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Systems for organising and developing local care pathwaysIneffective strategies included guidelines and educationalstrategies when not accompanied by organisational support,chronic care clinics and computer-based decision supportsystems.GILBODY2006 Depression symptoms at 6 months Collaborative care had a positive effect on depression outcomesat 6 months compared with standard care (SMD 0.25, 95%CI, 0.18–0.32), which were maintained at 12 months (SMD 0.31; 95% CI, 0.01 to 0.53), 18 months (SMD 0.25; 95% CI,0.03 to 0.46) and 5 years (SMD 0.15; 95% CI, 0.001 to 0.30).Regular supervision and the mental health background of casemanagers were significantly related to study effect size(0.15; 95% CI, –0.02 to –0.31 and 0.18; 95% CI,0.04 to 0.32, respectively).The addition of psychotherapy to medication management incollaborative care was not associated with any significantlyincreased effect size (0.10, 95% CI, –0.05 to 0.25).The number of case management sessions had no impact oneffect size (0.02; 95% CI, –0.008 to 0.04).GRIFFITHS2008 Depression symptoms The following were associated with an improvement indepression outcomes relative to treatment-as-usual or controlcondition:• Care management• Enhanced/extended care• Guided self-help in general practice(Continued)207
Systems for organising and developing local care pathwaysTable 42: (Continued)Study ID Outcomes Results• Systematic tracking by a non-doctor• Revision of professional roles• Incorporation of patient preferences into care.The following were associated with no improvement indepression outcomes relative to treatment-as-usual or controlcondition:• GP training and feedback• Pharmacist interventions• Community context.Telephone interventions, internet support groups and passiveeducation did not have enough evidence for evaluation oftheir effectiveness.GUNN2006 Recovery rates Studies generally favoured the multi-professional interventiongroups in comparison with the control groups at variousfollow-up points for depression outcomes.HEIDEMAN2005 Symptom improvement, rates of Audit and feedback had no effect on the majority of anxietyrecognition, correct diagnoses, outcomes, but did lead to significantly higher rates oflevels of recovery and appropriate recognition (RR 1.71, 95% CI, 1.27 to 2.29), treatment, chartprescriptions notation (RR 1.66, 95% CI, 1.23 to 2.30) and referral incomparison with the control group (RR 2.94, 95%CI, 1.33 to 6.51).208
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Commonmental healthdisordersTHE NIC
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© The British Psychological Societ
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Contents6 FURTHER ASSESSMENT OF RIS
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Guideline development group members
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Preface1 PREFACEThis guideline has
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Prefacecollaborative manner using t
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PrefaceThe experience of people wit
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Common mental health disorders2.2 T
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Common mental health disordersto ho
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Common mental health disordersManua
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Common mental health disordershighe
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Common mental health disordersNegat
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Common mental health disorderscours
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Common mental health disordersover
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Common mental health disorders2.2.6
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Common mental health disordersTable
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Common mental health disorders1996)
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Common mental health disordersSumma
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Common mental health disordersTable
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Common mental health disordersappli
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Common mental health disorderspatie
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Methods used to develop this guidel
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Access to healthcare4. ACCESS TO HE
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Access to healthcareunder the Menta
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Access to healthcare4.2.3 Studies c
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Access to healthcareIndividual-leve
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Access to healthcareJUNG2003 review
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Access to healthcareSCHEPPERS2006).
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Access to healthcare70Table 8: Clin
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Access to healthcareTable 9: Study
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Access to healthcareCHAPMAN2004 inc
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Access to healthcare4.4 SERVICE DEV
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Access to healthcareBEACH2006 [Beac
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Access to healthcareTable 12: Summa
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Access to healthcareAll studies wer
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Access to healthcarepractitioners h
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Access to healthcareIndividual-leve
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Access to healthcarefrom such popul
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Access to healthcarestructure and d
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Case identification and formal asse
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Further assessment of risk and need
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Page 157 and 158: Further assessment of risk and need
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Page 217 and 218: Summary of recommendations8.1.1.6 S
Page 219 and 220: Summary of recommendationsFigure 12
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Page 223 and 224: Summary of recommendations8.4 STEPS
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Page 227 and 228: Summary of recommendationsDiscuss w
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Page 231 and 232: Appendices9 APPENDICESAppendix 1: S
Page 233 and 234: Appendix 1of a depressive disorder
Page 235 and 236: Appendix 1b) Assessment of anxiety
Page 237 and 238: Appendix 2APPENDIX 2:DECLARATIONS O
Page 239 and 240: Appendix 2Mr Mike BessantEmployment
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Page 243 and 244: Appendix 2Actions takenMr Rupert Su
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Page 247 and 248: Appendix 3APPENDIX 3:STAKEHOLDERS A
Page 249 and 250: Appendix 4ClinicalpopulationPeople
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Page 253 and 254: Appendix 5APPENDIX 5:REVIEW PROTOCO
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Page 257 and 258: Appendix 9APPENDIX 9:METHODOLOGY CH
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Appendix 92.10 Are all important pa
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Appendix 9case also excludes costs
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Appendix 9For consistency, the EQ-5
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Appendix 9Answer ‘yes’ if the a
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Appendix 9Answer ‘yes’ if the e
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Appendix 9Answer ‘yes’ if appro
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Appendix 10APPENDIX 10: EVIDENCE TA
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Appendix 11APPENDIX 11:HIGH PRIORIT
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Appendix 11discussion of options bu
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Appendix 13APPENDIX 13:GENERALIZED
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ReferencesAndlin-Sobocki, P., Jöns
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ReferencesBower, P., Gilbody, S., R
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ReferencesCooper, S., Smiley, E., M
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ReferencesEhlers A., Gene-Cos N. &
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ReferencesGiles, D. E., Jarrett, R.
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ReferencesHorowitz, M. J., Wilner,
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ReferencesKnapp, M. & Ilson, S. (20
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ReferencesMarks, J., Goldberg, D. P
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ReferencesNCCMH (forthcoming) Self-
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ReferencesOzer, E. J., Best, S. R.,
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ReferencesSartorius, N. (2002) Eine
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ReferencesTiemens, B. G., Ormel, J.
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ReferencesWilkinson, M. J. B. & Bar
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Glossarybeliefs and interpretations
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Glossaryto learn to become more awa
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Abbreviations12 ABBREVIATIONSADDADS
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AbbreviationsOASISOCDONSORPHQ (-A,
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