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Purpose The purpose of this paper is to describe the development, implementation, delivery and evolution of a community-led, comprehensive, peer support service, including co-production approaches, peer support worker role development, outcomes, acceptability and lessons learnt over a five-year timeframe. Design/methodology/approach This case study presents a reflection on a charity’s peer support service development along with outcomes to highlight client progress. Findings Improvement in well-being as measured through the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) was evidenced along with demonstrating that the peer support service offers complementary support to Improving Access to Psychological Therapies (IAPT) services. Research limitations/implications There was limited quantitative data, and that which existed was analysed on a service-wide basis as opposed to looking at individual components of the service. Practical implications This paper demonstrates the value of peer support provision as part of an overall primary care, community-based mental health service, including findings that suggest that for some individuals, where IAPT services did not help them as much, a peer-based service appeared to be more suitable. Social implications The peer support service provided a complementary and alternative service to conventional primary care mental health services whilst offering individuals with lived experience to gain volunteering, employment and development opportunities. Originality/value Whilst peer support services have been well documented in the literature for clients experiencing serious mental illness, research on the use of such approaches in the management of common mental health difficulties including anxiety and depression is not as well established. The aim of this paper is to detail the experiences of a user-led charity in developing and delivering peer support services, including challenges encountered. Furthermore, this paper describes a peer support service that has been integrated with a co-existing low intensity IAPT service, reporting recovery rates for clients that have accessed both peer support and IAPT services.

Background: Anxiety and depression are highly prevalent. The aim was to examine the effectiveness of Anxiety UK's national psychological therapy service; benchmarking against NHS IAPT data.Methods: We examined psychological therapy outcome data for Anxiety UK clients who completed therapy between April 2019 – March 2020 and benchmarked this against NHS Improving Access to Psychological Therapies (IAPT) outcome data for the same period. Anxiety UK clients completed validated measures of anxiety and depression at two time points: the first and last therapy session. Caseness, recovery, reliable improvement and reliable recovery rates were based on IAPT definitions.Results: Nine-hundred-and-fifty-seven clients completed at least two psychological therapy sessions with an approved therapist. Recovery, reliable improvement, and reliably recovered rates exceeded IAPT targets. Depression and anxiety reduced from first to last session. Cognitive behavioural therapy produced the greatest change in anxiety over time compared to counselling and hypnotherapy. The more therapy sessions attended, the greater the change in anxiety and depression scores from the first to last session.Limitations: For some clients, anxiety and depression levels may have alleviated without therapy. No outcome data were collected following therapy cessation. Therefore, conclusions regarding maintenance and long-term effects of therapy cannot be made.Conclusion: Anxiety UK provide highly effective psychological therapies for anxiety and depression. Flexibility in the number of therapy sessions provided is recommended for NHS services and those of external organisations.

Objectives\ud \ud The objective of the study was to investigate the administration and use of routine outcome monitoring session by session in the context of improving guided-self-help interventions when delivered remotely at Step 2 care in the English Improving Access to Psychological Therapies (IAPT) services.\ud \ud \ud \ud Design\ud \ud Qualitative research using recordings of telephone-treatment sessions.\ud \ud \ud \ud Method\ud \ud Participants (11 patients and 11 practitioners) were recruited from four nationally funded IAPT services and one-third sector organisation commissioned to deliver Step 2 IAPT services, in England. Data collection took place prior to the COVID-19 pandemic. Transcripts of telephone–treatment sessions were analysed using thematic analysis.\ud \ud \ud \ud Results\ud \ud Four themes were identified: (1) lack of consistency in the administration of outcome measures (e.g. inconsistent wording); (2) outcome measures administered as a stand-alone inflexible task (e.g. mechanical administration); (3) outcome measures as impersonal numbers (e.g. summarising, categorising and comparing total scores); and (4) missed opportunities to use outcome measures therapeutically (e.g. lack of therapeutic use of item and total scores).\ud \ud \ud \ud Conclusions\ud \ud The administration of outcome measures needs to ensure validity and reliability. Therapeutic yield from session-by-session outcome measures could be enhanced by focusing on three main areas: (1) adopting a collaborative conversational approach, (2) maximising the use of total and items scores and (3) integrating outcome measures with in-session treatment decisions. Shifting the perception of outcome measures as impersonal numbers to being process clinical tools ensures a personalised delivery of psychological interventions and has the potential to enhance engagement from practitioners and patients what may reduce drop-out rates and improve clinical outcomes.

PurposeSelf Help Services is a pioneering charity in how it champions personal experience of mental health and uses these experiences in the treatment of people living with common mental health problems – anxiety, depression, phobias, and low self‐esteem issues. This paper aims to describe how the charity grew from one individual's journey with agoraphobia to being the main provider of primary care mental health services in the North West of England.Design/methodology/approachThe paper charts the growth of Self Help Services over time, with a particular focus on its employment of people with personal mental health problems. It describes the experiences of its founder and Chief Officer and includes case studies of a user of its e‐therapy services and the charity's Informatics and Governance Lead.FindingsThe case studies illustrate how the charity has grown in both size and success as a result of harnessing the skills and experience of large numbers of staff and volunteers living with a mental health problem. The case studies illustrate that, rather than being an issue, these personal experiences are vital tools in helping others work through their own difficulties.Originality/valueThe paper provides a detailed overview of a charity which was unique when it was formed and now thrives as a result of its uniqueness. It provides other similar organisations with advice on lessons learnt along the way, and advice for individuals or groups looking to establish similar organisations.

Purpose – Around the UK, a number of strategies are being employed to expand the availability and increase the accessibility of psychological treatments for anxiety and depression. Recommended interventions include supported self‐help programs based on CBT principles such as computerised cognitive behavioural therapies (CCBT) for mild‐to‐moderate depression, phobia, and panic. This paper seeks to describe innovative third sector, service‐user led CCBT clinics commissioned within Greater Manchester.Design/methodology/approach – The paper describes how the project was initially set up, how the services are managed, how they work, and the impact of these services on the population they serve.Findings – The CCBT clinic achieves a high throughput of service‐users, including more than one‐third accessing the service through self‐referral. Intake and outcome measures suggest that CCBT service users are representative of both the local population and those accessing increasing access to psychological therapies (I...

Background and aims:The efficacy and effectiveness of a computerized cognitive behavioural therapy (CCBT) package,Beating the Blues, has been demonstrated in a large randomized controlled trial and several pragmatic studies in the National Health Service (NHS). The current study tests the generalizability of this finding to the implementation of CCBT in a service user-led, third sector Self Help Clinic.Method:510 referrals for theBeating the Bluesprogram were received over a 16 month period in routine care. The Patient Health Questionnaire Depression (PHQ-9) and Anxiety (GAD-7) Scales were administered pre-treatment and during each treatment session. The 10-item Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), Work and Social Adjustment Scale and Patient Experience Questionnaire were also administered pre-treatment and immediately on completing treatment.Results:More than two-thirds of referrals were suitable for treatment and completed a baseline assessment; 84% of these started theBeating the Bluesprogram. Two-hundred and twenty-six people meeting caseness criteria at baseline completed at least two sessions of CCBT. Of these, 50% met recovery criteria at their final point of measurement. Completer and intention-to-treat analysis also demonstrated statistically and clinically significant improvements on key outcome measures.Conclusion:CCBT can be effectively implemented in a service user-led, third sector Self Help Clinic, increasing access to psychological therapies to meet local needs for tier two interventions for depression and anxiety.

Objectives: There is increasing evidence to support the effectiveness of eTherapies for mental health, although limited data have been reported from community-based services. Therefore, this service evaluation reports on feasibility and outcomes from an eTherapy mental health service.\ud Setting: ‘Self Help Services’, an Increasing Access to Psychological Therapies (IAPT) eTherapy service in Greater Manchester.\ud Participants: 1068 service users referred to the service for secondary care for their mental health difficulties.\ud Interventions: Participants were triaged into one of three eTherapy programmes: ‘Living Life to the Full Interactive’ for low mood, stress and anxiety; ‘Sleepio’ for insomnia; and ‘Breaking Free Online’ for substance misuse, depending on clinical need.\ud Primary outcomes measures: Standardised psychometric assessments of depression, anxiety and social functioning, collected as part of the IAPT Minimum Data Set, were conducted at baseline and post-treatment.\ud Results: Data indicated baseline differences, with the Breaking Free Online group having higher scores for depression and anxiety than the Living Life to the Full Interactive (depression CI 1.27 to 3.21, p

This revision of the 2005 British Association for Psychopharmacology guidelines for the evidence-based pharmacological treatment of anxiety disorders provides an update on key steps in diagnosis and clinical management, including recognition, acute treatment, longer-term treatment, combination treatment, and further approaches for patients who have not responded to first-line interventions. A consensus meeting involving international experts in anxiety disorders reviewed the main subject areas and considered the strength of supporting evidence and its clinical implications. The guidelines are based on available evidence, were constructed after extensive feedback from participants, and are presented as recommendations to aid clinical decision-making in primary, secondary and tertiary medical care. They may also serve as a source of information for patients, their carers, and medicines management and formulary committees.

Background: Evidence suggests that insomnia may be an important therapeutic target to improve mental health. Aims: Evaluating changes in symptoms of depression and anxiety after supported digital cognitive behavioural therapy (dCBT) for insomnia delivered via a community-based provider (Self Help Manchester) of the Improving Access to Psychological Therapies (IAPT) service. Method: Supported dCBT for insomnia was delivered to 98 clients (mean age 44.9 years, SD 15.2, 66% female) of Self Help Manchester. All clients received six support calls from an eTherapy coordinator to support the self-help dCBT. During these calls levels of depression (Patient Health Questionnaire, PHQ-9) and anxiety (Generalized Anxiety Disorder, GAD-7) were determined. Results: Depression (Mdifference-5.7, t(70) = 12.5, p < .001) and anxiety [Generalized Anxiety Disorder-7 (GAD-7), Mdifference-4.1, t(70) = 8.0, p < .001] were reduced following supported dCBT for insomnia. This translated into an IAPT recovery rate of 68% for depression and anxiety. Conclusions: These results suggest that dCBT for insomnia alleviates depression and anxiety in clients presenting with mental health complaints in routine healthcare.