A hundred and fifty years ago, physical disease was known to be widespread but was usually untreated. Anxiety and depression is now like that. Up to a fifth of the entire population are affected, of whom 84% were untreated in a UK community survey (Bebbington et al, 2000). ‘Developed’ countries are underdeveloped when it comes to treating anxiety and depressive disorders, even though effective treatment is available in the form of brief cognitive–behavioural therapy. In the UK, waiting times for such therapy can be as long as 2 years. Routine therapy outcomes are rarely reported. The delivery and monitoring and also teaching of therapy still largely conform to a 19th century model, and could be advanced by greater use of information technology. Such technology could catalyse a model of community care delivered mainly in the home, by enhancing access to effective self-help, audit of outcome and professional training.
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