CG123 Common mental health disorders - National Institute for ...

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3.9 VALIDATION OF THE GUIDELINEMethods used to develop this guidelineRegistered stakeholders had an opportunity to comment on the draft guideline, whichwas posted on the NICE website during the consultation period. Following the consultationall comments from stakeholders and others were responded to and the guidelineupdated as appropriate. The Guideline Review Panel also reviewed the guideline andchecked that stakeholders’ comments had been addressed.Following the consultation period, the GDG finalised the recommendations and theNCCMH produced the final documents. These were then submitted to NICE for thepre-publication check where stakeholders were given the opportunity to highlightfactual errors. Any errors were corrected by the NCCMH, then the guideline wasformally approved by NICE and issued as guidance to the NHS in England and Wales.57
Access to healthcare4. ACCESS TO HEALTHCARE4.1 INTRODUCTION4.1.1 Definition of access to healthcareMany people with a range of mental disorders are disadvantaged because of pooraccess to care. This may either be because care is not available, or because their interactionwith care givers deters or diverts their help seeking (Dowrick et al., 2009a).Improving the quality of care requires addressing both effectiveness of and access tohealthcare (Campbell et al., 2000). Access to healthcare is a complex phenomenonthat is notoriously difficult to define (Gulliford et al., 2007). Considerations of accessto mental healthcare for people with common mental health disorders have largelybeen restricted to concerns about recognition of mental health disorders by primarycare ‘gatekeepers’ in the NHS and the difficulties of training professionals to improverecognition and referral. This deals only with a small part of a more complex experienceof gaining access to healthcare for the individual, which has been recently characterisedby Dixon-Woods and colleagues (2005) as consisting of several stages,outlined in the paragraph below.Candidacy is defined as ‘how people’s eligibility for healthcare is a jointly negotiatedinteraction between individuals and healthcare services’, and as a ‘dynamic andcontingent process, constantly being defined and redefined through interactionsbetween individuals and professionals’. Following determination of candidacy, individualsundertake navigation to gain a point of entry to healthcare services.Appearance can involve a number of different approaches, including appearingbefore healthcare services through individual-initiated actions or through invitations(where people respond to healthcare services). Adjudication refers to professionaljudgements about the presentation of an individual for an intervention or service,influenced by categorisations made by professionals with reference to current servicesand relationships. Adjudication leads to an offer (or non-offer) of a healthcareservice, which may be accepted or rejected. The concept of recursivity captures howthe response of the system to individuals may reinforce or discourage future healthbehaviours (Rogers et al., 1999).4.1.2 Aim of the reviewAccess to healthcare is a large and diverse topic with a range of complex issues andconsiderations. For people experiencing mental health problems across a range ofsocial and demographic groups, access to healthcare can be challenging. This chapteraims to identify factors that affect access for those who require mental healthcare.This chapter also aims to evaluate the effectiveness of adaptations to existing models58
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Commonmental healthdisordersTHE NIC
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© The British Psychological Societ
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Contents6 FURTHER ASSESSMENT OF RIS
Page 7 and 8: Guideline development group members
Page 9 and 10: Preface1 PREFACEThis guideline has
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Further assessment of risk and need
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Summary of recommendations8.1.1.6 S
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Summary of recommendationsFigure 12
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Summary of recommendations●Genera
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Summary of recommendations8.4 STEPS
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Summary of recommendationsDiscuss w
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Summary of recommendationsinclude p
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Appendices9 APPENDICESAppendix 1: S
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Appendix 1of a depressive disorder
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Appendix 1b) Assessment of anxiety
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Appendix 2APPENDIX 2:DECLARATIONS O
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Appendix 2Mr Mike BessantEmployment
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Appendix 2Personal non-pecuniary in
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Appendix 2Actions takenMr Rupert Su
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Appendix 2Personal family interestN
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Appendix 3APPENDIX 3:STAKEHOLDERS A
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Appendix 4ClinicalpopulationPeople
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Appendix 4Case identificationNo. Pr
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Appendix 5APPENDIX 5:REVIEW PROTOCO
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Appendix 7APPENDIX 7:METHODOLOGY CH
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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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