Beyond drugs: UK Parliament must support social and psychological services

Editor’s note: The following speech was delivered by James Davies in the UK Parliament on 5 December 2023 as part of the launch of the all-party parliamentary group on Beyond Pills.

medium sizeMost of you here will have experienced poor or very bad mental health at some point in your life. But if you’re one of the lucky ones who doesn’t, you’re bound to know someone who has a friend, family member or close associate. Around half of people with mental health problems will seek support from the NHS at some point.

So what kind of support do they always get?

Well, when we look at the data, we understand that most people receive prescriptions for medications and little else. For example: Last year in the UK, around 8.5 million people received antidepressant medication, while around 1.5 million received psychotherapy. This huge imbalance in supply is not because most people prefer these drugs. Instead, we know from research that most people who receive primary care prefer psychological or social services. But that’s not what they get, and that’s not what they get because, for the most part, we as a society have grossly underinvested in social, psychological, community intervention in recent decades. This has created a huge gap in the service we provide, which has been filled by increasing prescribing.

For example, prescriptions for antidepressants in England have almost doubled over the past decade, from 47 million in 2011 to more than 85 million in 2022/23, and these figures are set to continue to rise. Additionally, the average length of time a person takes antidepressant medication has doubled in the past 15 years or so, with about half of patients now classified as long-term users. Finally, if we take all the psychiatric medications that we prescribe, such as anxiolytics, antipsychotics, stimulants, antidepressants, then in any given year, close to the adult population will be prescribed one of these medications.

But you might ask, what’s the problem with more people reaching out for help? Is there anything wrong with more people getting support?

Well, the problem is that more people don’t make it better. In other words, the rise in prescribing (antidepressant drug prescriptions) is not associated with improvements in population mental health outcomes. In fact, by some measures, outcomes get worse as antidepressant prescriptions increase (we see this correlation not only in the UK, but also in the US, Australia, Canada, Sweden, Iceland, etc. This correlation has been seen everywhere with these drugs. ).

Of course, while there are likely many variables that contribute to this worrying correlation, one variable that a growing number of international researchers and clinicians are concerned about is that our overreliance on medications is exacerbating this worsening outcome. The use of medications was excluded. Others: social and psychological support; community-based interventions that people need and want.

This is a particularly relevant question when considering the efficacy of these drugs. Multiple meta-analyses have shown that for the vast majority of people taking antidepressants, there is no clinically meaningful benefit from antidepressants over placebo except in the most severely depressed patients. However, unlike placebos, antidepressants have side effects and adverse reactions in 40-70% of patients, depending on which study you consult. They also cause withdrawal effects in about half of users who stop using them, with up to half reporting these effects being severe, and a significant proportion experiencing withdrawal effects for weeks, months, or longer.

So when we take into account adverse effects, poor outcomes for most people, and common-sense clinical observations, most people who present with mental health problems in primary care do not have brain disease in any biologically verifiable sense. dysfunction, but from the influence of nature. and the normal but painful human response to the difficult lives they lead and the difficult circumstances they find themselves in; conditions that their drugs were never designed to treat.

Today we are here to announce the establishment of the All-Party Parliamentary Group on Beyond the Pill. This group understands that, while medicines are vital and life-saving, there will never be one medicine that can treat all illnesses (contrary to what our prescribing habits seem to suggest), not just in psychiatry but in our health professions The same goes for fields. Medications can’t save a broken marriage; they can’t erase a painful past or build community. They can’t bring back their loved ones. They do not address poverty or poor housing, nor correct the wrongs of inequality or discrimination, nor address any of the other obvious social determinants of poor health. They are who they are; they have their place. But they also need to stay where they are.

Today we ask everyone in attendance to support this call to move beyond what is appropriate for medicine; to support the activities and future aspirations of this parliamentary group; to challenge the institutional silos that often prevent change from happening, rather than blocking every good idea through a declaration : But we are already doing it, or there is already a committee that is doing it. The reality is that things are not changing fast enough and we need to fix this now.

As a first step in driving change, APPG members and experts today spoke at british medical journal, makes an evidence-based call to reduce the prescribing of antidepressant medications and sets out how to do this. On this call, we align ourselves with the World Health Organization, which just last month released new depression guidelines. For the first time, these guidelines downgrade antidepressant drugs as first-line treatment of depression to adjuvant treatment, instead prioritizing social and psychological treatments. They call on us to look beyond medicine. We urge everyone to help make this change happen.

***

Mad in America features blogs written by a diverse group of writers. These posts are intended to serve as a public forum for broad discussion of psychiatry and its treatments. The opinions expressed are the author’s own.

***

Mad America has made some changes to its review process. You no longer need to be logged in or create an account on our site to post a comment. The only information required is your name, email and comment text. Comments posted using accounts prior to this change will remain visible on the site.

#drugs #Parliament #support #social #psychological #services
Image Source : www.madinamerica.com

Leave a Comment