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Provision for people with anxiety disorder by a community health care trust

Nottingham University Department of Psychiatry, Duncan Macmillan House, Porchester Road, Nottingham NG3 6AA;

Lisa Ball, Psychology Assistant, David Blore, Nurse Specialist, Cognitive/Behavioural Psychotherapy;, Helen Dunn, Senior Occupational Therapist, Margaret Foster, Community Mental Health Team Leader, Barbara Hart, Senior Occupational Therapist, Ifti Majid, Day Hospital Manager and Peter Rajan, Director of Psychology Services

Central Nottinghamshire Community Health Care Trust, Forest Hospital, Mansfield

^* Correspondence

Aims and method Provision for patients with loosely defined anxiety disorders has been reviewed. During a two-week period, 66 of the 69 adult mental health practitioners working in a modestly sized community health care trust surveyed all patients with anxiety disorder currently under their care.

Results These practitioners were seeing a total of 758 patients who fitted a loose definition of anxiety disorder. A further 134 patients had been treated in anxiety management groups during the preceding year. Disparate treatments were being used, reflecting idiosyncratic approaches to this otherwise homeogenous group of patients.

Clinical implications Less than one-tenth of the estimated population of anxiety disorder patients were receiving specialised treatment. Among those that were, choices of treatment were arbitrarily determined and idiosyncratic. It was clear that the management of these patients does not fulfill the requirements of ‘evidence-based practice’.