Randomised controlled trial of the clinical and cost effectiveness of a specialist mood disorders team for refractory unipolar depressive disorder
What we are doing:
Measuring implementation of NICE guidelines for depression so that the standard of care offered by both treatment as usual and the specialist mood disorder team can be judged externally.
Why we are doing it:
Mental disorder accounts for 40 per cent of all disability in Europe and 40 per cent of incapacity benefitclaims in England. In 1990, unipolar depression was the fourth leading cause of “disability adjusted life years” in the world and by 2020 it is projected to be the second leading cause. The majority of suicides are associated with unipolar depression. Suicides in East Midlands have increased by one per cent in contrast toa national drop of six per cent (Anderson, 2006).
What the benefits will be:
Improved care for patients with a clinical diagnosis of unipolar depressive disorder that has not been resolved within six months in three local mental health services. We also aim to understand whether better implementation of standard care outlined by NICE guidelines for depression or enhanced specialist careproviding pharmacotherapy and psychotherapy is required.
We are also exploring the feasibility and usefulness of research on the implementation processes, identifying barriers, drivers and distortions of care and evidence of effectiveness. This will usefully inform local commissioning and the implementation of clinically and cost effective care for high utilisers of care withunipolar depression.