National Institute for Health and Clinical Excellence (NICE)
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NICE issues priorities to help more adults with bipolar disorder

The National Institute for Health and Care Excellence (NICE) has issued a new quality standard to help more adults with bipolar disorder access better care that meets their needs.

Bipolar disorder is a serious mental health illness that can cause a person’s mood to swing from one extreme to another. These extremes can cause them to lose control in many areas of everyday life.

Diagnosing bipolar disorder

Adults with bipolar disorder will alternate between an abnormally heightened mood where they have no control of their actions and periods of depression. As most people will only see their doctor when they are depressed or with poorly defined symptoms, underlying bipolar disorder is often missed. People who seek help can wait up to 6 years before receiving a correct diagnosis1.

One of the priorities in the quality standard is to ensure that anyone who goes to their GP with symptoms of depression and has also experienced lack of control of their mood or behaviours for 4 days in a row or longer, is referred for specialist mental health assessment.

Tackling variation in care

Alongside drug treatments, NICE guidelines recommend that people with bipolar disorder should be offered a range of options to help them manage, including talking therapies and structured support programmes for education or work.

The Care Quality Commission 2014 review of community mental health servicesuncovered variation in the quality of care across England. Whilst it found trusts to be performing well with direct care, they generally performed worse on questions about providing support, advice and information.

The standard includes statements set out to tackle the variation in mental health services, to help ensure adults with bipolar disorder get the care they need, including:

  • Psychological therapies that have been specifically developed for adults with bipolar disorder.
  • Placement on an employment scheme that helps them if they wish to stay in their current job, or to find or return to work.
  • A physical health assessment at least once a year with support if any health problems are identified.

Professor Gillian Leng, deputy chief executive and director of health and social care at NICE, said: “There are many areas across the country providing high-quality one-to-one care to people with mental health disorders. However, living with a severe mental illness, such as bipolar disorder, can affect people in all areas and they often need support beyond drug options to manage their symptoms.

“This new quality standard sets out the key areas to prioritise from the NICE guideline so that local services can make sure they are delivering care that will improve quality of life for people with bipolar disorder. We want all adults with bipolar disorder to be confident in their local mental health services so they seek help when they need it the most.”

NICE has also published a separate quality standard for the care of adults with indigestion and heartburn (medically referred to as dyspepsia and gastro-oesophageal reflux disease). The standard includes 5 statements to help people know what to do to manage symptoms themselves, when to seek help, and how healthcare professionals should support people with persistent and unexplained symptoms who may need to see a specialist.

For more information call the NICE press office on 0300 323 0142 or out of hours on 07775 583 813. 

Notes to Editors

Further info

  1. Morselli PL, et al. GAMIAN-Europe/BEAM survey I. Bipolar Disorders. 2003.
  2. The quality standard for bipolar disorder in adults is available at/guidance/QS95.
  3. The quality standard for dyspepsia is available at /guidance/QS96.

 Key statistics:

   - Less than half (43%) of respondents felt that the staff they see through NHS mental health services ‘always’ understand what is important to them in their life.

   - Less than half (48%) of respondents said that during the last twelve months, they ‘definitely’ felt they had seen someone from mental health services often enough for their needs.

  • The Mind 2014 survey of 2,000 people, with various mental health disorders, who had tried to access talking therapies within the previous two years found that:

   - One third of people had to ask for therapy, rather than being offered.

   - Half had waited more than three months for an assessment, with 1 in 10 waiting more than a year for assessment.

   - 56% were offered no choice of therapy.

  • In 2013-2014, only 7% of adults using specialist mental health services in England were in paid employment. Full breakdown by local authority available from the Health and Social Care Information Centre.

About NICE quality standards

NICE quality standards aim to help commissioners, health care professionals, social care and public health practitioners and service providers improve the quality of care that they deliver.

NICE quality standards are prioritised statements designed to drive measurable quality improvements within a particular area of health or care. There is an average of 6-8 statements in each quality standard.

Quality standards are derived from high quality evidence-based guidance, such as NICE guidance or guidance from NICE accredited sources, and are produced collaboratively with health care professionals, social care and public health practitioners, along with their partner organisations, patients, carers and service users.

NICE quality standards are not mandatory but they can be used for a wide range of purposes both locally and nationally. For example, patients and service users can use quality standards to help understand what high-quality care should include. Health care professionals and social care and public health practitioners can use quality standards to help deliver high quality care and treatment.

NICE quality standards are not requirements or targets, but the health and social care system is obliged to have regard to them in planning and delivering services, as part of a general duty to secure continuous improvement in quality.

Quality standard topics are formally referred to NICE by NHS England (an executive non-departmental public body, established in October 2012) for health-related areas, and by the Department of Health and Department for Education for areas such as social care and public health.

About NICE

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for driving improvement and excellence in the health and social care system. We develop guidance, standards and information on high-quality health and social care. We also advise on ways to promote healthy living and prevent ill health.

Our aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.

Our products and resources are produced for the NHS, local authorities, care providers, charities, and anyone who has a responsibility for commissioning or providing healthcare, public health or social care services.

To find out more about what we do, visit our website:www.nice.org.uk and follow us on Twitter: @NICEComms.

 

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