Depression in Adults
News and presentations from today's conference looking ahead to the new NICE guideline for Depression. Chaired by Marjorie Wallace CBE, Chief Executive, SANE.
Opening Keynote: Opening Keynote: The Great Escape Part 1 – Depression, the NICE/IAPT axis for evidence-based practice: where are we in 2018?
Jeremy Clarke, Chair, New Savoy Partnership, National Clinical Lead, 2nd National Audit, and Expert Member, NICE Guideline Committee Depression in adults: treatment and Management 2009 & 2018
“Michael Gove put his finger on a good point, the people of this country have had enough of experts….. telling them they know best”
“There seems to be this absolute fixation on evidence bias”
“It is really depression our focus should be on”
“When you look at what policy makers are concerned about it seems to be a much smaller slice, but you can see that with the link to things like incapacity benefit it is taking up about 4.5% of the GDP. The UK is classed as – The sick man of Europe”
Identifying and treating more complex and treatment resistant depression and how to differentiate and manage bipolar depression
Dr Paul Stokes, Senior Clinical Lecturer in Mood Disorders, King’s College London
“people with bipolar disorder rank better for treatments for depression as a first priority”
In this presentation, Dr Stokes will begin by covering the importance of bipolar disorder and the costs and impacts of bipolar disorder on society. He will outline the complexities in treating bipolar disorder and will discuss the impact of anxiety and addiction co-morbidities on care. Dr Stokes will then discuss the challenges of correctly identifying and treating bipolar depression, and particularly bipolar II depression. He will discuss the lack of evidence for treating bipolar depression in the same way as major depressive disorder is treated. Dr Stokes will then provide an overview of the evidence base for best practice treatments for bipolar depression and will finish by discussing NICE and BAP guidelines for the treatment of bipolar depression.
Full PowerPoint Presentation
Behavioural couples therapy for depression: relational factors in depression
David Hewison, Member, NICE Guideline Committee Depression in adults: treatment and Management, Head of Research, Consultant to ‘Couple Therapy for Depression’ Training, Tavistock Relationships, Programme Leader & Supervisor, Professional Doctorate in Couple Psychotherapy, TCCR/UEL
Couple therapy is one of the most effective High Intensity therapeutic interventions for depression and has been part of IAPT since the 2009 Depression Guidelines. This presentation focuses on the relational aspects of depression and the circular ways in which depression and poor relationships affect each other.
Best practice and indications as to how more couple therapy as a treatment for depression can be made available across the country will be indicated. “Think couple” is the key.
Full PowerPoint Presentation
Talking about Depression
Bernard McAnaney, Chairperson, AWARE
Pre-Event Abstract: Talking About Depression
AWARE is a Northern Ireland based mental health charity and is the only one focused exclusively for people with depression and bi-polar disorder. It began in Derry just over 20 years ago when founder Gerry Ward, who suffers from bi-polar disorder, set up the first support group. We now have an established network of 24 support groups in rural and urban areas across N. Ireland which are run by our trained volunteers who will have had their own personal experience of depression. Support groups welcome people with depression and bipolar disorder as well as carers for people with the illness. We also deliver Information Outreach sessions and attend community events to give more information about depression and the range of other services now offered by AWARE.
As the name suggests, we aim to increase awareness of depression and bi-polar disorder. We want to get people ‘Talking about Depression’, offer support and advice and/or signpost on to other appropriate services.
Mental Illness in Northern Ireland
A research report to the N. Ireland Assembly in July 2017 indicated that:
• Mental illness is the single biggest health issue in N. Ireland. It has the highest levels of mental ill health in the UK with 1 in 5 adults and 45,000 young people affected at any one time.
• An estimated 20% of young people have a significant mental health problem.
• 1 in 6 of the population is currently on anti-depressant medication.
Contributing factors include:
• Stressful or traumatic life events
• Social deprivation
In that regard ‘Troubled consequences: A report on the mental health impact of the civil conflict in Northern Ireland’ published in 2012, found that:
• An estimated 39% of the study population have experienced a conflict-related traumatic event.
• The prevalence of PTSD in Northern Ireland is the highest of all countries that have produced comparable estimates including the USA, other Western European countries and countries that have experienced civil conflict in their recent history.
N. Ireland also has higher levels of multiple deprivation than the rest of the UK, with over a third of the population living on or below the breadline.
Depression and Anxiety in N Ireland
A 2013 report by the Organisation for Economic Co-operation and Development (OECD) noted that anti-depressant consumption “has increased significantly in most (Western) countries since 2000.” Iceland reported the highest prescription rates in 2011, followed by Australia, Canada, Denmark and Sweden.
An in depth analysis of the OECD report by Belfast based investigative news website The Detail, examined some 36 million UK prescription records. The Script Report found that N. Ireland generated 3.5 million anti-depressant prescriptions, proportionately more than any of the 23 countries examined in the OECD study.
AWARE are currently collaborating with the Ulster University on The Antidepressant Social Prescribing Project (ADSoPP). The research team have analysed:
• The population rates of antidepressant prescribing in Northern Ireland 2011-2015.
• Differences in prescribing across the lifespan.
• Variation in prescribing in urban and rural areas.
• The association between prescribing and deprivation.
The findings will be published in August 2018 and AWARE will use the information to target our services more effectively.
AWARE Services Now Include
Free Support groups across N. Ireland – for people affected by depression, anxiety and bipolar disorder, including their relatives and carers. The groups are facilitated by highly trained volunteers. The groups are an opportunity to meet with others who have similar experiences to discuss how they are feeling and support each other to move forward.
Online support group – offered weekly to people who are unable or who don’t feel ready or able to access our face-to-face support groups and delivered through the means of a Skype video call.
Support email service – for individuals who are seeking support and information to cope with, manage or recover from depression, anxiety and related conditions. Sometimes it can feel too difficult to pick up the phone and talk with someone, so writing might be an easier option for some people.
Wellbeing programmes – AWARE offer a number of wellbeing programmes into communities, schools, colleges and workplace settings across N. Ireland. The programmes offered are based on Cogitative Behavioural Therapy (CBT) concepts and include:
• Living Life to the Full
• Mood Matters For Young People
• Mood Matters For Adults
• Mood Matters For Later Years
• Mental Health First Aid
• Mood Matters Parent and Baby
• Mood Matters in the Workplace
Mindfulness programmes - Mindfulness is a form of meditation which can help you develop skills and techniques to cope with the daily challenges a busy life can bring such as stress and anxiety. It involves making a special effort to give your full attention to what is happening in the present moment –and to what's happening in your body, your mind and or your surroundings. Various courses are offered such as an evening session running for six weeks, condensed courses for professionals and a self-compassion course. There are also programmes for the workplace and primary schools.
Paws b Mindfulness Programme - Paws b is a mindfulness programme for primary schools. It is ideally taught to 7–11 year olds and is adapted from the ‘.b’ mindfulness curriculum for secondary schools as well as being influenced by adult Mindfulness courses.
.b Mindfulness Programme - .b, pronounced [dot-be], is the UK’s leading mindfulness curriculum for 11-18-year-olds in schools. .b stands for ‘stop and be’, a simple practice which is taught at the heart of this course.
Full PowerPoint Presentation
The importance of patient choice in depression
Dr Jessica Yakeley, Consultant Psychiatrist in Forensic Psychotherapy and Director, Portman Clinic, Tavistock and Portman NHS Foundation Trust, and Fellow of the British Psychoanalytical Society
The NICE Guideline on Depression in Adults: Treatment and Management rightly higlights the importance of patient choice in the treatment of depression. In this talk I will explore several areas pertinent to patient choice: models of depression and diagnostic controversies, the meaning of medication, the range of therapies available and the importance of longer term treatment; and I will highlight some omissions and methodological weaknesses in the Guideline which may impact on patient choice. I will conclude by outlining recommendations for clinicians in facilitating patient choice.
Full PowerPoint Presentation
Improving Services & Outcomes for People who Self Harm
Implementing the NICE Quality Standard for Eating Disorders
Psychological Therapies for Severe Mental Illness: Recovery through Early Interventions
IAPT: Improving Psychological Therapies for Older People
New Savoy Conferences presents Disrupting IAPT: can digital pathways 'change the game'?
Medically Unexplained Symptoms/Somatic Symptom Disorder National Summit 2018
Dual Diagnosis: Improving the Management of severe mental illness and substance misuse
27 April 2018