This technical appraisal issued by NICE in July 2006 recommends group-based parent-training/education programmes in the management of children with conduct disorders (individual-based programmes are only recommended where the family’s needs are too complex for a group-based programme).
All group-based and individual programmes should:
- Be based on principles of social learning theory (an approach to learning that includes learning from observing other people)
- Include ways of improving family relationships
- Offer enough sessions (usually between 8 and 12) to be as helpful as possible for those taking part
- Help parents to identify their own parenting goals include role play during sessions and homework between sessions so that parents can apply what they have learnt to their own family’s situation
- Be given by people who are suitably trained, skilled and supervised, who have access to any further training they may need, and who are able to work successfully with parents to help their children
- Follow the programme’s instruction manual and use whatever resources are needed to ensure that the programme is followed consistently.
For all programmes used, there should be good independent evidence that they work well. Those providing programmes should make sure that support is available to help parents take part if they would find it difficult to do so otherwise.
Advice only applies to the management of children with conduct disorders who are 12 years or younger, or who have a developmental age of 12 years or younger.
Public Health interventions
Public health interventions to promote positive mental health and prevent mental health disorders amongst adults
This briefing, published in January 2007, aims to:
- Identify all relevant systematic reviews, syntheses, meta-analyses and review-level papers on non-pharmacological interventions to promote positive mental health and prevent mental health disorders in adults aged over 16
- Review these papers and highlight effective ways to promote positive mental health and prevent mental health disorders either by reducing the risk factors for adults with no diagnosed mental disorder (primary prevention) or by preventing relapse (secondary prevention) in people previously diagnosed with a mental disorder, particularly those in disadvantaged and vulnerable groups
- Identify cost-effectiveness data for non pharmacological interventions that aim to promote positive mental health and prevent mental health disorders in adults
- Highlight any gaps in the evidence and make recommendations for future research.
This briefing is intended to inform policy and decision makers, NHS providers, public health physicians and other public health practitioners in the widest sense. It is designed to be accessed by a variety of users including those simply looking for headline findings, those wanting complete and detailed syntheses, and those who need to track back to the original primary and secondary sources.
Antenatal and postnatal mental health
Antenatal and postnatal mental health: clinical management and service guidance – Clinical guideline 45 (NICE)
This guideline, issued in February 2007, covers:
- Recognising mental health problems during pregnancy and in the first year after giving birth
- The care and treatment (including drugs and psychological treatments) of women who develop a mental health problem during pregnancy or in the first year after giving birth, and women who have a higher chance of developing a problem at this time
- The care and treatment (including drugs and psychological treatments) of women who already had a mental health problem before becoming pregnant
- How families and carers may be able to support women with mental health problems and get support for themselves.
National suicide prevention strategy for England (Department of Health)
This strategy, published in September 2002, aims to support the ‘Saving Lives: Our Healthier Nation’ target of reducing the death rate from suicide by at least 20% by 2010. The strategy seeks to be comprehensive, evidence-based, specific and subject to evaluation.
- The strategy has six goals (each with a set of specific actions and objectives):
- To reduce risk in key high risk groups
- To promote mental well-being in the wider population
- To reduce the availability and lethality of suicide methods
- To improve the reporting of suicidal behaviour in the media
- To promote research on suicide and suicide prevention
- To improve monitoring of progress towards the ‘Saving Lives: Our Healthier Nation’ target
A Positive Outlook - A good practice toolkit to improve discharge from inpatient mental health care
Approximately 9% of all patients in mental health beds currently experience a delayed discharge. This publication provides practical guidance and innovative practice examples to help local services improve discharge and reduce the level of delays being experienced by adults and older people in mental health services.
Best practice for adult medium-secure services
The document sets out quality principles, specifications and high-level indicators for all medium-secure services. It also clarifies the performance framework underpinning the quality principles.
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