Coaching for Mental Health: Ethical Dilemma or Ethical Development?

Appendix 5: Letter regarding reclassification of depression

10 April 2002 “The BMJ is suggesting that depression, for example, should be reclassified as a “non-disease”.” It is certainly an interesting move – and one that does reflect much of our research into the ways that people manage their own mental health, particularly focusing, for example, on social support, creativity, alternative and complementary therapies and talking treatments”.

However, reclassifying something as a “non disease” might seem to suggest that it’s less important, and somehow less worthy of support. With GPs overstretched, is there not a danger that this may be used as a way of rationing care and support, even deciding who to strike off patient lists? This would be a major step backwards.

GPs have a vital role to play as gatekeepers to support that people with depression do find helpful – whether it be writing prescriptions for gym membership, signposting people to support groups, arranging counselling or linking up with alternative therapists. Also, for many people, medication is a vital part of their support, although not the only answer and often not a long-term one.

One of the biggest challenges is enabling people with mental health problems to seek and receive support in the first place. The BMJ’s new pronouncement may make this even more to difficult to achieve, which is a risk we should all be concerned about”.

Ruth Lesirge, Chief Executive – Mental Health Foundation (


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