Page 98 - Depression in adults: treatment and management

Depression in adults: treatment and management (NG222)

Collaborative care and specialist care Collaborative care and specialist care

Recommendations 1.16.7 to 1.16.10

Why the committee made the recommendations Why the committee made the recommendations

There was good evidence that simple collaborative care improved outcomes in people with

depression, and that overall, it was cost effective in people with depression, including older people
with depression.

There was some evidence that certain components of collaborative care led to benefits, and this

was supplemented by the committee's expertise.

The committee did not specifically review evidence for specialist care for people with severe
depression with multiple complicating problems or significant coexisting conditions. However,

based on their in-depth understanding of the evidence base, the committee were aware of studies
suggesting benefits for this group of people, and together with their knowledge and expertise, the
committee recommended specialist care.

How the recommendations might affect practice How the recommendations might affect practice

The recommendations on collaborative care may increase resource use but there is evidence that
this is cost effective. Specialist care is likely to increase resource use, but will only be necessary for
a small number of people, and may offset future costs for long-term care and treatment.

Return to recommendations

Crisis care, home treatment and inpatient care Crisis care, home treatment and inpatient care

Recommendations 1.16.11 to 1.16.14

Why the committee made the recommendations Why the committee made the recommendations

There was some evidence that crisis resolution and home treatment (CHRT) teams improved

symptoms in people with severe non-psychotic mental illness, and that this was a cost-effective
option compared to standard inpatient care. However, based on their experience, the committee
recognised that people with more severe depression may need inpatient care.

Based on their knowledge and experience, the committee agreed that psychological therapies

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