The research, led by scientists at the Institute of Psychiatry, Psychology and Neuroscience (IoPPN) at King’s College London, aimed to assess how real-world care for depression compared to best practice and painted a grim picture. which sees huge numbers go undiagnosed and with very serious illness not referred for specialist care quickly enough. The paper concluded that “substantial and worrying” gaps in care provision meant that, for some, the illness persisted longer than it should have. “Effectively treating depression is one of the biggest national health challenges we are facing right now,” said Professor Allan Young, of King’s College and senior author of the paper. “High rates of missed diagnosis mean huge sections of the population are unable to get the help they need, while a lack of follow-up and access to more specialist care often means those experiencing severe depression are stuck on a path that is not treating them as effectively it should”. The study aimed to identify gaps in depression treatment across Europe, focusing on six individual countries, including the UK, by looking at evidence from academic papers, databases and from experts in the field. The research showed that only half of the approximately 30 million people in Europe living with depression have been diagnosed. In the UK, researchers found evidence of an average wait of eight years between a person experiencing initial symptoms and first coming into contact with a health professional, with some studies finding rates of untreated depression as high as 77%. In the UK, antidepressants and psychological treatments are both offered as first-line treatments and have been shown to be about equally effective. Evidence shows that people often benefit more when they receive both treatments at the same time. However, more recent work suggests that people take medication at about twice the rate of psychological therapy, such as cognitive behavioral therapy (CBT). It is known that about one in five people will not respond to first-line treatments, but the study found a referral rate to secondary care as low as 5%-6% in some studies. This, the authors said, suggests that many may be “stagnant” in primary care, not getting better, but also not getting more specialist help. The idea that mental health services are overstretched is not new, but Dr Rebecca Strawbridge, of King’s and first author, said it “was pretty much worse than we expected”. The paper, published in the journal European Psychiatry, includes recommendations on how services for people with depression could be improved, including longer GP appointments to ensure people can be correctly diagnosed, increasing the provision of treatment so that “correct” treatment being available to each patient and better monitoring so doctors know how patients have responded. But the authors note, “We cannot better serve those with depression without additional funded resources and capacity.”
