We’re cautiously optimistic that updated draft guidelines from the National Institute for Health and Care Excellence (NICE) on treatment for adults with depression include signs of improvement on previous draft versions.
NICE has finally launched an unprecedented third consultation ahead of planned publication of an updated guideline next year, more than a decade after the last guidance was published.
The guideline, especially the treatment options recommended, have a significant impact upon counselling and psychotherapy and their availability across a range of sectors, particularly the NHS.
We’ve long campaigned, alongside our members, other mental health organisations and MPs, for the guidelines to be updated, as we believe previous versions were not-fit-for-purpose.
What the guidelines say
This latest proposed draft guideline now offers a ‘menu of treatment’ options. NICE says people can pick which one is right for them after discussing this with their healthcare practitioners. Enhanced choice for people in their treatment is something we support.
It also says people with mild, or less severe, depression should be offered treatments including cognitive behavioural therapy (CBT) counselling, psychotherapy, or exercise as their first option – ahead of anti-depressants.
The guideline recommends that people with more severe depression should be offered a similar range of psychological interventions alongside the option of antidepressants.
We’re currently extensively reviewing the guidelines and will be submitting a detailed response to the consultation.
Matthew Smith-Lilley, our Policy and Engagement Lead for Mental Health, said: “At first look there appear to be some positive steps forward in this draft version compared to previous versions.
“For years, we’ve been calling on NICE to recognise the substantial evidence base showing the effectiveness of counselling and psychotherapy for the treatment of depression. It’s taken nearly a decade of campaigning and three draft guideline updates to start seeing tentative signs of improvement.
Choice of therapy
“We want to ensure that members of the public are able to access the choice of therapy that they deserve and that the skills and experience of therapists can be at the heart of providing support for people with depression.
“The increase in demand for mental health support means it’s more critical than ever before that both access to and availability of a range of options including counselling and psychotherapy – is improved.”
He added: “Despite signs of positive steps, we remain cautious and will be closely scrutinising the new draft - in particular the inclusion of service user experience research in the development of the guideline recommendations as well as assessing the robustness of the methodological analysis done by NICE.
“We know that our membership of highly skilled and qualified counsellors and psychotherapists have the capacity to take on more work. But they are currently under used and undervalued by commissioners, including the NHS. NICE guidelines play a significant role in impacting opportunities and the update to these guidelines must be backed up by further investment in paid employment opportunities for counsellors and psychotherapists to ensure people receive the mental health support they so crucially need.”
The campaign over the years
We’ve repeatedly highlighted to NICE that a failure to recommend counselling and psychotherapy be more widely available for adults with depression is a failure to meet the needs of the public.
Our collective campaigning over the past decade has successfully put pressure on NICE at every stage through the guideline update process. First, following an unacceptable first draft update in 2017 we successfully secured an ‘exceptional’ second consultation on a new draft in 2018.
During the second consultation in 2018, alongside our campaign partners, we once again successfully put pressure on NICE. Highlighting inadequacies in the proposed draft and emphasising how it wouldn’t deliver the quality of care the public are entitled too.
In 2018, and after two draft consultations, three years of guideline development and continuous pressure from us and our campaign partners, NICE agreed to undertake an unprecedented third draft revision of the Depression in Adults clinical guideline.
Take part in the consultation
The latest consultation runs until 5pm on 12 January 2022, with the final guidelines expected to be published in May 2022.
We’ll be publishing our own response on our website in January.
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Our response to the NICE consultation on depression guidance.
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