STEPS: Going beyond the tip of the iceberg. A multi‐level, multipurpose approach to common mental health problems

White, Jim; Joice, Anne; Petrie, Samuel; Johnston, Sandra; Gilroy, Dominic; Hutton, Paul; Hynes, Noreen A.

doi:10.1108/17465729200800007

Cited by 8 publications

(6 citation statements)

References 15 publications

(11 reference statements)

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“…The alternative of developing specialist teams to deliver targeted interventions may provide greater benefits in areas with sufficient need [52]. However, developing our understandings of how existing local services can better tailor mental health treatment is a necessary first step in developing services that are responsive to the needs of our increasingly diverse communities.…”

Section: Discussionmentioning

confidence: 99%

“…The intervention does show preliminary evidence of effectiveness in people who do engage, although clearly major problems remain in terms of encouraging higher rates of recruitment to ensure those benefits have sufficient reach into population in need. The alternative of developing specialist teams to deliver targeted interventions may provide greater benefits in areas with sufficient need [ 52 ]. However, developing our understandings of how existing local services can better tailor mental health treatment is a necessary first step in developing services that are responsive to the needs of our increasingly diverse communities.…”

Section: Discussionmentioning

confidence: 99%

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Development and evaluation of culturally sensitive psychosocial interventions for under-served people in primary care

et al. 2014

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BackgroundPsychological therapy is effective for symptoms of mental distress, but many groups with high levels of mental distress face significant barriers in terms of access to care, as current interventions may not be sensitive to their needs or their understanding of mental health. There is a need to develop forms of psychological therapy that are acceptable to these groups, feasible to deliver in routine settings, and clinically and cost effective.MethodsWe developed a culturally sensitive wellbeing intervention with individual, group and sign-posting elements, and tested its feasibility and acceptability for patients from ethnic minorities and older people in an exploratory randomised trial.ResultsWe recruited 57 patients (57% of our target) from 4 disadvantaged localities in the NW of England. The results of the exploratory trial suggest that the group receiving the wellbeing interventions improved compared to the group receiving usual care. For elders, the largest effects were on CORE-OM and PHQ-9. For ethnic minority patients, the largest effect was on PHQ-9. Qualitative data suggested that patients found the intervention acceptable, both in terms of content and delivery.ConclusionsThis exploratory trial provides some evidence of the efficacy and acceptability of a wellbeing intervention for older and ethnic minority groups experiencing anxiety and depression, although challenges in recruitment and engagement remain. Evidence from our exploratory study of wellbeing interventions should inform new substantive trial designs.Trial registrationCurrent controlled trials ISRCTN68572159

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Development and evaluation of culturally sensitive psychosocial interventions for under-served people in primary care

et al. 2014

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“…The rationale for the establishment of the STEPs Team and service outcomes have been fully described in earlier papers (White, 2008a,b;White et al, 2008). Access to all services offered by the team is by self-referral.…”

Section: Difficulties In Primary Carementioning

confidence: 98%

“…In an attempt to provide an innovative primary care model of service delivery in mental health, the STEPs team was established as one of the five Glasgow primary care mental health teams in 2005. The rationale for the establishment of the STEPs Team and service outcomes have been fully described in earlier papers (White, 2008a,b;White et al, 2008). Access to all services offered by the team is by self-referral.…”

Section: Difficulties In Primary Carementioning

confidence: 99%

Tackling inequalities in primary care mental health

Ross¹,

Craig

2011

Journal of Public Mental Health

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“…The main interventions offered by STEPS include 'Mood Matters', a six-session interactive CBT/positive psychology group approach for up to 20 individuals; 'Connect', a CBT social anxiety class; 'Stress Control', a transdiagnostic didactic CBT approach that, typically attracts over 40 people to the afternoon class and over 100 people to the evening class (White, 2010a) and a range of self-help options, including the 'Steps out of Stress' booklet (and audio booklet) series and a website (www.glasgowsteps.com; White, 2009). Information about the service can be found in White et al (2008) and White (2010b).…”

Section: Introductionmentioning

confidence: 99%

‘Callback’: increasing access to, and improving choice in, a multi-level, multi-purpose low-intensity service

et al. 2012

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In a previous paper auditing individual therapy in the STEPS team, we demonstrated a significant problem with attrition for both CBT and person-centred therapy. We argued that a root-and-branch change to the referral process was needed. This paper looks at the system which replaced it. 'Callback' allows self-referral with service users able to leave a phone message at any time. Clinicians call back and carry out a protocol-driven assessment, arranging, where appropriate, services at the end of the call. Reporting on the first 2500 calls, 92% of callers were successfully called back. Individuals were, on average, called back in 8.4 hours. Eighty-six percent of callers were offered an intervention within the STEPS service. They entered these STEPS services, on average, 9.4 days after the initial phone call. Of all callers 15.6% were offered individual therapy. Of these, 93% attended the first appointment and 82% completed a course of treatment. The results suggest that Callback is a significant improvement on the GP-referral system it replaced and provide evidence supporting the utility of 'multi-level, multi-purpose' services in primary care. ). © British Association for Behavioural and Cognitive Psychotherapies 2013'Callback' 125 the realities of inefficient models. We need to ensure that efficiency is given equal priority to effectiveness in order to achieve the best value for the money spent (White, 2008).STEPS is the NHS primary-care mental health team in south-east Glasgow. South-east Glasgow is a deprived community and generally performs badly compared to the rest of the country in terms of a range of indices of deprivation: greater numbers being income-and employment-deprived, more claiming benefits, lower life expectancy, higher infant mortality and low birthweight. The Pakistani community (the largest in Scotland) comprises 11% of south-east Glasgow, more than five times the Scottish average [Glasgow Centre for Population Health (GCPH), 2008].While mental health services within the Scottish NHS system differ from that of the English system, Glasgow had, possibly, the first dedicated primary-care mental health teams in Britain, offering an essentially low-intensity service (individual therapy is expected to offer up to 6-8 sessions) and involving, typically, higher banded workers -clinical psychologists, CBT therapists and person-centred counsellors. Since 2005, the STEPS service has offered a sixlevel, low-intensity service for those with common mental health problems. The levels are: individual therapy, groups/classes, single contacts, non-face-to-face interventions, working with others, and population level. The service can best be described as offering matched care -attempting to get the individual to the right level of service first time. The main interventions offered by STEPS include 'Mood Matters', a six-session interactive CBT/positive psychology group approach for up to 20 individuals; 'Connect', a CBT social anxiety class; 'Stress Control', a transdiagnostic didactic CBT approach that, typically...

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STEPS: Going beyond the tip of the iceberg. A multi‐level, multipurpose approach to common mental health problems

Cited by 8 publications

References 15 publications

Development and evaluation of culturally sensitive psychosocial interventions for under-served people in primary care

Development and evaluation of culturally sensitive psychosocial interventions for under-served people in primary care

Tackling inequalities in primary care mental health

‘Callback’: increasing access to, and improving choice in, a multi-level, multi-purpose low-intensity service

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