The largest psychiatry trial conducted in the developing world, the Manas intervention, demonstrated that training lay people can play a crucial role in resource poor primary healthcare settings by delivering low level care to those suffering with anxiety and depression.

The randomised controlled trial was conducted in India where there are only 4000 psychiatrists, serving a population of 1.3 billion. The trial found that patients receiving care experienced 30% decrease in common mental health problems and were less likely to attempt suicide. There was also a reduction in the number of days taken out of work for illness.

Professor Vikram Patel, clinical psychiatrist who set up the trial commented “We need to empower everyone to be able to understand the commonsense ways in which first they can promote their own mental health, ‘mental health literacy’. Secondly, to provide mental healthcare when someone close to them is in a crisis, ‘mental health first aid’, and thirdly, at the professionalised level, to use lay health workers to provide mental care for people with mental illness”.

Due to the nature of the cancer and the medication they must take, hormone replacement therapy HRT is not recommended for the majority of breast cancer patients.

The women were given weekly 90 minute sessions of CBT which included learning ‘paced’ breathing and other strategies to help manage their emotions and discomfort. The results found that at nine weeks after starting therapy their problems had significantly decreased, and at six months they still found hot flushes and night sweats less of a problem. They also reported that their mood, sleeping patterns and general quality of life had all improved.

Prof Myra Hunter who lead the research commented that it is not unusual for CBT to be used to help patients with physical problems.

“We don’t exactly know how hot flushes work, but we know stress seems to make them worse. Women who are more anxious before the menopause might be more likely to have them. With any physical symptoms, the way you manage them can make a difference,” she said.

A petition against the new manual was circulated by psychologists in the United States attracted 11,000 signatures. Among the anxieties to be labelled as mental health disorders in DSM-5 are shyness in children and loneliness.

Despite criticism, the American Psychiatric Association strongly defends DSM-5.  Darrel Regier, vice-chair of the DSM-5 task force commented “While we agree that human feelings and behaviours exist on a spectrum that contains some overlap of normal reactions to disease states, psychiatry also recognises that there are real and discrete disorders of the brain that cause mental disorders and that can benefit from treatment”.

The Guardian visited Hull to find out how G4S, one of the 18 private companies commissioned to run the programme, is currently tackling the challenge of getting people back into work.

The editorial reads “As the editors of the BMJ, Health Service Journal, and Nursing Times, we have divergent views on the government’s NHS reforms and its beleaguered Health and Social Care Bill. But on one thing we are agreed – that the resulting upheaval has been unnecessary, poorly conceived, badly communicated, and a dangerous distraction at a time when the NHS is required to make unprecedented savings. Worse, it has destabilised and damaged one of this country’s greatest achievements: a system that embodies social justice and has delivered widespread patient satisfaction, public support, and value for money. We must make sure that nothing like this ever happens again”.

Shadow Health Secretary Andrew Burnham commented that: “The chorus of protest against Andrew Lansley’s ill-conceived plans for the NHS grows louder by the day, uniting voices across the health world. This is a powerful and scathing critique of the government’s handling of its NHS re-organisation from three of the most respected voices in healthcare.

“It reflects the strength of feeling in the health professions and echoes the widely-held that this bill is unnecessary and a distraction from the financial challenge facing the NHS.”

A Department of Health spokesperson defended the bill in their response to the criticisms, claiming that: “Our reforms are based on what NHS staff themselves have consistently said; they want more freedom from day to day bureaucracy and political interference so they can get on with the job of caring for patients. That is exactly what this bill achieves.”

Shadow Health Secretary Andy Burnham has said that the government’s “happiness agenda” is in danger of promoting “middle class” materialistic aspirations. He claims that instead the focus should be on “resilience” to help people cope with life’s peaks and troughs.

Burnham believes that the concept of ‘happiness’ is too often defined by possessions and wealth, and that in a time of economic uncertainty and where communities are fragmented, this goal of ‘happiness’ is setting people up for a fall.

Burnham believes that the priority should be supporting people and help protect them from the stresses of modern living.

“Cameron and Clegg have done this whole thing about happiness, and I am not against the principle, but I think that is the wrong word. There is a slight danger that it sets people up: ‘You have got to be happy. If you are not happy, you are failing’.

“So talking about mental health in terms of happiness has become the modern way of talking about mental health: ‘Mental health is happiness’. And I don’t think it is. It is slightly in danger of being a middle-class construct there, builds a bit of materialism into it. I think what we are talking about is resilience. Are you coping? Are you getting by? That is the bottom line.”

The World Health Organisation predicts that by 2030 more people will be affected by depression than any other health problem. Despite this, most developing countries, including Britain, spend less than 2% of their national budgets on mental healthcare.

A new group has been created on Linkedin to help bring together all those who are involved with, or interested in the Children and Young People’s IAPT (CYP IAPT) programme. The group is an opportunity for people to share ideas and have discussions about the mental health of children and young people in the UK.
 
You can join the group by clicking here. 

The update gives an account of how the NHS is performing at national level against the requirements and indicators set out in the NHS Operating Framework.

It also gives forecast figures for the savings that the Quality, Productivity, Innovation and Prevention Programme (QIPP) should generate broken down by sector alongside the actual savings realised this quarter by these groups.