(2) what estimate she has made of the number of referrals for computerised cognitive behavioural therapies in the NHS in the latest period for which figures are available.
These computerised cognitive behavioural therapies (cCBT) packages were reviewed by the National Institute for Health and Clinical Excellence (NICE), in Technology Appraisal 097 in February 2006. NICE recommended the use of Beating the Blues in the management of mild to moderate depression and FearFighter as an option for delivering cognitive behavioural therapy in managing panic and phobia.
NICE decided that there was insufficient evidence for it to recommend the use of COPE and Overcoming Depression as clinically or cost-effective options for managing depression, except as part of ongoing or new clinical trials that are designed to generate robust, relevant data on the clinical effectiveness of these specific cCBT packages.
OCFighter (previously known as BTSteps) was not recommended for delivering cognitive behavioural therapy in managing obsessive compulsive disorder. Where people are currently using OCFighter, whether as routine therapy or as part of a clinical trial, they should be allowed to choose to continue this therapy until the patient, general practitioner and/or specialist, consider it appropriate to stop. NICE will consider reviewing this guidance in September 2008.
We have worked with suppliers and the National Health Service Purchasing and Supplies Agency in negotiating a framework agreement and tariff to ensure that the NHS can provide Beating the Blues and FearFighter in a cost effective and value for money way.
Information on the number of referrals made for cCBT is not collected centrally. However, as part of the implementation guidance which we launched on 28 March, a demand estimate tool has been developed which helps commissioners to establish the likely demand for cCBT in their local areas. This calculates the number of people who are likely to have mental heath conditions which will respond to cCBT, like depression or phobias and also estimates the number who might want to use this technology.
Since the publication of the “National Service Framework for Mental Health” in 1999, mental health services in England have seen significant improvements, particularly in access to specialist community-based services that aim to reduce unnecessary hospital admissions and the length of in-patient stays. However, in-patient services remain a key element of mental health service provision and a national acute in-patient mental health programme, which is hosted by the Care Services Improvement Partnership and supported by its regional infrastructure, is helping local services in implementing the Department’s policy implementation guidance published in 2002. The Department has also announced that over 2006-07 and 2007-08, £130 million of extra capital investment would be targeted to upgrade the mental health estate, particularly in improving psychiatric intensive care units and places of safety for assessment under the Mental Health Act 1983 and enhancing the sexual safety of women.
In recognition of the important role they play in promoting and facilitating social inclusion, the Department published a good practice guidance on commissioning of day services in 2006. The aim of this guidance is to improve access to mainstream opportunities for people with mental health problems in closer partnership with other agencies and organisations including the voluntary and community sector. The national social inclusion programme, also hosted by the Care Services Improvement Partnership and supported by its regional infrastructure, is helping local services in implementing this guidance in line with their assessment of local need.