This new guideline covers the identification and pathways to care for adults with common mental health disorders, specifically depression, generalised anxiety disorder, panic disorder, obsessive-compulsive disorder and post-traumatic stress disorder.

The vast majority of depressive and anxiety disorders that are diagnosed are treated in primary care, but recognition of anxiety disorders, in particular, is poor. The focus of this guideline is to improve access to services and recognition of common mental health disorders, and provide advice on the principles that need to be adopted to develop appropriate referral and local care pathways.

The importance and uniqueness of this new guideline, which is aimed at primary care practitioners, managers and commissioners, is in bringing together treatment and referral advice from existing NICE mental health guidelines and combining it with new recommendations, specifically for this guideline.

The guideline contains the method developed especially for this guideline and all the evidence on access to healthcare, identification of common mental health disorders, assessment of risk and need for treatment, and systems for organising local care pathways, including the characteristics of studies in an accompanying appendix.

Contents

• GUIDELINE DEVELOPMENT GROUP MEMBERS
• ACKNOWLEDGEMENTS
• 1. PREFACE
  • 1.1. NATIONAL CLINICAL GUIDELINES
  • 1.2. THE NATIONAL COMMON MENTAL HEALTH DISORDERS GUIDELINE
• 2. COMMON MENTAL HEALTH DISORDERS
  • 2.1. INTRODUCTION
  • 2.2. THE DISORDERS
  • 2.3. TREATMENT
  • 2.4. IDENTIFICATION, ASSESSMENT AND PATHWAYS TO CARE
• 3. METHODS USED TO DEVELOP THIS GUIDELINE
  • 3.1. OVERVIEW
  • 3.2. THE SCOPE
  • 3.3. THE GUIDELINE DEVELOPMENT GROUP
  • 3.4. REVIEW QUESTIONS
  • 3.5. SYSTEMATIC CLINICAL LITERATURE REVIEW
  • 3.6. HEALTH ECONOMIC METHODS
  • 3.7. FROM EVIDENCE TO RECOMMENDATIONS
  • 3.8. STAKEHOLDER CONTRIBUTIONS
  • 3.9. VALIDATION OF THE GUIDELINE
• 4. ACCESS TO HEALTHCARE
  • 4.1. INTRODUCTION
  • 4.2. FACTORS AFFECTING ACCESS
  • 4.3. ADAPTING MODELS OF SERVICE DELIVERY AND THERAPEUTIC INTERVENTIONS
  • 4.4. SERVICE DEVELOPMENTS AND INTERVENTIONS SPECIFICALLY DESIGNED TO PROMOTE ACCESS
  • 4.5. RECOMMENDATIONS
• 5. CASE IDENTIFICATION AND FORMAL ASSESSMENT
  • 5.1. INTRODUCTION
  • 5.2. CASE IDENTIFICATION
  • 5.3. FORMAL ASSESSMENT OF THE NATURE AND SEVERITY OF COMMON MENTAL HEALTH DISORDERS
  • 5.4. RECOMMENDATIONS
• 6. FURTHER ASSESSMENT OF RISK AND NEED FOR TREATMENT, AND ROUTINE OUTCOME MONITORING
  • 6.1. INTRODUCTION
  • 6.2. RISK ASSESSMENT
  • 6.3. FACTORS THAT PREDICT TREATMENT RESPONSE
  • 6.4. ROUTINE OUTCOME MONITORING
• 7. SYSTEMS FOR ORGANISING AND DEVELOPING LOCAL CARE PATHWAYS
  • 7.1. INTRODUCTION
  • 7.2. CLINICAL EVIDENCE REVIEW
  • 7.3. HEALTH ECONOMIC EVIDENCE
  • 7.4. FROM EVIDENCE TO RECOMMENDATIONS
  • 7.5. RECOMMENDATIONS
• 8. SUMMARY OF RECOMMENDATIONS
  • 8.1. IMPROVING ACCESS TO SERVICES
  • 8.2. STEPPED CARE
  • 8.3. STEP 1: IDENTIFICATION AND ASSESSMENT
  • 8.4. STEPS 2 AND 3: TREATMENT AND REFERRAL FOR TREATMENT
  • 8.5. DEVELOPING LOCAL CARE PATHWAYS
• APPENDICES
  • APPENDIX 1. SCOPE FOR THE DEVELOPMENT OF THE CLINICAL GUIDELINE
  • APPENDIX 2. DECLARATIONS OF INTERESTS BY GUIDELINE DEVELOPMENT GROUP MEMBERS
  • APPENDIX 3. STAKEHOLDERS AND EXPERTS WHO SUBMITTED COMMENTS IN RESPONSE TO THE CONSULTATION DRAFT OF THE GUIDELINE
  • APPENDIX 4. ANALYTIC FRAMEWORK AND REVIEW QUESTIONS
  • APPENDIX 5. REVIEW PROTOCOLS
  • APPENDIX 6. SEARCH STRATEGIES FOR THE IDENTIFICATION OF CLINICAL STUDIES
  • APPENDIX 7. METHODOLOGY CHECKLISTS FOR CLINICAL STUDIES AND REVIEWS
  • APPENDIX 8. SEARCH STRATEGIES FOR THE IDENTIFICATION OF HEALTH ECONOMICS EVIDENCE
  • APPENDIX 9. METHODOLOGY CHECKLISTS FOR ECONOMIC STUDIES
  • APPENDIX 10. EVIDENCE TABLES FOR ECONOMIC STUDIES
  • APPENDIX 11. HIGH PRIORITY RESEARCH RECOMMENDATIONS
  • APPENDIX 12. COMPLETED METHODOLOGY CHECKLISTS FOR ECONOMIC STUDIES
  • APPENDIX 13. GENERALIZED ANXIETY DISORDER SCALE (2 ITEMS) QUESTIONNAIRE
  • APPENDIX 14. CLINICAL STUDY CHARACTERISTICS TABLES
• REFERENCES
• GLOSSARY
• ABBREVIATIONS

The views presented in this book do not necessarily reflect those of the British Psychological Society, and the publishers are not responsible for any error of omission or fact. The British Psychological Society is a registered charity (no. 229642).