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Abstract
The Department of Health and National Institute for Clinical Excellence (NICE) have recommended the use of self-help as an important intervention in a stepped care approach, for mild to moderate mental health problems. However, there has been little attempt to guide the primary care practitioner in the appropriate use of such materials. The `Cardiff Book Prescription Scheme' was set up in 2002 in response to this need and to enhance the availability of psychology in primary care services, helping primary health services identify alternative routes to psychological help, in the form of self-help manuals. The current study aimed to evaluate this new and innovative service, looking at prescribers' (GPs, counsellors and psychologists), dispensers' (librarians) and users' (those who have been prescribed books) experiences of the `Cardiff Book Prescription Scheme'. A two-stage mixed-methodology design was used. At stage one, a questionnaire was sent out to all prescribers and dispensers in Cardiff asking for basic information regarding their experience of the scheme. Prescribers and dispensers were also supplied with questionnaires to give out to users of the scheme (a specially designed `Users Questionnaire' and the Client Satisfaction Questionnaire - 8; CSQ-8). Prescribers and dispensers returned sixty-three questionnaires (50 prescribers and 13 dispensers; 24% response rate) and users returned six questionnaires. Out of the 50 prescribers who returned the questionnaire, 37 prescribed books from the scheme, and all reported finding the scheme helpful. The main reason for not prescribing books was due to being `unaware of the scheme'. The CSQ-8 scores for users indicated a satisfaction level comparable with similar services. All users rated the scheme as a good idea and reported finding the book helpful for their problem. In the second stage of the research, interviews were conducted with prescribers and users to explore their experience of the `Cardiff Book Prescription Scheme'. The interviews were analysed using a grounded theory approach. From the analysis, information regarding choice to use the scheme, characteristics that might be associated with a good response to self-help and beneficial and non-beneficial aspects of the self-help approach, amongst others were discussed. Theoretical, clinical and research implications are discussed in relation to these findings.
