The importance of choice in mental health

23rd October 2019

This week annual mental health medication statistics for 2018/19 were published. The figures show that the number of prescriptions of antidepressants, antipsychotics, and medications to treat Deficit Hyperactivity Disorder (ADHD) have increased over the last decade. The number of hypnotics and anxiolytics – used to treat insomnia and anxiety - have decreased slightly over the last ten years. 

Looking at antidepressants specifically - 936 thousand patients were prescribed at least one antidepressant during 2018/19. This an increase of 48% in the last decade and 4% compared to 2017/18. As with other forms of mental health medication people in more deprived areas were more likely to be prescribed antidepressants. 

The way in which rises in antidepressant prescriptions is reported on, including at time by politicians and journalists, can be stigmatising. Too often the rise in antidepressant use is greeted as a ‘bad news’ story, with sensationalist claims and headlines. So what are the facts and what does SAMH want to see happen in regards to mental health medication?

Importantly, medications used to treat mental health conditions, including the use of antidepressants, can play an important, even lifesaving, role in supporting someone recover. Antidepressants have a clear evidence base for treating depression, with detailed clinical guidance on how and when they should be used. Medications used to treat mental health problems, including antidepressants, also have other uses, so we can’t assume everyone being prescribed these medications has a mental health problem. The increase in prescriptions may also be partly due to greater awareness about mental health and more willingness to seek help. This is a good thing.

At SAMH our focus isn’t on prescription numbers but ensuring people receive the most appropriate treatment to support them. What is important to us is that people receive the right help at the right time and are fully involved in decisions about their care and treatment.  We want to see prescribers correctly following guidance on involving people in prescribing choices. For example, NICE guidelines advics that for initial treatment of mild to moderate depression people should be offered talking therapies such as Cognitive Behavioural Therapy (CBT), self-help or physical activity.  It is also important that people are provided with accurate information about possible side effects to medication, with side-effects taken seriously. We need to focus on giving people choice and evidence-based treatments.