New study finds increased role for practice nurses in treating depression has mutual benefits

Posted Wednesday 31 August 2011

Mind, in association with the Royal College of Nursing, today (31 August) releases new findings that show structured contact with practice nurses can help people with chronic and recurrent depression in their recovery.

The three-year ProCEED intervention study conducted on behalf of the mental health charity by University College London, with funding from Big Lottery Fund, found evidence that enhanced nurse-led care can have significant mutual benefits for nurses and patients.

The report coincides with the launch of a new training pack on depression aimed at practice nurses.

Depression is one of the most common illnesses in the UK, affecting one in six people at some stage in their lives and accounting for a quarter of GP visits. Despite this, practice nurses receive limited or no training and many feel ill-prepared to discuss depression.

Proactive care is routinely provided by practice nurses for physical chronic conditions such as asthma or diabetes but is not always offered for depression, with nurses often feeling apprehensive about broaching the subject with patients. 

The ProCEED intervention study ¹ involved nurses from 42 general practices across the UK being trained to offer proactive, enhanced levels of care, in the form of ten appointments over two years, to patients experiencing severe and recurrent depression.

Sessions addressed satisfaction with current treatments and social factors such as isolation, housing and employment.    

Key findings of the study included:

• nurses had improved confidence and skills when empowered to manage patients with depression.
• patients experienced significant improvements in social functioning after receiving regular sessions with practice nurses, reporting increased confidence and self esteem.
• there were small improvements reported in the severity of depression experienced by patients when compared to a control group.
• patients attending all ten sessions were likely to experience significant improvements in both symptoms and social functioning.
• many patients felt that ongoing proactive care should be provided by a practice nurse rather than a GP.   
• Proactive care was shown to be potentially cost effective in achieving positive changes in severity of depression and improving the patient’s ability to play a fuller role in society.  

Mind’s Chief Executive Paul Farmer said:

There is clearly an unmet need in offering people with depression ongoing holistic consultation in primary care. Practice nurses are on the front line so are well placed to provide this kind of advice and support. Nurses are already offering enhanced care packages to patients for physical conditions and with the right training and support could be equipped to do the same for depression. There must be a parity of esteem in how mental and physical health problems are addressed in primary care settings.

One of the most encouraging findings of this study was the positive impact the experience had on the lives of participants. It’s time for more collaborative working on mental health. It’s been shown to be potentially cost effective and has achieved great results for all involved.  The Mind and Royal College of Nursing new training pack is a great starting point and will hopefully become essential reading for practice nurses.

Royal College of Nursing Chief Executive & General Secretary Dr Peter Carter said:

General practice nurses play a huge role in managing the care of patients with long term physical conditions. However their potential for improving the quality of life for patients with depression has never been realised across the board. We are delighted to support this new initiative and hope that nurses will be encouraged to use this excellent training pack to enhance their skills, knowledge and confidence in the management of depression.

Depression is a co-existing factor in many long term conditions and this new approach will see a more holistic approach to treatment for the benefit for patients and clients.

Research nurse Kate O’Brien who took part in the study said:

Caring for patients with depression is challenging and, consequently, extremely rewarding. I found that I needed to develop new skills to enable me to feel that I could be of benefit to my patients. The most important thing was listening, really listening to pick up what patients were trying to tell you. This often meant identifying what they weren’t saying and finding a way of allowing them to talk comfortably. 

If I am checking notes for any reason and the person is someone I have worked with on ProCEED it is such a positive feeling to see that they have not needed to restart their antidepressants or that they have only had a couple of GP consultations in the last year. It reinforces the impression of making a difference.     

Comment from a patient who participated in the study: 

I have huge faith in my doctor if I go with a medical problem that’s fine but I think depression isn’t an acute medical problem. I think it’s more something that you need to have time with somebody. And the time to me is more important that the prescription. That time to me (with the nurse) was worth 100 prescriptions.

***ENDS***

1. ProCEED (Pro-active Care and its Evaluation for Enduring Depression) intervention study: 558 people were recruited to participate in this study, with 282 in the intervention group and 276 in the control group. www.mind.org.uk/proceed  

Notes to Editors

• To request copies of the ProCEED report and training pack please email media@mind.org.uk  
• Mind is the leading mental health charity in England and Wales. We work to create a better life for everyone with experience of mental distress. www.mind.org.uk
• For more information, interviews and a range of case studies please contact Mind media office on T: 020 8522 1743 M: 07850 788514 E: media@mind.org.uk
  ISDN line available: 020 8221 0817.
• Please note that Mind is not an acronym and should be set in title case.
• The Royal College of Nursing (RCN) is the voice of nursing across the UK and is the largest professional union of nursing staff in the world. The RCN promotes the interest of nurses and patients on a wide range of issues and helps shape healthcare policy by working closely with the UK Government and other national and international institutions, trade unions, professional bodies and voluntary organisations
• For further information or interviews please contact the RCN Media Office on 0207 647 3633, press.office@rcn.org.uk or visit  http://www.rcn.org.uk/newsevents/media
• The Big Lottery Fund (BIG), the largest distributor of National Lottery good cause funding, is responsible for giving out 46% of the money raised for good causes by the National Lottery.
• BIG is committed to bringing real improvements to communities and the lives of people most in need and has been rolling out grants to health, education, environment and charitable causes across the UK since June 2004. The Fund was formally established by Parliament on 1 December 2006.
• Since the National Lottery began in 1994, 28p from every pound spent by the public has gone to good causes. As a result, over £26 billion has now been raised and more than 330,000 grants awarded across arts, sport, heritage, charities, health, education and the environment.

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