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The UK Council for Psychotherapy (UKCP) has examined the National Institute for Health and Care Excellence (NICE) anxiety guideline in detail and the extent to which it had fallen behind was startling. This HSJ article argues that NICE’s anxiety guideline is outdated and no longer fit for purpose, having not been meaningfully updated since 2012. It relies on obsolete diagnostic frameworks such as DSM‑IV, omits newer standards like DSM‑V and ICD‑11, and contradicts NICE’s own depression guideline, creating confusion for clinicians treating common cases of comorbid anxiety and depression. A coalition of more than 50 organisations and individuals, including Mind and Rethink Mental Illness, and more than 20 parliamentarians, including Danny Chambers MP and Bell Ribeiro-Addy MP, have written to NICE calling for an urgent, wholesale review of the anxiety guideline. We are calling for the guideline to be brought into line with the depression guideline, to properly address access for marginalised groups, and to place genuine patient choice at its centre.

This briefing was commissioned by the Maternal Mental Health Alliance who are dedicated to ensuring all women, babies and their families across the UK have access to compassionate care and high-quality support for their mental health during pregnancy and after birth. One woman in five experiences a mental health problem during pregnancy or after they have given birth. Maternal mental health problems can have a devastating impact on the women affected and their families. NICE guidance states that perinatal mental health problems always require a speedy and effective response, including rapid access to psychological therapies when they are needed. Integrated care systems (ICSs) have a unique opportunity to ensure that all women who need support for their mental health during the perinatal period get the right level of help at the right time, close to home. Key points Maternal mental health problems are common and can be extremely serious. Timely access to effective help can make a big difference to long-term health outcomes for mothers and generations to come Integrated care systems can ensure that comprehensive and evidence-based support is provided to women and birthing people during the perinatal period Maternal mental health care must be developed equitably, adapting to the needs of groups of women with higher risk and poorer access to effective support Universal services – midwifery, general practice, and health visiting – are vital to identify needs and provide timely support Access to NHS Talking Therapies is essential for women with many diagnosable mental health difficulties during the perinatal period Specialist community perinatal mental health services are a priority for the NHS Long Term Plan and can meet the needs of women with more serious and complex conditions Adequate provision of specialist Mother and Baby Inpatient Units prevents women being separated from their babies if they need to be admitted to hospital The voluntary sector, including peer support, plays a vital role and needs to be commissioned and properly funded

A study from Jackson et al. looked at how the prevalence of psychological distress in the adult population of England has changed since 2020. The study found that the proportion reporting any psychological distress was similar in December 2022 to that in April 2020 (an extremely difficult and uncertain moment of the COVID-19 pandemic), but the proportion reporting severe distress was 46% higher. These findings provide evidence of a growing mental health crisis in England and underscore an urgent need to address its cause and to adequately fund mental health services.

The World Health Organization (WHO) has published the third edition of the Mental Health Gap Action Programme (mhGAP) guideline which includes important new, and updated, recommendations for the treatment and care of mental, neurological and substance use (MNS) disorders. MNS disorders are major contributors to morbidity and premature mortality in all regions of the world. Yet it is estimated that over 75% of people with MNS disorders are unable to access the treatment or care they need. The mhGAP guideline supports countries to strengthen capacity to deal with the growing burden of these conditions. It is intended for use by doctors, nurses, other health workers working in non-specialist settings at primary health care level, as well as health planners and managers. The guideline contains a new module on anxiety reflecting the increased number of people with anxiety disorders, which are among the world’s most common mental disorders. The module includes the following recommendations: Psychological interventions based on cognitive behavioural therapy (CBT) should be offered to adults with generalized anxiety disorder and/or panic disorder. These interventions can be offered in a variety of formats including online, in-person, in groups, or self-guided. Stress management techniques should be considered for adults with generalised anxiety and/or panic disorder. Selective Serotonin Reuptake Inhibitors (SSRIs) should be considered for treating adults with generalized anxiety and/or panic disorder. Psychological and psychosocial interventions The guideline sets out the continuing importance of psychological treatments for a range of MNS conditions. The mhGAP guideline contains new recommendations on psychosocial interventions for carers of persons with psychosis or bipolar disorder as well as new recommendations on psychosocial interventions for psychosis, alcohol dependence, substance use, dementia, and children and adolescents with neurodevelopmental disorders including autism, ADHD and cerebral palsy. Women and girls who want to become pregnant or may become pregnant should not use valproic acid (sodium valproate) The guideline contains an updated recommendation which advises against the use of valproic acid (sodium valproate), a medicine for the treatment of epilepsy and bipolar disorder, due to risk of birth defects if taken during pregnancy. The guideline recommends the following: Valproic acid (sodium valproate) should not be prescribed to women and girls who want to become pregnant or may become pregnant because of the high risk of birth defects and developmental disorders in children exposed to valproic acid in the womb. For women and girls currently prescribed valproic acid (sodium valproate), advice should be provided on use of effective contraception. It is important that women and girls do not stop taking valproic acid (sodium valproate) without first discussing it with their doctor. Women should be advised to consult their physician as soon as they are planning pregnancy and the need to urgently consult their physician in case of pregnancy. Every effort should be made to switch to appropriate alternative treatment prior to conception. A specialist should periodically review whether valproic acid (sodium valproate) is the most suitable treatment for the person. Other recommendations: Digitally-delivered psychological and psychosocial interventions feature across multiple modules - alcohol use disorders, anxiety, conditions related to stress, drug use disorders, and self-harm and suicide Recommendations for non-pharmacological interventions to improve outcomes for people with dementia have been updated to include physical exercise, CBT, cognitive stimulation therapy and cognitive training. The antipsychotic medicines quetiapine, aripiprazole, olanzapine, paliperidone, and the long-acting antipsychotics haloperidol and zuclopenthixol are included for treatment of psychosis and bipolar disorder. Levetiracetam and lamotrigine are included for treatment of epilepsy.

If a manager approaches your desk, do you feel a sense of anxiety? If your team wants to challenge an idea or offer a different perspective, do they feel free to speak up? These are both examples of psychological safety - or a potential lack thereof - in the workplace. Organisations have focused heavily on mental health and well-being at work over the last few years, but many still lack an awareness of psychological safety, how it can impact your team and the consequences of an unsafe culture. This article looks at how you can measure and improve psychological safety.

Technologies to assist with diabetes treatment and care have evolved rapidly over the past two decades. With each new innovation coming to the market, there are hopes that technologies will solve the numerous, complex issues related to diabetes. However, although it has been demonstrated that overall, these technologies—when available—bring major benefits to people living with diabetes, they do not make the condition disappear. This article in Diabetes Epidemiology and Management discusses the interconnections between technologies and diabetes distress, an often under-acknowledged consequence of the continuous demands of diabetes.

It will take years to unpack how badly the pandemic damaged our collective mental health. But what we know now is no one is immune. Healthcare providers, grocery store workers, executives, stay-at-home parents, food service workers: We’re all suffering in some way. In 2019, 10.8% of adults in the United States reported symptoms of anxiety or depression. By December 2020, that number had skyrocketed to 42.4%. Regina Hoffman, Director of Patient Safety Authority, talks about the importance of self-care and gives her top three tips.

Conscious sedation can help a patient undergo dental treatment. There are several reasons why they may need sedation – anxiety, medical needs or complex treatment. The Care Quality Commission (CQC) outlines the regulations and standards of conscious sedation.

Conscious sedation helps reduce anxiety, discomfort, and pain during certain procedures. This is accomplished with medications and (sometimes) local anesthesia to induce relaxation. Conscious sedation is commonly used in dentistry for people who feel anxious or panicked during complex procedures like fillings, root canals, or routine cleanings. It’s also often used during endoscopies and minor surgical procedures to relax patients and minimise discomfort. Find out more about the procedure, the drugs used and the side effects.

The purpose of this study from Roberts et al. was to explore anxiety, worry, and posttraumatic stress symptoms (PTSS) in parents of children with food allergies, and to evaluate whether these three psychological outcomes could be predicted by allergy severity, intolerance of uncertainty, and food allergy self-efficacy. The study highlights the need for greater awareness of mental health in parents of children with food allergy. 

Everybody responds differently to the stresses and strains of modern life. We all need and, to a degree, thrive on pressure: it gives us energy, helps with performance and inspires confidence. But excessive pressure can lead to stress. Stress may become a problem when someone feels they don’t have the resources to cope with the demands placed upon them. Harmful levels of stress can lead to a mental health condition such as anxiety or depression. This booklet from the Devon Partnership NHS Trust aims to give you some very practical information and guidance – and provides spaces for you to make notes so you can make it work for you.

Tokophobia is an extreme fear of pregnancy and childbirth; it causes severe psychological distress and can have far reaching consequences. Despite this, tokophobia is under-researched and many healthcare professionals have never heard of it, explains Sarah-Jane Archibald in this BMJ Opinion article.