Extract from Openmind Issue 115, May/Jun 2002 - Prescribing choices

...Taking medication for depression, and for a range of mental health problems, can be an impersonal, lonely affair. And the world, it seems, is gobbling up the message of ‘just keep on taking the pills’. Prescriptions for anti-depressants, for example, rose by a staggering 700 per cent during the nineties. But at the same time, mental health service users - many ready to testify that drugs are not the global panacea for misery - are forever frustrated by the lack of choice in treatment.

Bromley-by-Bow Healthy Living Centre in Tower Hamlets, London, has, however, become an example at primary care level of how to operate within a holistic approach to health, offering a variety of treatments and therapies. In so doing it has pioneered an alternative to orthodox drug treatment models. Sure, the centre’s doctors prescribe medication; perhaps no less than those at traditional surgeries. But patients can also be ‘prescribed’ gardening, exercise in a gym, homoeopathy, counselling, aromatherapy, acupuncture and employment training.

Its professionals work on the premise that mental health problems are as much related to unemployment, bad housing, loneliness and poverty as they are with serotonin neurotransmitters.... ‘We are about looking at the whole person and their whole needs,’ explains centre GP Dr Sam Everington. ‘My attitude to a patient would be not what can I do for you, but what can your community and your family do for you.’

In fact, the centre, with its sprawling allotments, gym, community café, computer training room, crèche, massage facilities, pottery, and after-school club facilities, resembles more a bustling community resource than a clinical GP surgery. Taking up most of a three-acre park, its 100 workers include eight GPs, three practice nurses, two psychologists and dozens of complementary therapists. It serves a catchment population of 15,000, a large proportion of which is of Bengali descent.

Many hopes are pinned on the Bromley-by-Bow Healthy Living Centre becoming a blueprint for other similar centres around the UK. Dr Everington admits there is, as yet, no ‘statistical’ proof that a holistic approach at a primary care level reaps better results than a traditional approach. But, he claims, instinct tells you that no such proof is needed....

Mind itself has been keenly following the Bromley-by-Bow Healthy Living Centre model, particularly in light of the launch of its My Choice campaign aimed at increasing choice to service users at primary care level.

But Dr Everington, who worked for six months as a psychiatrist at the start of his career, admits there have been many obstacles in bringing the centre together over the last nine years. Finance is usually temporary and is sourced from organisations such as the Lottery, the Single Regeneration Budget, social services, the Kings Fund and the private sector (like Tescos, which has paid for building work at the centre)...

The centre’s existence owes much to the dedication of a team committed to a multifaceted approach to mental health. It could also be well positioned as the government pledges to allow resources to be more closely aligned to the needs of local people via primary care trusts, which are replacing primary care groups....

Despite the achievements, Dr Everington is wary of complacency. He says: ‘Even though we now get visits from government ministers supportive of our centre, it has not meant the obstacles are, as yet, gone.’