Mid and South Essex: Weekly telephone calls for people newly diagnosed with depression

Following an initial diagnosis of depression by a GP, the NHS England standard is for people to be seen again for a follow-up appointment between 10 and 56 days later. During that time, while the patient might be taking the prescribed medication or waiting for talking therapies treatment to begin, they may not have access to any other mental health support.

Mid and South Essex Integrated Care Board (ICB) recognised that this can be a challenging time, and that people newly diagnosed with depression can be at increased risk of suicidal thoughts or behaviours. They have used suicide prevention programme funding to implement a new offer of support which runs alongside the clinical treatment.

Since 2021, the ‘Wellbeing Calls’ service has provided weekly phone calls to newly diagnosed people for four to six weeks after diagnosis. It is delivered by two local voluntary sector providers, Trust Links and Thurrock and Brentwood Mind, which cover different parts of the ICB area.

New referrals are allocated to a wellbeing calls operator who will phone them once a week at a mutually agreed time. These calls provide a chance to discuss how they are feeling, how they are getting on with the medication and any other concerns. The operator can check whether a referral has been made to talking therapies, discuss medication side effects and signpost the client to other local services.

Wendy Robertson, Deputy CEO of Thurrock and Brentwood Mind, said service users value having someone to talk to. 

That weekly call might be the only person they speak to about their daily struggles. Our operators are also trained to spot if someone is deteriorating. The pathways are so well established in Mid and South Essex that it’s easy to move people to other support if things escalate.

This ICB includes areas covered by Thurrock Council, Southend-on-Sea City Council and Essex County Council. Maria Payne, Thurrock’s Head of Public Health, said the service began from a suicide prevention angle but now sits within the wider mental health and wellbeing offer.

The position of both providers, in terms of their reputation, resource and staffing, means that they are well placed to make the links to prevent any crisis from escalating.

Simon Ford, Health Improvement Practitioner at Southend-on-Sea City Council, said people can be particularly vulnerable in the first two months after diagnosis. 

They sometimes feel that they become invisible for that period of time. This service removes the stigma and allows them to have an open and honest non-clinical conversation about how they feel. It helps them to feel visible again.

The two providers combined received 691 referrals in the 2022/23 financial year. Almost half came from primary care mental health teams (44%), 22% from GPs, and 18% from other health professionals including pharmacists. A small number of people self-referred.

Trust Links recorded depression test scores (PHQ-9) at initial assessment for almost all service users, with an average score of 18 (moderately severe depression). At the four to six-week follow-up stage, the average score was 12.5 (moderate depression).

In a survey of service users by Thurrock and Brentwood Mind, all of them answered 7/10 or above in response to whether they would recommend the service. All said either ‘agree’ or ‘strongly agree’ in response to whether they had been supported well and listened to. One service user commented: ‘Weekly chats have been so helpful, I have gone from no hope to now looking forward to a better future.’ Another said: ‘You don’t realise the impact a phone call makes to my life.’

Wendy Robertson said:

People tell us what a difference it makes. During depression people’s instinct can be to withdraw and not communicate, but we have people saying how much they look forward to the weekly call.

This was one of several Mid and South Essex initiatives which made use of the NHS England suicide prevention programme funding. Other work included data analysis, awareness-raising and a community fund to improve people’s mental health.

The original Wellbeing Calls funding has already ended but a one-year extension was granted by the ICB. Maria Payne said: 

The ICB have agreed in principle that the programme is worth continuing with as part of the broader primary care mental health offer.

At the time of writing, funding for 2024/25 was under discussion.

There is also scope for expansion, with around 12,000 new depression diagnoses each year in Mid and South Essex (2021/22 figures). If funding is cut, support will be targeted to those people who are at highest risk.