NICE depression guideline recognises importance of supporting communication needs

The RCSLT engaged with the NICE guideline on depression in adults: treatment and management as it was developed over 2021 and 2022. Our aim was to highlight the vital link between mental ill-health and communication needs, and the key role that speech and language therapists (SLTs) play in promoting better mental health and supporting people of all ages living with mental health disorders.​​

A significant number of both children and adults in contact with mental health services require support:

• 81% of children with social, emotional and mental health needs have undetected speech, language and communication needs.
• 80% of adults showed impairment in language and 60% of people had an impairment in communication in one acute psychiatric inpatient unit.

The evidence is clear, unsupported speech, language and communication needs can be a barrier to:

• Accurate care and treatment planning: the person may not be able to express their health needs.
• Rehabilitation and psychological programmes: the verbal delivery of these are inaccessible if a person has difficulties understanding or making themselves understood.
• Accurate risk assessments for capacity and consent: the person will not be able to weigh up the information and communicate their wishes.

We are pleased to see the guideline reference:

• Adapting methods of communication depending on the person’s language and communication difficulties.
• Addressing any barriers to the delivery of treatments because of any disabilities, language or communication difficulties.
• A requirement on commissioners and providers of mental health services to ensure that accessible and inclusive information about the pathways into treatment and different explanatory models of depression is available.

​We are also pleased that:

• Extra time will be allowed at the initial discussion about treatment options. This is critical to ensure that a person with communication needs can understand the information being given to them and make choices.
• The link between cognition and communication is recognised. People with cognitive impairments often have quite complex communication challenges and we are pleased to see this referenced.

We thank our members who helped us respond to this guideline and supply vital evidence to make this case.

The guideline will be a good start in improving support to people affected by communication difficulties in contact with mental health services.

However, despite the high incidence of communication difficulties, SLTs are not always embedded in mental health services and the links between mental health and communication and swallowing often go unrecognised.

Until speech and language therapy is recognised as part of the core mental health workforce, people will continue to be denied this vital communication support. So, we repeat our call for SLTs to be embedded in mental health services.

Visit the NICE website for the full guideline on depression in adults.