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In excess of 40 self help book prescription schemes are now in existence across the UK, with more under development. The majority of these have adopted the GP prescription model initially developed by Professor Neil Frude for use across Cardiff (Frude, 2004).

A growing number of supported self help book schemes however are being developed with the self help clinics being run by graduate mental health workers within England, often based upon the protocol implemented by Dr Paul Farrand (Farrand, 2005).

Self Help Book Scheme Location

The following list highlights the areas or regions we are currently aware that book schemes are in operation. Due to such schemes being established all the time it is likely that there are omissions. If you are aware of any others then please e-mail Dr Paul Farrand who will be pleased update the list.

The Self Help Book Prescription List

  • The original self help book prescription list was developed by Professor Neil Frude (Frude, 2004) on the basis of extensive consultation undertaken with mental health professionals to identify the titles they had used and found useful and also on the basis of efficacy being shown in research. From these suggestions an original list of 35 titles written predominantly by clinical psychologists, psychiatrists and psychotherapists has been constructed.
  • The book list (Wales, Devon) covers 20 mental health problems with over 80% of the titles employing a cognitive behavioural approach and many subjected to clinical trial.
  • To maintain and update the book list some areas have established a self help book review panel, consisting of mental health professionals, public librarians and user representatives.
  • Due to updating, minor variations from the original book list have arisen between different schemes as the book lists are beginning to respond to local need and demand that exists for different titles.

The GP Prescriber Model

  • Clients presenting to their General Practitioner (GP) with a mild to moderate mental health problem are ‘prescribed’ a suitable self help title from a standardised list covering many of the mental health difficulties commonly encountered in primary care.
  • The book prescription is taken to the local public library where all the self help books are stocked and clients issued with the specified book in a manner similar to a standard library book loan.
  • No specific further forms of support are offered once the book has been prescribed.

The Supported Self Help Model

  • Clients initially present to their GP with a mild to moderate mental health problem (click to see protocol). If self help is considered to be of possible benefit and the client is presenting with a mild to moderate mental health problem with little or no risk the client is encouraged to make an appointment at the self help clinic.
  • Waiting time for these clinics vary but most clients are seen within a week up to a maximum of a fortnight.
  • Self help clinics are based upon the two-plus-one model of service delivery (Richards et al, 2002) which has been reported to be highly acceptable to clients, efficient in terms of client throughput and clinically effective (Lovell, Richards & Bower, 2003).
  • Clients are initially offered a 30 minute self help orientation consultation, followed by two 15 minute fortnightly sessions to support their treatment and a final 15 minute session 3 months later to evaluate progress (Richards et al, 2002).

What Is Included Within the Self Help Sessions?

  • During the initial consultation clients are provided with an explanation concerning the nature of self help (Rogers et al, 2004), advice concerning how to use the resources (Sorby, 1991) and are empowered to take control of their mental health difficulty. If the client wishes to proceed with self help they are given a prescription for a self help book from the book list.
  • Prescriptions can be handed over at most of the major public libraries in exchange for the self help title indicated.
  • Follow up sessions offer motivational interviewing, and support for the acquisition of the skills promoted in the books.
  • In the case of a client initially experiencing difficulties with self help the mental health worker supporting the clinics is encouraged to use their discretion and offer additional sessions of support.

Who Runs the Clinics?

In many areas the supported schemes are run by graduate primary care mental health workers (GMHW) many of whom have received specific post graduate level training in the skills required to support self help (Department of Health, 2003). The role of the GMHW was introduced across England in response to the need to increase the provision and accessibility of mental health services in primary care (Department of Health, 1999).

Involvement of the Public Library Service

  • Within participating areas the public library play a major role in the delivery of the self help schemes, often helping in the development of the schemes, in many areas purchasing multiple copies of all the titles on the book list and involved in auditing and maintaining book stock.
  • Books on the list are commonly located in all the main public libraries in areas involved in the scheme, libraries closest to the locations where the self help prescriptions are being supplied and also in many of the smaller branch libraries.
  • Books on the list are stocked within the libraries in the same manner as any other book. The books can therefore be accessed in a number of ways:
    • If the client has obtained a self help book prescription it can be handed over in exchange for the self help title. Accessing the books using the prescription can be beneficial as it can also activate additional library benefits which may vary between libraries in different regions.
    • Additionally however the books can be accessed in the same manner as any other library book, simply by going into the library and taking if off the shelf.

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