NCPA - National Center for Policy Analysis


August 15, 2005

Under a new program in the United Kingdom, doctors are prescribing books instead of antidepressants for patients with mild to moderate depression or anxiety, says the Wall Street Journal. Doctors in the U.K. began prescribing books out of concern that too many depressed people were either being medicated too hastily with antidepressant drugs or going untreated. They also saw it as a cost-saving strategy.

The programs, called "bibliotherapy" or "guided self-help," were endorsed by the National Institute for Clinical Excellence, a British health agency. The Journal says other countries, including the United States, should take note of how the British experiment has worked:

  • Most cases of depression and anxiety are diagnosed at the general physician's office, where the average visit in Britain lasts just seven minutes.
  • In Devon County, England, doctors in nearly 100 physicians' offices now send mildly to moderately depressed patients down the hall to a mental-health worker, who tries to determine the core problem.
  • Then the mental-health worker prescribes a self-help book and meets four more times with the patient to discuss the book and its exercises and ensure the treatment is working.

In Britain, the National Health Service covers everyone's medicines and doctor visits, free of charge. Bibliotherapy frees up busy counselors to deal with more seriously depressed or mentally ill patients. The Journal says bibliotherapy has already been used to treat thousands of patients and has lead to significant improvements for those patients.

However, bibliotherapy raises some concerns. Some patients fail to check out or read the books and fall through the cracks, says the Journal. And, in a few cases, severely depressed people have been directed to the self-help program when more serious treatment was needed. In those cases, the mental-health worker should refer the patient back to the physician.

Source: Jeanne Whalen, "For Mild Depression, Some U.K. Doctors Prescribe Reading," Wall Street Journal, August 9, 2005.

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