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NIHR Highlight Options in the care of people with depression

Published on 15 March 2017

Depression may affect more than one in ten of the UK population at any one time, and cost the NHS in excess of £500m per year, with high additional costs in informal care and lost working time. Depression is typically a recurring condition, and more than half of people who experience depression once will go on to have at least one more episode. Up to 90% of patients with depression are treated in primary care, but care can be complex, involving a number of different specialists and requiring access to different forms of treatment. In practice, care can become fragmented and reactive rather than proactive.There is also high demand for treatments for depression. Provision of psychological therapies has increased under the NHS ‘Improving Access to Psychological Therapies’ programme, but waiting lists remain in some areas. The NIHR has funded important new research which provides evidence for a different way of managing care of people with depression – collaborative care – by coordinating this through a designated care manager. A key element of collaborative care is the provision of behavioural activation, a simple psychological therapy. Behavioural activation can be delivered as a standalone therapy too and this Highlight also considers the evidence for how effective it might be.

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