Historical context

Boab Health Services and Broome Libraries Books on Prescription Scheme “One sheds ones sickness in books” Quote byDH Lawrence Historical context The idea that books help us both emotionally and psychologically has been around for centuries. Plato said that “the muses gave us the arts not for mindless pleasure but as an aid to bringing our soul-circuit, when out of tune, into harmony with itself” (Morrison,2008). The first books on prescription scheme (BPS) was set up in the UK in 2004 by Dr Neil Frude. This innovative approach to alternative therapeutic interventions became the Cardiff Books on Prescription Scheme. Neil Frude ‘s (2004) research indicated that 90% of people experiencing mental health issues would present in a primary care setting and that 25% of any primary care consultations would have a significant mental health component. At this time there were two broad approaches to psychological distress, which were either pharmacological or psychological (including psychotherapy and counselling). However, access to psychological interventions were impeded by the cost and availability of individual therapists. Given these limitations, an alternative method of delivering psychological interventions was sought through the use of high quality mental health self help materials. The term ‘Bibliotherapy’ has been coined for the therapeutic use of books in the treatment of illness or personal problems.

The National Institute for Clinical Excellence (NICE) in the UK evaluates evidence to support all clinical interventions within the National Health Service. Self help is now recognised as an essential component of treatment for people experiencing depression, anxiety, and eating disorders as part of a stepped care approach. Evidence suggests that bibliotherapy has a therapeutic benefit for people experiencing common mental health issues in the UK (Anxiety NICE Guidelines 2007, Depression in Adults Guideline NICE 2009, Depression in Children and Young People Guidelines NICE 2005) Today there are over 80 schemes across the UK for books on prescriptions. These are usually based on a collaborative model between local libraries and primary care trusts (Hicks, 2006). Today there are over 80 schemes across the UK for books on prescriptions. These are usually based on a collaborative model between local libraries and primary care trusts ( Hicks, 2006).The Cardiff books on prescription scheme saw 1600 prescriptions for books presented by clients at their libraries within the first year (Turner, 2008).

The Australian Context At the Australian public libraries summit 2009 there was a conference recommendation for a future state-wide or national Bibliotherapy Program, to be developed by public library networks in partnership with Healthcare Services. One in five Australians aged 16 to 85 years had a mental disorder in 2007, according to the Australian Bureau of Statistics. Women were more likely to experience mental health problems (22%) than men (18%). It was also found that younger people were more likely to have a mental health problem than older people. Just over a quarter 26% of people aged 16 to 24 has a mental health problem compared to 6% of people aged between 75 to 85. Anxiety disorders such as panic and obsessive compulsive disorder were the most common, affecting 14% of people. Affective disorders such as depression was found to cause 6%, whilst 5% suffered from substance use disorders. When we consider the rural and remote areas of Australia these figures could well be higher and access to psychological services considerably reduced. Therefore a ‘Books on Prescription Scheme’ could be of benefit to both referrers and referees.

Who benefits from the Scheme? Clinical evidence from the UK suggests that clients experiencing common mental health problems or high prevalence mental health problems are the target group of consumers for this form of intervention. Given the evidence, the stepped care model from the NICE guidelines recommendclients who are assessed with mild to moderate mental health issues may be offered self help. This will usually involve recommendation of a book, with follow up sessions to offer guidance and monitoring of the effectiveness of the intervention. The books can also be used as an adjunct to traditional individual therapies such as Cognitive Behavioural Therapy. Who recommended the Book list? The books provided through the Boab Health Services BPS have been recommended by a panel of expert psychologists in the UK, with additional resources added by the Boab Counselling services team. The majority of the books have therefore been used in UK Books on Prescription schemes for at least five years. The Videos available in this scheme were provided by Beyond Blue, who kindly consented to their use.

What sort of Books will be on the list? All the books on the list are self help orientated. They will inform, educate, and guide consumers through different aspects of their mental health problem, with reading and exercises to complete. The majority of the books are cognitive behavioural based texts. What subject areas will the books cover? • Depression • Anxiety Disorders • Eating Disorders • Anger • Assertiveness • Low Self Esteem • Relationship Issues • Sexual Abuse • Trauma • Grief • Post Natal Depression

How does the referrer benefit? The referrer has an alternative intervention previously not available to them. The referrer may use this intervention to help a client who is waiting to access a mental health professional. The Referrer has clear guidelines on how to use the scheme and access to the prescriptions and patient information leaflets electronically. How does the consumer benefit? The consumer gains access to another choice of therapy or an adjunct to therapy they are already receiving. Some consumers are reluctant to engage with one to one therapeutic interventions and bibliotherapy can act as an alternative method of intervention. Some clients may wish to try and help themselves before seeking the services of a mental health professional. Some clients may be too busy or have a work schedule that does not fit in with weekly appointments with a mental health professional. Consumers gain access to the public library and this may help them towards engagement with others, as well as activities that may be occurring in the library. More remote libraries will also be able to participate in the scheme. However they will need to request the book from the main Library, which will initially be Broome

How does the Books on Prescription Scheme work? A Mental Health Professional or General Practitioner will identify a client who they feel may benefit from the scheme. The Mental Health Practitioner or General Practitioner will look through the book list with the client and decide what book is likely to help. A follow up session may also be agreed. The Mental Health Practitioner or General Practitioner gives the client a leaflet about the scheme. The Mental Health Practitioner or General Practitioner use MMEX to generate and print the prescription. The client goes to the library either with the prescription, or borrows the book using the normal processes. All those accessing the scheme will need to become library members. The client will be able to borrow the book for a month, with the option to renew, unless the book has been ordered by another client.

Audit and evaluation of the project Clients will be encouraged to return the feedback slip on the bottom of the script to qualitatively evaluate their experience of the scheme. This can be returned via freepost to Boab Health Services Counselling Team, or to the library on return of the book. MMEX (online medical information management system) statistics will be compared to Library statistics to evaluate the amount of prescriptions issued compared to the books that are actually taken out of the library. This will also assist in identifying which books are the most popular, and may require additional copies. The library will stock four of the titles that Boab Health Services has provided to the library, ensuring that the statistics on loans are accurate, and reflect the veracity of the scheme. The Project will initially be audited at three months, then six monthly in the future.

Future Development Boab Health Services Counselling Team has resources to develop a future site for the scheme in Kununurra. This scheme also has the potential to assist in addressing a wide range of community needs. For example, other professions within primary care may be able to add to the scheme. These could include professionals in areas such as dietetics, health promotion, carer organisations and children’s services. The Self help model can also be applied to provide information education and support in specific diseases such as asthma, diabetes and insomnia. It can also be developed for smoking cessation, as well as other drug and alcohol related issues. Indigenous services may develop a similar self help scheme to offer literature specific to cultural issues and needs. The scheme could be extended into prison libraries. The Library collection may eventually expand into CD Rom self help packages. Author Andy Williams 2010

References • Frude N. A book prescription scheme in primary care. Clinical psychology (2004; 39:11 -4) • Grundy L. Evaluation of the Cardiff books on prescription scheme: Prescription of self help books for people with mild to moderate mental health problems: Cardiff University (2005) • Hicks D. An audit of bibliotherapy/books on prescription activity in England. Arts Council England and museums libraries and archives council (2006) • Martin J. A Bibliotherapy partnership between public libraries and health services. Australian public libraries summit paper (2009) • Morrison B. The Reading Cure . Guardian newspaper (5th January 2008) • National Institute for Health and Clinical Excellence (NICE): Guidelines for the Management of depression in adults. London NICE (2009) • National Institute for Health and Clinical Excellence (Nice: Guidelines for the management of depression in children and young people: London NICE (2005) • National Institute for Health and Clinical Excellence (NICE) Guidelines for the management of anxiety: London NICE (2007) • National survey of mental health and wellbeing summary of results (2007) • Turner J. Bibliotherapy for health and wellbeing: An effective investment report. Australian public libraries and information services. (2008)

Books on Prescription Words for Wellbeing A Partnership with Broome Public Library

Boab Health Services Books on Prescription Boab Health Services Books on Prescription is a collaboration between The Kimberley Division of General Practice and the Shire of Broome Library Services. The Book Prescription allows specially chosen self-help books to be prescribed by your mental health professional. Once issued, the prescription can be exchanged for the book at the Broome Library. The program is used by Broome GP’s, Mental Health Professionals at Boab Health Services and other Mental Health service providers in Broome. Words for Wellbeing

Books Can Help Books on Prescription offers a source of self help for people experiencing common mental health problems. Of course, this approach will not be suitable for everyone, but research indicates that books can often help. • There is good evidence that the best self-help books can be highly effective in helping people with emotional problems. • Many practitioners regularly recommend particular books to their clients or patients and soon get to know which of these books are most useful. • Self-help books can be highly effective when used as the main source of self help, or in addition to other interventions. • The use of self-help books is known as ‘bibliotherapy’.

What are the Books about? The program includes books on many of the common mental health problems that people experience, including depression, eating disorders, panic, anger, stress, low self-esteem, relationship difficulties and the aftermath of sexual abuse. Although they contain good information which has been checked by mental health practitioners, they are not medical books. They are all written in an understandable, accessible style and aim to help you to help yourself. Can I Buy The Books? You might want to buy the prescribed book for yourself from a bookshop rather than go to the library. All the books on the list are currently available. We can provide you with an ISBN number if required.

How To Pick Up Your Prescription Just take your prescription to Broome Library and it will be exchanged for the prescribed book. If you are not a member of the library already, you need to take some identification which has your name and address on it (such as driving licence, Health Care Card, rental agreement etc.) If you are already a member, remember to take your library card with you. The normal loan period for your book will be 4 weeks. If you find you need it for longer, this can be extended by taking it to the library or by telephone. (If nobody else has requested it.) If the book is on loan to someone else, you can reserve it to loan when the book is returned. Once you have your library ticket, you can borrow other books, videos or DVDs and use the computers.

Location and Opening Hours Broome Public Library Phone: 08 9191 3477 Fax : 08 9191 3476 Email: library@broome.wa.gov.au Library opening times Mon, Wed, Fri: 10am to 5 pm Tues & Thurs: 10am to 7pm Saturday: 9am—12noon Boab Health Services Counselling Team The team provide focused psychological interventions for people experiencing mental health issues. A GP referral is required to access services in Broome. Tel 08 9192 6555 Fax 08 9192 5655

Words for Wellbeing Books on Prescription

Historical context