The findings of BBC Panorama’s piece on antidepressants last week spotlight the dangers of antidepressants. There is a lack of evidence to suggest that they always create a positive outcome. The drugs don‘t always work.
Panorama referenced that long-term antidepressant use may lead to a higher risk of withdrawal symptoms in some people. These findings chime with historical concerns from the Royal College of Psychiatrists of the risk to some people of severe and long-lasting withdrawal effects from antidepressants and the associated risks of overprescribing.
People need to be allowed to make better-informed choices about their treatment. It is vital that people with depression can access the right treatment for their needs, which is why we and other organisations continue to campaign for NICE to collaborate with mental health organisations to create fit-for-purpose guidelines for mental health treatment.
Treatment choices must include a range of evidence-based talking therapies, sadly lacking in many parts of the country.
In partnership with the All-Party Parliamentary Group for Prescribed Drug Dependence and the British Psychological Society, we produced guidance 2019 for therapists working with clients taking psychiatric medication. This aimed partly to minimise the disconnect between therapists and prescribers.
Unfortunately, since the 1950s, drugs have become the backbone of psychiatric treatments and major types of drugs used in the field are assumed to reverse, or partially reverse, underlying disease progression. An overreliance on a ‘disease-centred’ model has continued to build.
The guidance found little evidence to support this model. Where psychiatric drugs produce helpful effects, we regard them as a temporary tool or coping mechanism that can be a precursor to psychological change.
These challenges strain the health service and are not helping people manage their mental illness. Many people with complex needs are stuck in a revolving door of being prescribed antidepressants that don‘t form an effective treatment, leading them to return to care repeatedly because it wasn’t good enough the first time.
We need a mental health system that is strong enough to cope with the complexity of these needs. We commissioned a UK-wide survey of over 2,000 people in 2021, indicating that more than half who’d been prescribed antidepressants claimed they made no difference or worsened their mental health.
Additional results from the survey showed that for those who overcame barriers and sought support, the frontline NHS services they received often did not improve their mental health as expected.
Over half of respondents found that NHS support made no difference or worsened their mental health. The services that fell short of expectations were most frequently accessed through GPs, one of the UK’s first points of access for mental health services.
A lack of understanding of the prescribing options available may be a viable cause. GPs must be provided with better tools to support the increasing number of their patients with mental health needs. The provision of choice of referral pathways is part of the solution.
These disappointing figures demonstrate the importance of increasing the range of mental health treatments available through the NHS. We urge the government, GPs and the NHS to collaborate to give people a genuine choice, including significantly expanding the choice of talking therapies as a priority. There has got to be a positive change to the dominance of antidepressant prescriptions across public mental health services.
Jon Levett, chief executive of the UK Council of Psychotherapy.
