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

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Access to healthcareOutcome Service user Ability to Use of healthcare Objective (not Attendance and Question asking, Healthsatisfaction, increase access services self-reported) adherence to individuals’ anxiety, knowledge,appointment to services utilisation of programmes, service knowledge and healthkeeping healthcare services user accessability to satisfaction behavioursby healthcare programmes, service and use ofprofessionals and user satisfaction and healthcareindividuals healthcare utilisation servicesParticipant General ICD-10 or Vulnerable groups General population General population General population People with lowcharacteristics population DSM diagnoses (BME groups; literacy skillsof mood or older people)functional(non-organic)mental healthproblem – thatis, depression,anxiety oranxiety-relateddisordersReview quality Adequate Adequate Adequate Adequate Included study Adequate Adequatequality is assessedbut not reportedPooled effectsizes orsummary offindingsInteventionsresulted in:• higher serviceuser satisfaction• fewer unkeptappointments• higher utilistaionofpreventativehealthcare byelderlyindividualsVersus control:• depression:0.44 (95%CI, 0.29 to0.59; sevencomparisons,N 726)• anxietyrelateddisorders:1.15(95% CI, 0.81to 1.49; threecomparisons,N 168)Overall evidence isinsufficient to makerecommendations, butfirst-wave personnelmedical-services pilotsshowed evidence ofimproved access toprimary care inunder-servedareas/populationsMass media canhave an impact onhealthcare serviceutilisation, butevidence is methodologicallyflawedand should beviewed with cautionInteventions resultedin:• greater attendance• greater adherence• higher service usersatisfaction• healthcareutilisation wasrarely measured inincluded studiesand the results areinconclusiveInteventionsresulted in:• significant increasein question asking(0.27, 95% CI,0.19 to 0.36)• individuals’ satisfaction(0.09, 95%CI, 0.03 to 0.16)• non-significantchanges inindividuals’anxiety before andafter consultation,individuals’knowledge, lengthof consultationEffectiveness ofinterventionsinconclusive1 Mental healthcare-specific.73
Access to healthcareCHAPMAN2004 included papers conducted in the UK only. BALAS1997,GRILLI2002, and KAIRY2009 were not UK-focused and included studies from anumber of different of countries. BEE2008 and KINNERSLEY2008 were not limitedto specific countries, but were notably conducted by UK-based groups and includeda number of studies conducted in the UK. PIGNONE2005 was limited to developedcountries only, in order to include research most applicable to the US.4.3.4 Clinical evidenceA summary of the individual review findings can be found in Table 9, with furtherexplanation below.Systematic reviews assessing mental healthcare for the general populationBEE2008 conducted a meta-analysis evaluating the effectiveness of a psychologicaltherapy (any therapy) delivered via remote communication rather than face-to-face,for increasing access to services. The study reported that psychotherapy via remotecommunication was more effective than control (pooled control groups consisting ofusual care, waitlist and no treatment) for both depressive disorders (effectsize 0.44; 95% confidence interval [CI], 0.29 to 0.59) and anxiety-related disorders(effect size 1.15; 95% CI, 0.81 to 1.49). However, only two studies included in thereview evaluated the effectiveness of remote communication psychotherapy versusface-to-face psychotherapy and the results of the sub-group analyses were found to benon-significant.Systematic reviews assessing the general population (non-mental healthcare-specific)GRILLI2002 reported that planned mass media interventions, such as educationalcampaigns, for physical health issues such as cancer screening and immunisationprogrammes had a positive effect on healthcare utilisation. However, there was insufficientevidence to evaluate the most effective mass media intervention for increasinghealthcare utilisation.KAIRY2009 evaluated telerehabilitation (physiotherapy via remote communication)for individuals with spinal cord injuries requiring neurological, cardiac andspeech/language impairment rehabilitation. Telerehabilitation was associated withgood attendance of treatment programmes, as well as good adherence.Telerehabilitation was also associated with high service user and therapist satisfaction.Outcomes assessing healthcare utilisation were conflicted, with some studiesreporting greater utilisation and some reporting less utilisation. However, it must benoted that the intention of the interventions was not always to increase the utilisationof healthcare. For example, studies might report fewer hospitalisations or visits tohealthcare professionals as a positive impact on healthcare utilisation.In keeping with this, BALAS1997 evaluated various electronic communicationmethods and reported that telephone follow-up and counselling was more effectivethan control for individuals keeping appointments, and was rated higher for serviceuser satisfaction. In addition, a telephone reminder system was effective in persuading74
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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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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 recommendations●●a g
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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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