Computers replace counsellors for depressed patients

Published on Sunday 12 February 2012 00:00

THOUSANDS of patients suffering from anxiety or depression will be offered counselling by computer under a controversial move that could see the end of the traditional therapist’s couch.

Patients across Scotland will be offered computer counselling sessions instead of appointments with trained therapists as part of a radical plan to cut NHS waiting times and costs.

The move is being considered by ministers amid high rates of stress and depression among Scots and tightening NHS budgets.

Patients who visit their GP with mild to moderate depression or anxiety will be referred to an NHS website encouraging positive thinking.

The experts behind the move insist it would make treating patients cheaper and easier by slashing the number of appointments patients have with qualified therapists.

But patients’ groups last night warned that the system could fail to spot serious cases and said computers were no replacement for experienced counsellors.

One in five Scots suffers from depression at some time, and thousands are thought to be suffering high stress levels triggered by financial worries and job pressures as the economic recession worsens.

Yet waiting times to see an NHS therapist vary, with some patients forced to wait for several months.

The new initiative involves cognitive behavioural therapy (CBT) computer software which aims to help patients manage their problems with positive messages about changing how they think and act.

A report by Professor George Crooks, medical director of the national phoneline NHS 24, which will run the service, claims it could halve the number of appointments needed and offer “a much reduced cost” compared with traditional counselling.

Prof Crooks said: “CBT is an evidence-based treatment for a range of mental disorders including anxiety and depression. It is usually delivered by trained therapists.

“Computerised CBT is also an evidence-based treatment. It removes the need for clinicians to be involved in the process and enables patients to access treatment from home at the time of their choosing.”

He insisted it was “safe and effective” if it was properly monitored, adding that patients would still have some face-to-face appointments.

But Margaret Watt, chairman of the Scotland Patients’ Association, said there were serious concerns about the move.

She said: “Face-to-face counselling is the answer. I am not saying this won’t help some people, but we do have cases of people taking their own lives and how does a computer program know this might happen? You can’t talk to a computer. So we have reservations about this.”

Catherine Eadie, health officer for the mental health charity Action on Depression, warned that not all patients would be suitable.

She said: “Some people do want to go and speak one to one and you can’t use online CBT as an excuse to cut staff. Someone with severe depression needs much more intensive support and we still need professionals there.”

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AndrewJohnYounger

Monday, February 13, 2012 at 09:13 AM

Health care big pharma robot alert! Previous poster wrote. "Research also proves beyond doubt that psychotherapy such as CBT in combination with anti-depressants are by far the most effective treatment. " More factual lies, SSRIs are a no cure, no method of action dose. That is there are only theories and the truth and those are the facts most decent humans require is that SSRIs only mask. Too many doubts were SSRIs are a concern and CBT, nice try NHS, keep trying. All for choice if that is based on factual truths and clinical should avoid these witch doctors that hijack good medical practice.

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11

Hetzer

Sunday, February 12, 2012 at 11:46 PM

Not sure which century the writer of this article thinks he's in, the "Traditional Therapists Couch"? that went out with inkblot tests. There is no suggestion from any mental health care proffessional that computer would replace counsellours, what we are talking about is an additional resource that does help a significant amount of people. The current online CBT "Living Lfe to the Full" check it out before passing judgement. Fact is the NHS is driven by evidence based practice and for good or ill value for money is an important aspect of evidence. 10% of Scots are currently prescribed an anti-depressant drug (usually an SSRI) SSRI medications have been proven to work in almost 70% of cases where such treatment is approriate. Research also proves beyond doubt that psychotherapy such as CBT in combination with anti-depressants are by far the most effective treatment. There is simply not enough trained therapists to provide this gold standard treatment, (we are talking about 600,000 patients throught scotland) so any therapist has to prioritise cases. Computer based therapy is an evolution of the traditional self help book its not the answer in it self but it is a useful tool for some people and extends the benifits of some aspects CBT to poeople who would normally be getting a prescription and repeat appointment in a months time. However if at any time however I find out that mental health service funding is been reduced in favour of unproven cheaper alternatives I asure you I will be shouting from the rooftops but at the moment that is not the case.

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10

Cat88

Sunday, February 12, 2012 at 07:23 PM

It's already being delivered in England: http:www.beatingtheblues.co.uk + http:www.fearfighter.com and there is a well known one in Aus that anyone around the world can use http:moodgym.anu.edu.auwelcome. But it certainly shouldn't replace someone needing support and help in an individual way. These are stress and mild depression management tools.

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duelaynomore

Sunday, February 12, 2012 at 02:53 PM

Maybe if Mr Cook's house was on fire he might like to listen to a machine, which would inform him to raise the alarm but keep calm, don't run, close doors behind you, and if heavy smoke, crawl along the floor....I'm sure he'd wait for the whole "spiel " from a computer in Basingstoke, before doing something. People do not want to listen to machines...especially sick people .

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duelaynomore

Sunday, February 12, 2012 at 02:48 PM

This plan is enough to drive one to insanity...then you can talk to a machine...to calm yourself down.!!!!! Is this a legacy of George Orwell's 1984....or a bit more of that farm ??? Some civil servants just ought to keep their mouths shut, and appear foolish, rather than opening their mouths and confirming the case. What's to bet there's a crook idea in here somewhere?

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aberdingdong

Sunday, February 12, 2012 at 11:09 AM

There is scientifically evaluated, and then there is just plain stupid. Remember common sense? This is a hoax story.....surely? This is the worst idea I've ever heard (and that's saying something). The person who suggested this should be seeking therapy, because they are clearly living in a fantasy world.

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6

Allan

Sunday, February 12, 2012 at 11:04 AM

Until the scheme has been scientifically evaluated then no-one can have a valid opinion on it one way or the other. Once this has been done I will know what to think.

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5

AndrewJohnYounger

Sunday, February 12, 2012 at 09:56 AM

Words are now going to excite folk into positive thought, that in itself maybe telling us all something about depression and nervousness. Least using computers we are unlikely to find hanging out here the usual human robots telling all how depression be a real disease and that treatment arrives from drugs. When that disease be found, then I shall believe. When any psychiatric disease be found using science of pathology instead mere looking at folk and listening to their words. Perhaps we all get the hint. If I may add a dose of certain foods to that and anyone out there got the full house (bingo). Some prefer that to Cinderella or Frankenstein (movie). Better a choice than none at all and it is a start to attempt to "foster good relations" with those whom disagree invasive compulsory dose. On fostering good relations, the NHS is very far aware from any positive moves, that complaint is well over three days and not a word from the Greater Glasgow & Clyde Health Board. Three days huh? CBT is never for me, too easy to unplug, bit like psychiatry, wish those mental retardation; lacking mental capacity, at the Parliament could catch a light.

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4

75celtickisses

Sunday, February 12, 2012 at 07:56 AM

This makes me so MAD! It's f**king ridiculous that people are patting themselves on the back for saving tiny bit of $, instead of saving lives. They are trivializing people's pain with some "Wizard of Oz" mentality. (just click your heels together 3x and everything will be magically better.) How much is your life worth?

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Hector the Lessor

Sunday, February 12, 2012 at 07:11 AM

If it works, goodonya. Personally if I was depressed given the option of speaking to a computer or talking to myself, I reckon I would pick the latter. Mind you it does not go down well with the family or your neighbours.

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2

michaelkavbox

Sunday, February 12, 2012 at 02:29 AM

This is HUGE business online support groups are up for almost everything. People use them in place of therapy because the medical services can't cope with the numbers. Medics won't post online usually for legal reasons. So they are often badly moderated.

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1

Charles Linskaill

Sunday, February 12, 2012 at 02:03 AM

This is rather a seesaw idea, There is nothing better than the human personal touch to share ones Ill's, At the same time meeting a therapist for the first time can hold distrust, not what the patient would be feeling from a computer, At the End Off Day, Computer or not, Any Help is Better than no Help for our patients suffering from anxiety or depression.

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