Beating the Blues
Manchester PCT is working with partner mental health commissioners to offer people who suffer depression or anxiety a chance to recover by attending computerised therapy sessions at a caf�. The PCT has commissioned Self-Help Services, part of the Big Life Charity, to provide �Beating the Blues�, a computerised cognitive behaviour therapy programme approved by the National Institute of Health and Clinical Excellence (NICE)
By Norma Beavers
Manchester PCT is working with partner mental health commissioners to offer people who suffer depression or anxiety a chance to recover by attending computerised therapy sessions at a café. The PCT has commissioned Self-Help Services, part of the Big Life Charity, to provide ‘Beating the Blues’ a computerised cognitive behaviour therapy programme that’s been approved by the National Institute of Health and Clinical Excellence (NICE). So far, more than 250 people have been through the programme and outcomes data show many are already giving something back by volunteering or working in the health and social care sector.
Nicky Lidbetter, Chief Executive, Self-Help Services, says: “We can see a lot of people in a week. It is high throughput large volume therapy but it is delivered in a nice supportive way. People come in and we assess them and look at their risks. They watch an introductory video which has case studies of individuals who are all experiencing a raft of moderate mental health problems that these people can relate to.”
After the video introduction people attend eight one-hour sessions of computerised therapy for the next two months. The service operates from the Zion Community Resource Centre in Hulme, Manchester, and is run from the IT Suite in the café. Ms Lidbetter explains: “We have support workers on hand who are volunteers to assist people as they work through the computer programme if people experience any difficulties and also to keep them motivated. We know that with computerised cognitive behaviour therapy people do drop out and quickly become demotivated if they are left to get on with it all on their own. A lot of PCTs across the country have bought in packages where people access the service on-line and we know that people drop out when that happens.”
To minimize the drop-out rate in Manchester she says the Manchester programme “is based on people actually coming in and physically accessing the service. We offer a lot of wrap around things around the service, so for example, people will come in and get a drink in the café and we will tell them about other things happening in the centre. A lot of the people who access the services are quite socially excluded so they won’t have been in work or they might want to hear about volunteering opportunities, and we tap them into other services. This works well because they are not just coming in to do one hour of computerised services and the experience can take them beyond that.”
Each of the computerised cognitive behaviour therapy clinics runs for four hours on Monday and Wednesday afternoons or Tuesday evenings. The evening sessions give people who work or have children a chance to work through their problems when they have free time or while the children are taken care of by someone else.
Most of the support workers “are people who have had personal experience of anxiety or depression. “They know what it is like and have used the package to assist in their own recovery. When they work with new clients that works well because they are coming at it from a realistic point of view. It is not just somebody who is a mental health worker who has not experienced mental distress. Our support workers know exactly what it is like and they offer an informal self-help group to support new users,” says Ms. Lidbetter.
Other staff on the programme include an on-site coordinator who weighs up risks and can quickly liaise with the client’s GP if necessary. “It means from a clinical governance point of view everything is covered although the service is offered in the very relaxed environment of the café,” she adds.
So far there have been more than 250 referrals to the service predominantly from GPs. But there are also self-referrals of people who do not want to discuss their problems with their GP. Says Lidbetter: “There is some stigma around anxiety and depression and a lot of the people we see just do not want it on their medical records. They come and access the service, get the support they need and off they go.”
The service is collecting outcomes data to track what people go on to do and whether people return to employment after treatment. “We assess people before they start they package. Most will have a PHQ-9 Scale, which is a measure of the severity of depression, of about 14 when they start. We find when they have completed the package within eight weeks, PHQ-9 scores drop to about seven, which is a 50 per cent reduction rate and is comparable to what you see in a face to face capacity,” explains Ms Lidbetter.
“What we are finding is the government’s agenda around worklessness is assuming everybody with depression or anxiety is out of a job. We find that is not the case. We do, of course, have people who are quite socially excluded and because of their anxiety or depression they might not have worked for years but we also have a large proportion of people who are in employment and are struggling with anxiety or depression. By doing the package they find it enables them to stay in their job. So that is a big outcome for us. There are also people who go on to do volunteering within the health and social care field and people who feel strong enough to look at some part-time or full-time employment or to go back into education. So we are getting very good real life outcomes as well as number crunching the depression stats.”
