Authors: RHODES, L.; GENDERS, R.; OWEN, R.; O'HANLON, K.; BROWN, J. S. L.

Source: Journal of Psychiatric & Mental Health Nursing, Volume 17, Number 2, March 2010 , pp. 147-151(5)

Publisher: Wiley-Blackwell

Abstract:

Accessible summary

• The National Institute for Health and Clinical Excellence produce clinical guidelines that make recommendations for treatment of various physical and mental health conditions.

• Recent research with Community Mental Health Team's in a South London borough showed that the National Institute for Health and Clinical Excellence guidelines for Depression were not being fully implemented.

• To find out some of the reasons for this a questionnaire was given to staff about their knowledge and use of these guidelines.

• Staff reported that the services do not have enough resources to provide the recommended treatments for all people with depression.

• The majority of staff also reported low levels of confidence in using the guidelines and very few had received any formal training on the guidelines. Many staff stated they would like more support in using the guidelines.

• The results of this research suggest that changes could be made to increase implementation of the guidelines but that these are limited by the availability of resources; full implementation could only be achieved with additional support and funding. Abstract

Clinical guidelines have been designed to lead to significant and consistent improvements in health care but are rarely fully implemented within healthcare services. The study involved a survey of staff at four Community Mental Health Teams, which aimed to assess their knowledge and use of both the psychological recommendations of the National Institute for Health and Clinical Excellence (NICE) guidelines for Depression and specifically of cognitive-behavioural therapy (CBT) based interventions. It also aimed to assess team members' clinical assessment skills and decision-making patterns when making recommendations about services for patients with depression. The results indicated that while over 90% of staff said they were using the NICE guidelines for Depression, less than 20% were very confident in using them. Most staff had knowledge about CBT and most (88%) would be very willing to refer to CBT but mentioned problems such as lack of resources and/or social problems affecting service delivery. Most staff were generally able to correctly identify the severity and type of depression. Despite this, some staff were making decisions that were not in accordance with the NICE recommendations. Reasons for these patterns are discussed.

Keywords: clinical decision making; clinical guidelines; cognitive behavioural therapy; community mental health; depression; NICE guidelines

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2850.2009.01488.x

Publication date: 2010-03-01

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