Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-7479d7b7d-m9pkr Total loading time: 0 Render date: 2024-07-12T01:43:39.689Z Has data issue: false hasContentIssue false

Chapter 31 - Service Delivery for Mood Disorders

Published online by Cambridge University Press:  16 May 2024

By
Karine Macritchie
Edited by
Allan Young ,
Marsal Sanches ,
Jair C. Soares  and
Mario Juruena
Allan Young
Affiliation:
Institute of Psychiatry, King's College London
Marsal Sanches
Affiliation:
Baylor College of Medicine, Texas
Jair C. Soares
Affiliation:
McGovern Medical School, The University of Texas
Mario Juruena
Affiliation:
King's College London
Get access

Summary

Mood disorders constitute a substantial burden to patients, including a significant risk of suicide. In this chapter, the multidisciplinary components of services for mood disorders are delineated. Areas of special difficulty for service providers are recognised. Service development for mood disorders is necessary to meet existing treatment guidelines and to offer new evidence-based treatments, as they emerge. The elements of a general business case for local service development are outlined. The premise that early, correct diagnosis and effective treatment can produce savings in direct service costs and in indirect costs to society is explored briefly. The needs for co-production in partnership with service users and consultation with clinical stakeholders and managers are emphasised. Examples of service development are discussed, including a national programme to improve access to psychological treatments, a bipolar psychoeducation programme, and local specialist bipolar services. Finally, the need for rigorous planning of clinician recruitment, training and retention is highlighted.

Keywords

mood disordershealthcare systemservice developmenttreatment accessservice costsservice usersclinicians
Type
Chapter
Information
Clinical Textbook of Mood Disorders , pp. 323 - 328
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Angst, J, Angst, F, Gerber-Werder, R, et al. Suicide in 406 mood disorder patients with and without medication. A forty to forty-four years follow-up. Arch Suicide Res. 2005;9 279–300.CrossRefGoogle Scholar
Appleby, L, Kapur, N, Shaw, J et al, The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. Annual Report: England, Northern Ireland, Scotland and Wales. The University of Manchester, July 2013. Available at https://documents.manchester.ac.uk/display.aspx?DocID=37595Google Scholar
Bayes, A, Dong, V, Martin, D, et al. Ketamine treatment for depression: a model of care. Aus N Z J Psychiatry. 2021;55:1134–43.CrossRefGoogle ScholarPubMed
Bipolar UK Commission. Hidden in Plain Sight: A Lived Experience Report by Bipolar UK. March 2022.Google Scholar
Goodwin, GM, Consensus Group of the British Association of Psychopharmacology. Evidence-based guidelines for treating bipolar disorder: revised second edition – recommendations from the British Association for Psychopharmacology. J Psychopharmacol. 2009;23:346–88. (N.B. further updated guidelines were published in 2016).CrossRefGoogle ScholarPubMed
Hirschfeld, R. The Mood Disorder Questionnaire: a simple, patient-rated screening instrument for bipolar disorder. Prim Care Companion J Clin Psychiatry. 2002;4:9–11.Google ScholarPubMed
Jones, SH, Akers, N, Eaton, J, et al. Improving Access to Psychological Therapies (IAPT) for people with bipolar disorder: summary of outcomes from the IAPT demonstration site. Behav Res Ther. 2018;111:27–35.CrossRefGoogle ScholarPubMed
Kessing, LV, Hansen, HV, Hvenegaard, A, et al. Treatment in a specialised out-patient mood disorder clinic v. standard out-patient treatment in the early course of bipolar disorder: randomised clinical trial. Br J Psychiatry. 2013;202:212–19.CrossRefGoogle Scholar
Kroenke, K, Spitzer, RL, Williams, JBW. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003;41:1284–92.CrossRefGoogle ScholarPubMed
Macritchie, K, Mantingh, T, Hidalgo-Mazzei, D, et al. A new inner-city specialist programme reduces readmission rates in frequently admitted patients with bipolar disorder Br J Psychiatry Bull. 2019;43:58–60.Google ScholarPubMed
Martin, C, Iqbal, Z, Airey, N D, Marks, L. Improving Access to Psychological Therapies (IAPT) has potential, but is not sufficient. How can it better meet the range of primary mental health needs? Br J Clin Psychol. 2022;61:157–74.CrossRefGoogle Scholar
McCombs, JS, Ahn, J, Tencer, T, et al. The impact of unrecognised bipolar disorders among patients treated with depression with antidepressants in the fee-for services California Medicaid (Medi-Cal) program: a 6-year retrospective analysis. J Affect Disord. 2006;97:171–9.Google Scholar
McCrone, P, Shanasiri, S, Patel, A, et al. Paying the Price: The Cost of Mental Health Care in England to 2026. London: King’s Fund, 2008. ISBN 978 1 87175714.Google Scholar
National Institute for Health and Care Excellence. The Impact of Introducing a Lithium Care Pathway. 2015. Available at: www.nice.org.uk/sharedlearning/the-impact-of-introducing-a-lithium-care-pathwayGoogle Scholar
NHS. The NHS Long Term Plan. July 2019. Available at: www.longtermplan.nhs.uk/publication/nhs-long-term-plan/Google Scholar
NHS. We Are the NHS: People Plan 2020/21 – Action for Us All. July 2020. Available at: www.england.nhs.uk/wp-content/uploads/2020/07/we-are-the-nhs-action-for-all-of-us-final-march-21.pdfGoogle Scholar
Nierenberg, AA, Gray, SM, Grandin, LD. Mood disorders and suicide. J Clin Psychiatry. 2001;62:27–30.Google ScholarPubMed
Royal College of Psychiatrists. Faculty of Child and Adolescent Psychiatry and Faculty of General Adult Psychiatry. Good Mental Health Services for Young People. Faculty Report CAP/GAP/01. 2017. Available at: www.rcpsych.ac.uk/docs/default-source/members/faculties/child-and-adolescent-psychiatry/fr-cap-gap-01-good-mh-services-for-young-peop.pdf?sfvrsn=606ce0ae_2Google Scholar
Scott, J. Leboyer, M. Conséquences du retard diagnostique dans la dépression bipolaire [Consequences of delayed diagnosis of bipolar disorders]. L’Encéphale. 2011;37:S173–S175.CrossRefGoogle Scholar
Smith, KA, Cipriani, A. Lithium and suicide in mood disorders: updated meta-review of the scientific literature. Bipolar Disord. 2017;19:575–86.CrossRefGoogle ScholarPubMed
Soo, SA, Zhang, ZW, Khong, SJ, et al. Randomized controlled trials of psychoeducation modalities in the management of bipolar disorder: a systematic review. J Clin Psychiatry. 2018;79:17r11750.CrossRefGoogle ScholarPubMed
Spitzer, RL, Kroenke, K, Williams, JBW. Validation and utility of a self-report version of PRE-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA. 1999;282:1737–44.CrossRefGoogle Scholar
Strawbridge, R, Tsapekos, D, Hodsoll, J, et al. Cognitive remediation therapy for patients with bipolar disorder: a randomised proof-of-concept trial. Bipolar Disord. 2021;23:196–208.CrossRefGoogle ScholarPubMed
Thornicroft, G, Chatterji, S, Evans-Lacko, S, et al. Undertreatment of people with major depressive disorder in 21 countries. Br J Psychiatry. 2017;210:119–24.CrossRefGoogle ScholarPubMed
Wakefield, S, Kellett, S, Simmonds-Buckley, M, et al. Improving Access to Psychological Therapies (IAPT) in the United Kingdom. A systematic review and meta-analysis of 10 years of practice-based evidence. Br J Clin Psychol. 2021;60:1–37.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×