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Rethink warns that new schizophrenia guideline needs reality check
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Tuesday, 24, Mar 2009 12:00
Leading mental health charity Rethink severe mental illness today (March 24) welcomed a new guideline on the treatment of schizophrenia from the National Institute for Health and Clinical Excellence (NICE), but warned that it would fail unless local services were forced to offer real choice.
Rethink Director of Public Affairs Paul Corry said: The guideline sets out 21st century treatment options that, if implemented, would support peoples early recovery from an illness that too often condemns people to a life of isolation and poverty.
The guideline promotes choice in medication, access to the latest psychological treatments and help to be made available as early as possible.
Unfortunately, the reality on the ground is that too many people are denied choice of any kind, face 18 month long queues for their first contact with a psychiatrist and cant even get on a waiting list for the latest psychological treatments.
It is going to be an uphill struggle to get these guidelines implemented on the ground and NICE still lacks the teeth to enforce its guidelines within a National Health Service that treats mental health as the poor relation.
NICE has reversed its previous advice to make modern atypical medicines a first line of treatment for schizophrenia. It now says that doctors should offer a choice between a range of older and newer medications, because newer medications have been shown to have worrying side effects as serious as those associated with older medication.
Mr Corry said: The newer medications can cost up to £2,000 for a years treatment. This is cheap by comparison with cancer drugs but still up to 10 times as much as the older drugs.
Our worry is that unless NICE is given the teeth to insist on choice, the NHS will opt for the older, cheaper drugs that are associated with long-term debilitating and stigmatising side effects.
NICE calls for the psychological treatment Cognitive Behavioural Therapy (CBT) to be made available to people with schizophrenia.
Mr Corry said: CBT should be available to everyone who can benefit from it. The government is investing over £170 million in making it available to people with anxiety and depression which is welcome but so far people with schizophrenia have missed out.
The government needs to come up with the extra resources to enable clinicians to offer CBT as a matter of course to people with schizophrenia, otherwise NICE will leave a nasty taste in the mouth of those whose expectations are dashed.
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