Mental Illness in Leicester and Evington Part II Treatment of Common Mental Disorder

Treatment for common mental disorders (CMDs), mainly anxiety and depression, follows a stepped, evidence-based approach in the UK, guided by the National Institute for Health and Care Excellence (NICE). What you’re offered depends on severity, duration, and risk.

Psychological therapies are seen as the treatments of choice, delivered through NHS Talking Therapies (formerly IAPT). These include Cognitive Behavioural Therapy (CBT), which has a strong evidence base and is most widely used, guided self-help including workbooks or online CBT with practitioner support, Behavioural activation (for depression) and Counselling or person-centred therapy.

Medication, when needed, is used when symptoms are moderate to severe, or when therapy alone isn’t enough or if it is the patient’s preference. Common medications include SSRIs (first-line), Sertraline, and Fluoxetine. Alternatives also include Citalopram and Mirtazapine.

It should be noted that they take between 2-6 weeks to work and are often used for 6–12 months minimum. Side effects vary but may include disturbance of sleep, appetite, sexual function.

Combined treatments are commonly used for many people. Therapy plus medication together

gives better outcomes for moderate/severe CMD.

Social and practical interventions are also useful and might include social prescribing, debt advice, housing support, community groups, employment support or physical health management (e.g. diabetes + depression link).

Treatments are usually accessed via a family doctor (GP) or link worker. Often lifestyle interventions (evidence-based but supportive) are recommended such as regular exercise (strong effect for mild depression), sleep regulation, reducing alcohol or sticking to a structured routine.

These are adjuncts, not replacements for treatment; when symptoms are significant and when they are more severe it may be necessary to make a referral to secondary care for example Leicestershire Partnership NHS Trust who have community mental health teams, crisis teams and psychiatric outpatient services. Such a referral might be made when there is a high risk of self-harm/suicide or in complex or treatment-resistant cases.

The typical access pathway in Leicester is by way of the family doctor (GP) or other primary care professional who will refer on the relevant specialist consultant team.

Normal clinical triage is via GPs in order to filter demand, prioritise risk and route to the right service. So, in practice you have to go through primary care first.

In Leicester demand is high but many people with CMD are untreated or undertreated due to perceived barriers to assessment and treatment such as long waiting times, cultural stigma or even language barriers.

The key exceptions, where you can self-refer, are in cases of crisis/urgent mental health support when you can go direct via NHS 111 (mental health option), which is available 24/7 without referral needed and it is open to anyone. They can assess you, connect you to a clinician or escalate into specialist services if needed.

Alternatively, you can make a talking therapies self-referral. If you feel you are having mental health problems. You can access NHS psychological therapies (IAPT) services directly refer yourself directly without a referral. Services offer talking therapies, such as cognitive behavioural therapy (CBT), counselling, other therapies, and guided self-help. Also help for common mental health problems, like anxiety and depression.

Examples of specific conditions IAPT may be able to help with include Depression, low mood due to a physical condition (such as diabetes or pain), excessive worry or anxiety, excessive worry about your health, panic attacks, sleep problems, stress, phobia(s), obsessive compulsive disorder (OCD) and experience of a traumatic event

In Leicester, Leicestershire and Rutland the NHS IAPT self-referral service is provided by Vita Health Group and can be accessed online.

Full details of the service can be provided on the Vita Health Group website or by calling: 0333 0153 494.

There are also Neighbourhood Mental Health Cafés (NMHC) spread around Leicester, Leicestershire and Rutland, run by trained and supportive staff, who are there to listen and provide the practical support you may need when you need it most. If you’re 18+ and struggling with your mental health, they can help you make plans to enable you to feel safer, as well as explaining who you can turn to for help in your local community.

NMHCs are a safe, welcoming space where you can talk through what’s on your mind with trained staff, find support for your mental health and wellbeing, get practical advice and coping strategies and simply walk without judgment or pressure.

The nearest one to Evington is:

Oadby & Wigston Neighbourhood Mental Health Café-provided by Age UK Leicestershire & Rutland

Open Mondays, 9.30am – 12.30pm and Fridays, 9.30am – 12.30pm

Contact:

LSFB Community Hub, 40 Bell Street Wigston. Leicestershire LE18 1AD

Email: nmhcafe@ageukleics.org.uk

Phone: 07734 960 243

You can also book an appointment on-line by visiting:

https://www.leicspart.nhs.uk/service/neighbourhood-mh-cafes/

For other sources of mental health support visit:

https://www.leicspart.nhs.uk/mental-health/

Sources

• https://www.leicspart.nhs.uk/referrals-2/
• https://www.myselfreferral-llr.nhs.uk/
• https://www.leicester.gov.uk/public-health-and-safety/public-health/improve-your- health/mental-health
• https://www.lathamhouse.nhs.uk/services/talking-therapies-self-referral/?
• https://www.leicspart.nhs.uk/service/central-access-point
• https://www.leicspart.nhs.uk/service/neighbourhood-mh-cafes/
• https://www.leicspart.nhs.uk/mental-health/