By Toni Giugliano
FIGURES showing an increase in the prescription of antidepressants set off a political row at Holyrood. The Scottish Conservatives said an ever-rising tendency to prescribe the drugs was “completely out of hand” while the SNP argued it was a consequence of more people seeking help. Antidepressants are not used exclusively to treat mental health problems. Amitriptyline, for example, is used to treat pain from conditions such as arthritis and spinal problems.
While the figures show that more antidepressants are being prescribed, they don’t tell us what conditions they’re being used to treat. Common mental health problems develop for many reasons, including trauma, abuse, loneliness, unemployment or the stresses and pressures of everyday life. Often physical illness is the lead cause: 70 per cent of young people treated for cancer, for example, experience depression. Regardless of the cause, mental health problems require appropriate treatment.
For many people, antidepressants are an appropriate treatment that play a pivotal role in their recovery. The Royal College of Psychiatrists estimates that one-half to two-thirds of people treated with an antidepressant for depression will see an improvement in their symptoms. But they’re not the only form of treatment, and they don’t work for everyone.
What’s more important than the raw number of pills prescribed is a person-centred approach in which patients have a measure of control over how they’re treated, whether it’s medication or talking therapies, prescribed exercise or mindfulness techniques. People with mild to moderate depression should initially be offered therapy before embarking on a course of antidepressants, though in some cases it can be a mixture of both. Children should be prescribed antidepressants only as a last resort. Antidepressants still carry a degree of suspicion. But for scores of people, particularly those with severe and chronic depression, they are a lifeline. Newer drugs have fewer side-effects and medicines are being prescribed for longer periods of time, reducing the chances of relapse.
But more needs to be done to ensure that patients are aware of potential side-effects (including suicidal impulses), how to managing them and where to get help in a crisis. If the increase in antidepressants is the result of more people seeking help, that’s something we should welcome as many people with mental health problems don’t seek any professional help.
There are valid concerns around over-medicalising mental health but we need to be careful that we don’t stigmatise the use of anti-depressants.
The answer is not to discourage their use but to ensure that GPs are able to provide people with a full range of treatment and support options. Local social prescribing opportunities can also work wonders for some patients. Antidepressants shouldn’t be used as alternatives for these services.
None of this is free, of course, but by investing in prevention we can make big savings in hospital admissions and nurture a resilient Scotland that’s more at ease with itself. It’s not just public services that will benefit. Mental ill health costs Scottish employers more than £2 billion a year. We can all take steps to improve our mental wellbeing. Too many schools and workplaces aren’t mentally friendly environments.
Local and national government needs to be ambitious in implementing the Christie Commission’s recommendations on putting prevention front and centre. This matters because the measure of success of any nation is the health and wellbeing of its people.
Toni Giugliano is Policy and Public Affairs manager at the Mental Health Foundation.
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