Did we really intend to create a £2billion a year service to treat ‘distress’? The gateway to its’ services have been by prospective users completing the PHQ-9 and GAD-7, measures respectively of the severity of depression and generalised anxiety disorders. With three quarters of people identified as ‘cases’ of either using established cut-offs, Vos et al (2026). These authors recommend instead the use of the CORE-10 a measure of general distress, which produces a caseness level of 87.3%, ensuring that all are casualties and presumably in need of treatment. The corresponding proportions for caseness for the PHQ-9 and GAD-7 were respectively 71.0% and 74.8%. It is doubtful that the measures are meaningfully distinguishing amongst each other.
NHS Talking Therapies boasts NICE compliance. But the latter make no recommendations on ‘distress’ how then can the National Service be compliant? Let us be honest the Service does whatever its clinician’s fancy. It is scarcely credible that this randomness can usher in real-world changes in the lives of clients.
Levis et al (2019) found half the depression cases identified using the PHQ-9 were actually misdiagnosed. What a waste of treatment efforts. If you wanted to set up a wasteful treatment Service NHS Talking Therapies fits the bill perfectly. But no hint of this in the missives of the annual gathering of the British Association of Behavioural and Cognitive Psychotherapists (BABCP) in mid-July. However this Saturday May 31st, in a presentation titled ‘All Talk and No Action’ to be given at the annual meeting of the Spanish Society for Clinical Psychology I will give voice to such concerns.
Dr Mike Scott