Treatment Options
If you have turned to this section it is likely that you want to find out more about what treatments are available for you and your relative.
We will give you a description of the different treatments available and how to get them. We have focused on the main treatments currently available through NHS mental health services.
How do I Know What Treatments Should be Available?
The National Institute for Health and Clinical Effectiveness (NICE – www.nice.org.uk) has made some recommendations about the treatments you and your relative should be offered. These are based on a careful review of all the available evidence by a panel of clinical experts, service users and relatives.
NICE guidelines recommend:
People with psychosis should be offered:
- A comprehensive multidisciplinary assessment in specialist mental health services
- A written collaborative care plan (service user should have a copy)
- Appropriate antipsychotic medication chosen by the service user and health professional together and based on a thorough understanding of the effects and side effects of the drug
- Cognitive Behaviour Therapy (CBT; at least 16 planned sessions)
- Family intervention (at least 10 planned sessions including the service user where practical)
- Consider offering arts therapies – especially for negative symptoms
- Support to get back into education / work
- Regular physical health checks
- Healthy eating and physical activity programme
- Help to stop smoking
- Access to crisis teams where needed
- Many people find it helps to receive support from other people with lived experience of psychosis. The guideline recommends teams consider offering peer support from a trained peer support worker
People with bipolar disorder should be offered:
- A comprehensive assessment and written care plan
- Referral to secondary care services where needed
- Appropriate medication chosen by the service user and health professional together and based on a thorough understanding of the effects and side effects of the drug, taking into account advance statements
- Structured psychological intervention (individual, group or family) designed for bipolar disorder using a published evidence based manual
- Regular physical health checks
- A risk management plan where appropriate
- Access to crisis teams where needed
The guideline also encourages people with Bipolar Disorder to consider developing advance statements and lasting power of attorney while their condition is stable (see ‘Module 9 – Understanding Mental Health Services’ and Resource Directory for more information on these).
Relatives of people with psychosis or bipolar disorder should be offered:
- An assessment of their own needs and a care plan to address any identified needs (relative should have a copy)
- Advice about their right to a formal carer’s assessment provided by social services as outlined in the Care Act 2015
- Written and verbal information about:
- diagnosis and management of psychosis and schizophrenia / bipolar disorder
- positive outcomes and recovery
- types of support for carers
- role of teams and services
- getting help in a crisis
- An agreed plan about how information about the service user will be shared, which is reviewed on a regular basis to ensure relatives have the information they need, whilst respecting the service users’ rights for personal and sensitive information to be kept confidential
- Carer-focused education and support programme which may be part of a family intervention
- Family intervention – at least 10 planned sessions including the service user (where practical) is recommended for psychosis
The full NICE Guidelines can be downloaded for free here:
NICE Guideline for psychosis and schizophrenia in adults: prevention and management www.nice.org.uk/guidance/cg178
NICE Guideline for Bipolar Disorder: assessment and management www.nice.org.uk/guidance/cg185
As indicated above people can have a range of needs which can be addressed in an variety of ways from medication, talking therapies and other forms of support. Many people experience personal recovery alongside engaging with these interventions, for more information on recovery see module 12.