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Patient Choice in Depression: Are We Failing to Implement NICE Guidelines?

Susan McPherson1, Claire Wicks2, Peter Beresford3

  • 1Institute of Public Health and Wellbeing, University of Essex, Colchester, UK.

Journal of Patient Experience
|April 7, 2025
PubMed
Summary

National Institute of Health and Care Excellence (NICE) guidelines now emphasize patient choice in depression treatment. However, data shows treatment options have not widened, suggesting patient choice is not yet realized.

Keywords:
depressionhealth policypatient choicepatient experiencepublic health

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Area of Science:

  • Mental Health
  • Health Policy
  • Clinical Guidelines

Background:

  • The National Institute of Health and Care Excellence (NICE) introduced "patient choice" in 2022 guidelines for adult depression treatment.
  • A "patient decision aid" was launched in 2024 to support this principle.

Purpose of the Study:

  • To evaluate if "patient choice" in depression treatment has been practically enabled by NICE guidelines and decision aids.
  • To analyze UK National Health Service depression treatment data before and after the guideline implementation.

Main Methods:

  • Comparative analysis of depression treatment data from the UK National Health Service.
  • Examination of treatment trends pre- and post-NICE guideline introduction.

Main Results:

  • Common depression treatments (Guided Self-Help, Counseling for Depression, CBT, antidepressants) remain the most frequent.
  • The range of treatment choices available to patients has not demonstrably expanded.

Conclusions:

  • Current NICE guidelines on "patient choice" for depression treatment have not yet led to a broader selection of therapies for patients.
  • Further investigation is needed into guideline development priorities and potential ideological barriers impacting patient choice and experience.