Page last updated at 02:06 GMT, Sunday, 14 June 2009 03:06 UK

Treating the body, not just the head

By Jane Elliott
Health reporter, BBC News

Julie and Jenna
Julie and her daughter Jenna

Shortly after the birth of her first child, Julie Clarke suffered from insomnia.

She lay awake for hours worrying about what she thought were just 'little things'.

It took others to point out that Julie had post-natal depression and was in need of counselling.

"My main problem was that I was not sleeping. I had a baby that slept through the night but I was wide awake all night," she said.

Sleeping problems

"I was upset and anxious and depressed.

"I saw my doctor and was prescribed sleeping tablets and he asked if I wanted to see a counsellor."

I was worried about big things, such as things happening to the baby and me
Julie Clarke

Within weeks Julie who was made redundant last year, was getting cognitive behaviour therapy (CBT).

She had three face-to-face sessions and then a series of weekly phone calls over a three-month period.

And she said she had been surprised by some of the issues uncovered by her counselling.

"There were things going through my mind that I thought were very silly, such as worrying about not doing the washing.

"But the counsellor would ask me to lie down and say the first thing that was in my head and it turned out I was worried about big things, such as things happening to the baby and me."

Julie was also offered help with her sleeping.

Her counsellor suggested that she adopt a bed-time routine and she has found this has helped ease, although not cure, her insomnia.

"I needed to switch off and go into my room and stop doing chores and wind down and quietly read, and it did help.

"It is still not 100% better and I tend to wake up a couple of times, but now I can go back to sleep."

Better access

Former Health Secretary Alan Johnson had said that by 2010, £170m a year would be spent - allowing 900,000 more people to be treated using psychological therapies.

As many as six million working age adults suffer from depression or anxiety at any one time, resulting in a estimated 91 million working days being lost every year.

The problem is estimated to cost the economy £12bn a year.

Currently, treatments such as cognitive behavioural therapy (CBT) are in short supply - on average, patients wait 18 months to start treatment.

The new plan aims to reduce that wait to just a fortnight, in line with improvements in outpatient waiting times in other parts of the NHS.

Baljeet Ruprah-Shah, head of the mental health and wellbeing services for Ealing Primary Care Trust (PCT), where Julie was treated, said they had almost doubled their CBT therapists - going from four to seven, with 37 trainees.

There are 325,000 people in the borough of Ealing, and Baljeet said the aim is to treat those who need help for mental health problems as a whole.

"We try to make it as holistic as possible.

"So if someone is coming for CBT, we try to have other arms to the service like offering them smoking cessation, or help with their eating and how to do that on a budget. We also do cooking classes.

"You may be overweight, for instance, or not eating properly in addition to your psychological problems so what we wanted to do was to support them completely.

"So if the patient has six to eight weeks, say, of CBT, we can also help them with their housing and benefits.

"One in four people have mental health problems but it is not going to be rectified by one intervention.

"So we have advocates to support your physical health and have a trainer who can support with one-to-one or group training."

More accessible services

She said the trust was also trying to make the borough's services even more accessible to minority groups - running a weekly Punjabi radio show and translating leaflets promoting services into numerous languages including, Hindi, Polish and Somali.

There are also plans to run a "battle-bus" from the summer, which can tour the borough giving information.

It would also have a therapist on board to offer initial CBT sessions to those who need it and sign them up for therapy.

Joe Wade, from the marketing agency Don't Panic, said the bus - which it is helping to set up - was a good way to reach those needing help.

"We will carefully identify areas and tell people about the service. If they are stressed we can bring them back at their own convenience or they can go and have introductory sessions on the bus."

To counteract the stigma of mental health services, Ealing patients are encouraged to self-refer to specialist services.

If they do not want to be referred by a GP, and unless they are a high risk, the GP does not even have to be informed.

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