Computers replace counsellors for depressed patients

Crooks: 'much reduced cost'
Crooks: 'much reduced cost'
Have your say

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.”