Quality standard
Quality statement 4 (developmental): Psychological interventions
Quality statement 4 (developmental): Psychological interventions
Developmental quality statements set out an emergent area of cutting‑edge service delivery or technology currently found in a minority of providers and indicating outstanding performance. They will need specific, significant changes to be put in place, such as redesign of services or new equipment.
Quality statement
Adults with bipolar disorder are offered psychological interventions.
Rationale
Currently very few adults with bipolar disorder can access appropriate psychological interventions because of capacity and training issues within mental health services. Psychological interventions specifically developed for adults with bipolar disorder (such as enhanced relapse prevention/individual psychoeducation or cognitive behavioural therapy for bipolar disorder) have been shown to improve symptoms and prevent relapses and hospitalisation. Adults with bipolar disorder can be offered psychological intervention as individual, group or family intervention depending on accessibility and suitability to them.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured and can be adapted and used flexibly.
Structure
a) Evidence of local arrangements for the provision of psychological intervention programmes.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from local service specifications.
b) Evidence of practice arrangements and written clinical protocols to ensure that adults with bipolar disorder are offered psychological interventions.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from local service specifications.
Process
Proportion of adults with bipolar disorder who receive a psychological intervention.
Numerator – the number in the denominator who receive a psychological intervention.
Denominator – the number of adults with bipolar disorder.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.
Outcome
a) Relapse rates for adults with bipolar disorder.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.
b) Hospital admission rates for adults with bipolar disorder.
Data source: NHS Digital Hospital Episode Statistics.
What the quality statement means for different audiences
Service providers (such as GP practices, community health services and mental health services) ensure that systems are in place for adults with bipolar disorder to be offered psychological interventions.
Healthcare professionals offer adults with bipolar disorder psychological interventions.
Commissioners commission services that deliver psychological interventions and ensure that adults with bipolar disorder are offered a referral to these services.
Adults with bipolar disorder are offered psychological treatment for bipolar disorder to help them manage their symptoms and stay well in the future.
Source guidance
Bipolar disorder: assessment and management. NICE guideline CG185 (2014, updated 2023), recommendations 1.2.5, 1.6.1 and 1.7.3
Definitions of terms used in this quality statement
Psychological interventions
Psychological interventions recommended specifically for adults with bipolar disorder include:
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a psychological intervention that has been developed specifically for bipolar disorder and has a published, evidence‑based manual describing how it should be delivered or
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a choice of psychological intervention (cognitive behavioural therapy, interpersonal therapy or behavioural couples therapy) in line with the advice on treatment options for more severe depression in NICE's guideline on depression in adults.
Psychological interventions can be delivered as a one‑to‑one, group or family therapy and should address the presentation of adults with bipolar disorder. [NICE's guideline on bipolar disorder, recommendations 1.2.5, 1.6.1 and expert opinion]
Equality and diversity considerations
Specialist mental health services should provide person‑centred psychological interventions that are appropriate for different ethnic and cultural backgrounds and that take into account differences in beliefs about biological, social, psychological and family influences on mental states.