Fighting Anxiety, Stress and Depression
A New Therapy for Common Mental Health Syndromes
Nov 27, 2008
New Zealand's Otago University Medical School is working to develop a "talking treatment" for doctors (general practitioners, or GPs) to have available for patients who are feeling "low", or suffering from stress or anxiety.
Dr. Sunny Collings and Fiona Mathieson from the School of Psychiatry and Population Mental Health Research Unit have identified a gap in interventions for those whose lives are being affected by common mental health syndromes, but who would not be diagnosed as having a mental health problem. They might be pushing the boundaries with alcohol or drugs, or otherwise having trouble coping with their daily lives.
According to Mathieson (The Wellingtonian, November 13, 2008), more than a quarter of people who visit a general practitioner have symptoms of this nature, which may place them at greater risk of developing problems such as clinical depression later in life. While doctors are sympathetic and do their best, many such patients do not receive any treatment.
Interventions through GPs
In their book Beating Stress, Anxiety and Depression (London: Piatkus Books, 2008), J. Plant and J. Stephenson note that "...family doctors are essentially professional human biologists trained to diagnose illness and to treat symptoms rather than to identify underlying causes." What the Otago project is aiming at is a kind of "counselling for self help" that GPs and their nurses could offer over one or several brief sessions.
Plant and Stevenson consider that "talking treatments" of this nature can be particularly effective in treating anxiety. Some such treatments are based on cognitive behavioural therapy, the purpose of which "is to help the patient to unravel distortions in thinking and learn how to develop more rational problem-solving approaches."
Self-Help and Mental Health
While, as Mathieson observes, a significant proportion of mental health care is delivered through GPs, there are people who cannot or will not access a family doctor, perhaps because of financial or trust issues.
Many individuals with common mental health syndromes will on their own initiative tap into self-help books and websites offering strategies for improvement. These sources tend to provide advice on nutrition and exercise, reducing the impact of "ordinary" or everyday stress, managing alcohol and drug use, and mind-body approaches such as yoga. The authors of self-help publications do, however, warn that there can be a risk in "going it alone." Plant and Stephenson's book warns that "diagnosis and treatment of mental health problems is a responsibility shared between you and your medical advisors" and rejects liability "for readers who choose to self-prescribe."
Talking to Someone: Help Lines
In New Zealand, a high profile advertising campaign about depression featuring All Black rugby legend John Kirwan urges people afflicted by mental health problems to talk to someone (and to "keep talking until someone listens"). Telephone and online helplines have been a way for some people to begin to access support, and have also provided backup for those already receiving treatment.
Helplines vary in their broader aims, the level and nature of staff training and their accessibility. (For example, although young people in particular may not have a telephone landline, some helplines cannot be accessed free of charge from a pay phone or cell phone). All helplines, however, provide a listening ear for the stressed, anxious, depressed or others not in good mental health, and aim to connect people with other support services in the community.
Examples of helplines in New Zealand include Warmline, staffed by people who have personal experience of mental health services; and Youthline, "a multi-faceted community development organisation" that operates two websites as well as offering telephone, text and e-mail counselling.
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