Meditation must be available on the NHS, says Mental Health Foundation

Release Date: 05 January 2010

Source: Mental Health Foundation

Country: United Kingdom

Just 1 in 5 GPs have access to Mindfulness Based Cognitive Therapy (MBCT), a NICE approved treatment based on meditation techniques.

  • MBCT cuts relapse rates in half for recurrent depression. 
  • Large majority of GPs (72%) think mindfulness meditation would benefit the mental health of their patients. 
  • Depression affects 1 in 10 people and costs the economy £7.5 billion annually.
  • The national charity, the Mental Health Foundation, has today released a report calling for people who suffer repeated episodes of depression to be offered Mindfulness Based Cognitive Therapy (MBCT), a clinically approved treatment based on meditation techniques.

Patients denied access to clinically approved treatment

National Institute for Clinical Excellence (NICE) guidance for the NHS has recommended MBCT for recurrent depression since 2004.  However, the Be Mindful report reveals that five years on, just 1 in 5 GPs say they can access the treatment for their patients and only 1 in 20 prescribe MBCT regularly.

MBCT is proven to cut relapse rates in half for those who experience more than two episodes of depression. Recurrent depression is extremely common, with 50% of sufferers having more than one episode.  After the second and third episode, the risk of relapse rises even higher to 70% and then 90%.  

The Mental Health Foundation is calling for the NICE clinical guidelines for depression to be fully implemented, and for all patients with recurrent depression to be offered MBCT. The treatment consists of an eight week course in mindfulness meditation, alongside elements of Cognitive Behavioural Therapy and yoga.

GPs need alternatives to antidepressants

The number of prescriptions made each year for antidepressants in England has doubled in a decade, reaching 36 million in 20083. The Be Mindful report found that three-quarters (75%) of GPs have prescribed medication to people with long term depression believing another treatment would have been more appropriate.

The charity argues that MBCT would be a valuable alternative to antidepressants for GPs and patients. A large majority (72%) of GPs believe mindfulness meditation would help their patients who have mental health problems while nearly all (93%) think there should be greater availability of other effective treatments for recurrent depression, in addition to medication.

MBCT through the Improving Access to Psychological Therapies (IAPT) programme

The Be Mindful report says that the training and development needed to increase the availability of MBCT could be achieved as part of the government’s Improving Access to Psychological Therapies (IAPT) programme, which is already funded until 2011.

Dr Andrew McCulloch, Chief Executive of the Mental Health Foundation, said:

“Mindfulness-based therapy could be helping to prevent thousands of people from relapsing into depression every year.  This would have huge knock on benefits both socially and economically, making it a sensible treatment to be making available, even at a time when money is short within the NHS.

“Depression tends to come back for many people, with the odds of further bouts increasing each time. A single episode is serious enough but having the illness return year after year can have a devastating impact of people’s jobs, relationships, and their chances in life generally.  

One of the UK’s leading mindfulness experts, Mark Williams, Professor of Clinical Psychology and Director of the Mindfulness Centre at the University of Oxford, said:

"We're beginning to discover that meditation practices can have extremely powerful effects on our health.  We now have a very good treatment for recurrent depression which urgently needs to be rolled out to all patients that need it.  Exciting new research is revealing exactly how meditation works on the brain and how it can be applied more widely."

Professor Steve Field, Chairman of the Royal College of General Practitioners, said:

“GPs encounter patients with depression on a daily basis, and some patients seek an alternative to antidepressants. The IAPT initiative is increasing access to psychological therapies and allows patients a greater choice of treatment. Mindfulness-Based CBT is gaining an increasing evidence-base and should be offered to people with recurrent depression according to the recently updated NICE guidelines."

Dr Jonty Heaversedge, a South London GP and one of the BBC’s Street Doctors, said:

“Depression is something that affects a huge number of my patients, often year after year, with devastating consequences. MBCT gives them the opportunity to develop a healthier, more accepting relationship with their thoughts and feelings. It is helpful both as an alternative to - or alongside - medication and is something people with depression can actively do to help themselves. Mindfulness makes an ongoing difference in managing a condition that, for so many people, is a recurrent issue in their lives. The only problem is that it can be quite hard to find a place on an MBCT course.”

Mindfulness for mental and physical health problems

The Be Mindful report also outlines the potential of mindfulness approaches for the treatment and management of many other mental health problems, including eating disorders, anxiety problems and psychosis.  

Mindfulness has also been shown to be effective in managing symptoms of physical health problems such as HIV and cancer.  More research is needed to develop this promise into clinical interventions that can be rolled out alongside MBCT for depression, according to the Foundation.  

Mindfulness and the brain

Mindfulness meditation has been shown to affect the workings of the brain and even its structure, according to evidence laid out in Be Mindful.  People undertaking mindfulness training have shown increased activity in the area of the brain associated with positive emotion – the pre-frontal cortex – which is generally less active in people who are depressed.  More than 100 studies shave shown changes in brain wave activity during meditation and researchers have found that areas of the brain linked to emotional regulation are larger in people who have meditated regularly for five years.

Find out more at Be Mindful – a new website dedicated to mindfulness

The Mental Health Foundation has produced information materials to raise awareness of the benefits of mindfulness approaches.

Order from Be Mindful where you can also search for mindfulness course providers in your area, hear from people who use mindfulness techniques and lend your support the charity’s campaign to make the treatment more widely available on the NHS.

The report launch is the first stage of a year long campaign to promote the benefits of mindfulness approaches to health and wellbeing. The Foundation has previously promoted other alternatives to medication to help in the treatment and management of mental health problems, including psychological therapy, exercise therapy and diet.

Key findings from the Be Mindful survey


GP attitudes to mindfulness

  • 72% of GPs think it would be helpful for their patients with mental health problems to learn mindfulness meditation skills. 
  • 68% of GPs think it would be very or quite helpful for their patients in general to learn mindfulness meditation skills. 
  • 64% of GPs think it would be helpful for them to receive training in mindfulness skills themselves.

Referrals to mindfulness compared to prescriptions for medication

  • More than two-thirds (69%) of GPs say they rarely or never refer their patients with recurrent depression to MBCT. Five per cent refer to it very often. By comparison, 47% say they very often prescribe antidepressants.
  • Three-quarters (75%) of GPs have prescribed antidepressants to patients with recurrent depression believing that an alternative approach might have been more appropriate. 
  • Two-thirds (67%) did so because there was a waiting list for the suitable alternative treatment, 57% because they didn’t have sufficient access to other suitable treatments, and 50% because it was the treatment option preferred by the patient.

Access to mindfulness treatment

  • A fifth (20%) of GPs say they have access to MBCT courses for their patients (48% say they do not, and 32% don’t know if they have access or not).
  • Nearly all (93%) the GPs surveyed agreed that it would be valuable to have more effective treatment options for patients with recurrent depression. 
  • 66% of GPs say they would support a public information campaign to promote the potential health benefits of mindfulness meditation.

Be Mindful

References:

  • Psychiatric Morbidity Among Adults Living in Private Households, The Stationery Office, 2000.
  • Paying the Price, Kings Fund, 2007. 
  • Prescription Costs Analysis, NHS Information Centre, 2009.

For more information, to arrange interviews with experts and case studies, please contact the Mental Health Foundation press office on 020 7803 1110.

Footage and audio of interviews with experts, spokespeople and case studies will be available upon request.