TalkingSpace Plus Referral CriteriaFor People with Common Mental Health Problems (mild to moderate depression and anxiety) mental health clusters 0-3

For all Adults 18 or over including people over 65 who are registered with an Oxfordshire GPTalkingSpace Plus operates a simplified pathway for people to access ‘Talking Treatment’ at Step 2 & 3 for Common Mental Health

Problems. Individuals who require a Step 2 and/or 3 intervention (as described below) can self refer by telephoning TalkingSpace Plus 01865 901222, or by completing a referral form on our website www.TalkingSpacePlus.org.uk

Individuals whose presentations are more complex and require a Step 4 Psychological Services intervention will require a written referral to the relevant Adult Mental Health Team (AMHT) or Older Adults CMHT.

When an individual requires a psychiatric assessment with or without significant risk to self or others, refer directly to the Adult Mental Health Team (AMHT)/OACMHT.

Health Care Professionals can contact TalkingSpace Plus on 01865 901222 and ask to speak to the Day Supervisor if they would like to discuss suitability of any referral.

Stepped Care

Service Presenting Problem Intervention Organisation

Step 1 Primary Care Based

Active Monitoring, psycho – education, pharmacotherapy

Common mental health disorders managed by General Practice

GP to monitor the patient’s PHQ 9 and GAD 7 scores at presentation, and 5 to 12 weeks later, GP suggests referral to TalkingSpace Plus to those patients who continue to have a PHQ 9 of 10 or more and a GAD 7 of 8 or more.

GP, Health Visitor, District Nurse, Dentists, Integrated Teams.

Information support and counselling for specific problems

Specific problems that are not diagnosed as mental health disorders: Refer to the most appropriate service (some of these services may ask for a financial contribution)

Non Statutory Agencies e.g.- Cruse, Relate, Rape Crisis, Victim Support

Step 2 Primary Care Based

NICE approved Psychological Therapies

Depression & Anxiety disorders (Generalised Anxiety Disorder (GAD), Panic Disorder, Obsessive Compulsive Disorder (OCD), Social Anxiety, Health Anxiety, Specific Phobia) - mild to moderate severity: • Specific problem amenable to Cognitive Behavioural Therapy (CBT);

• Suicide / other risk – minimal;• None or brief previous psychological therapy

Depression – Guided self-help, Computerised CBT, Psycho educational groups

TalkingSpace Plus

Social Anxiety – guided self-help TalkingSpace PlusGAD, OCD, Panic disorder, Health Anxiety, Specific Phobia – guided self-help, psycho educational groups

TalkingSpace Plus

All disorders – support groups, educational and employment support services; referral to further assessment and interventions.

TalkingSpace Plus

Depression & Anxiety Disorders AND Long Term Conditions/Persistent Physical Symptoms:, Cardiac, Diabetes, COPD, Adherence to treatment issues, Disability, Trauma, Mortality concerns

Manualised treatment planning for Chronic Obstructive Pulmonary Disease (COPD)

TalkingSpace Plus LTC

Cardiac rehab Psychoeducation group for cardiac patients

TalkingSpace Plus LTC, OUH & OH Cardiac Nurses

Diabetes Psychoeducation GroupTalkingSpace Plus LTC and OH diabetes nurses & practice nurses

TalkingSpace Plus Referral CriteriaFor People with Common Mental Health Problems (mild to moderate depression and anxiety) mental health clusters 0-3

For all Adults 18 or over including people over 65 who are registered with an Oxfordshire GP

Stepped Care Service Presenting Problem Intervention Organisation

Step 3 Primary Care

Based

IAPT NICE approved

Psychological Therapies

Depression: Persistent subthreshold depressive symptoms or mild to moderate depression that have not responded to a Step 2 intervention or initial presentation of moderate to severe depression, excluding Bipolar Affective Disorder.Suicide/other risk - minimal

First order treatments: Cognitive Behavioural Therapy (CBT) (individual and group), Interpersonal Therapy

TalkingSpace Plus

Second order treatments: Behavioural Couples Therapy, Short term Dynamic Interpersonal Therapy (DIT), Counselling.

TalkingSpace Plus

Relapse prevention: Mindfulness Based Cognitive Therapy(MCBT) TalkingSpace Plus

Anxiety DisordersGAD- with marked functional impairment or that has not responded to a Step 2 intervention

CBT (Individual or Group) TalkingSpace Plus

Panic disorder – moderate to severe or that has not responded to a Step 2 intervention

CBT (Individual or Group) TalkingSpace Plus

Specific Phobia CBT (Individual or Group) TalkingSpace Plus

Health Anxiety CBT (Individual or Group) TalkingSpace Plus

OCD (excluding hoarding) - with moderate to severe impairment or that has not responded to step 2 intervention

CBT (Individual or Group) TalkingSpace Plus

Social Anxiety - moderate to severe CBT (Individual) TalkingSpace Plus

Body Dysmorphic Disorder CBT (Individual) TalkingSpace Plus

Post Traumatic Stress Disorder (PTSD) (Single event trauma)

Trauma Focused CBT or Eye Movement Desensitization and Reprocessing (EMDR)

TalkingSpace Plus

Long Term Conditions/Persistent Physical Problems and Depression/ Anxiety: Cardiac, Diabetes, COPD Specific problem amenable to a NICE approved Psychological therapy; • Suicide / other risk – minimal;• None or brief previous psychological therapy

CBT (Individual) TalkingSpace Plus LTC

Adjustment Reaction – Mild to Moderate to specific life events, which has not responded to active monitoring e.g. loss

TalkingSpace Plus

All Disorders (as above) Employment support services TalkingSpace Plus

TalkingSpace Plus Tel: 01865 901222 Fax No: 01865 261717 Email: talkingspaceplus@nhs.net Website: www.talkingspaceplus.org.uk