MILLIONS of people suffering from depression, phobias and panic attacks will be able to get counselling by computer on the NHS by the end of this year.

An appraisal of computerised cognitive behaviour therapy by the National Institute for Health and Clinical Excellence recommends that two computer programmes be offered as treatment for mild and moderate depression, panic and phobia. The programmes, Beating the Blues and FearFighter, are the first computer therapies to be promoted by the institute, the treatment watchdog that advises on best practice for the NHS.

They work by asking questions that encourage patients to explore the conditions from which they are suffering and help them to identify coping strategies.

The watchdog advised against use of this treatment in 2002 because of lack of conclusive research but new evidence has now persuaded it of the clinical benefits and cost- effectiveness.

Rates of depression have soared in recent years, with an estimated six million Britons now affected. GP consultations jumped from four million to more than nine million between 1994 and 1998, while in 2002, doctors prescribed 26 million antidepressants such as selective serotonin reuptake inhibitors (SSRIs) — more than double the quantity of a decade earlier.

The World Health Organisation recently gave warning that soon depression will be the second biggest burden on healthcare globally, after heart disease.

The final guidance from the institute, which is not expected to change from its current draft appraisal form, is due to be released in September.

Primary care trusts, which treat 95 per cent of mental health problems, will then have three months to ensure they have the computer therapies available for patients.

Implementation is expected to cost around £100million.

Unlike conventional depression treatment, based on consultations with doctors and psychotherapists and regimented courses of medication, both programmes require a single guidance session, dramatically reducing costs and pressure on staff. Random trials have shown Beating the Blues to be as effective as, and greatly enhance, other clinical treatments. For many patients, particularly those who fear confrontation with a clinician, it has been found to be a far quicker “cure”.

Of the 1.3 million sufferers of severe depression, only 10 per cent receive adequate therapy because of a reluctance to seek help and waits of up to a year to see a counsellor. Depression costs the NHS more than £1 billion a year and accounts for £6 billion in lost productivity.

Last year Swindon Primary Care Trust became the first trust in Britain to bring in Beating the Blues. A further three trusts have since adopted the programme, as well as private clinics such as The Priory, in southwest London.

Peter Crouch, one of the first GPs to trial the programme, said it had increased capacity more than fivefold. The programme, which was developed by the Institute of Psychiatry in London and Ultrasis, an IT healthcare company, takes sufferers through systematic steps to help them to think differently about everyday triggers of anxiety — from running late in a traffic jam to being “stood up” in a bar. Character case studies — the middle-class housewife, the elderly widow, the single parent — offer insights and emotional responses.

HOW IT WORKS

• The computer asks the patient how depressed or anxious they feel on a scale of one to eight. A progress report is compiled, and users are asked to identify particular anxious moments.

  “What has been worrying you?”

  “I lost my dog.”

  “I’m sorry to hear that. That must have been very upsetting for you. Have there been events that have made you happy?”

  “I found my dog.”

  “That is good news. You must be pleased.”

  The user is asked to respond to different scenarios that might induce depression and anxiety.

  “You are in a bar waiting for a friend. Your friend has not turned up. How would you feel?”

  “I would be concerned that they might have been in an accident.”

  The computer summarises the particular emotion at play, for example anxiety. The programme introduces case studies of others — who offer their responses to the scenario, helping the user to identify patterns of negative thoughts.

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