Emotional problems are very common

Many people-perhaps even the majority develop emotional or psychological problems at some time during their life. At any one time for example, about 10% of adults are feeling somewhat depressed. Others feel anxious about leaving the house, or about meeting people, or have worries that just seem to go on and on. Some experience panic attacks that can be very frightening and unpredictable, while others realise that their tidiness around the house is becoming obsessional. Some people are highly stressed by work or family life, while others are haunted by abuse that happened in childhood. And many people just don’t feel good about themselves. Their self-esteem is low, they lack confidence and feel useless and unlovable.

GPs can offer help for emotional problems

Many people consult their G.P. for help with their emotional difficulties, and G.P.s can help in several ways. They might refer the person to a counsellor, for example, or to specialist mental health services where psychologists, psychiatrists and others are able to provide treatment. However, the availability of these specialist resources is limited. More often, the G.P. will offer advice, prescribe medication to relieve such symptoms as anxiety or depression, or recommend contact with a local voluntary agency.

Books can help

Medication has an important role in helping people with emotional problems, and is often very effective. However, people can also be helped by reading appropriate ‘self-help’ material. Many self-help books have been shown to be very useful in helping people to overcome a range of psychological problems. The use of books as a means of providing psychological therapy is known as ‘bibliotherapy’.

The North Inner City Book Prescription Scheme

A book prescription scheme introduced in the North Inner City of Dublin in 2007 allows highly selected self-help books to be prescribed by GPs and others. Once issued, the prescription can be exchanged for the book at any participating Library in the North Inner City. The scheme extends to every GP surgery in the North Inner City Partnership in Primary Care. It involves the close collaboration of the HSE and Dublin City Public Libraries. Other participants in the scheme include counsellors and mental health specialists, GPs and voluntary organisations in the area.

Many thousands of self-help books exist and while the best of these are highly effective, others are not so useful. Psychologists, counsellors and psychotherapists working in Ireland were surveyed to discover which self-help books they would personally recommend.

Books used in schemes in Wales were also considered. A list of highly recommended books was then compiled and stocks of all these books were placed in the Central Library (Ilac Centre) and the Branch Libraries across the North Inner City.

How the scheme works

GPs and other professionals (such as psychologists and counsellors) have been sent the list of the self-help books recommended by specialists and invited to issue an appropriate‘ Book Prescription’ to patients in their care. The prescription entitles the patient to take out library membership free of charge and specifies the length of time for which the book can be borrowed. This will normally be between 4 and 8 weeks, and therefore exceeds the standard time for a library loan. The patient (who does not need to be a current holder of a library membership card) can extend the borrowing time, if necessary, by requesting a renewal from the library.

Many of the most effective books present self-help versions of the kind of therapy that would be given by a psychologist or counsellor. In many cases they present complete step-by-step treatment programmes with exercises, self-assessments, diary sheets, etc. to be completed by the reader. Of course, those who use a prescribed library book should make their own copy of exercises and not write on the book.

The scheme includes books on many of the common emotional problems that people experience, including depression, eating disorders, obsessional-compulsive problems, social phobia, panic, anger, stress, low self-esteem and the aftermath of sexual abuse.

Some people might wish to buy the prescribed book for themselves, and all of the books are currently in print. Many are normally in stock in leading bookshops such as Eason’s. Any books that are not in stock will be available to order.

The book prescription scheme offers an additional source of help for people experiencing emotional problems. A self-help book can be used in addition to any medication that has been prescribed or while the patient is waiting to see a counsellor or mental health specialist. Of course this approach will not be suitable for everyone, and will not always be effective. But there is now good evidence to show that... Books can (often) help

Books can help overcome emotional problems. Talk to your G.P. about the North Inner City Book Prescription Scheme.

• There is good evidence that the best self help books can be highly effective in helping people with emotional problems
• The use of self-help books is known as ‘bibliotherapy’
• The North Inner City Book Prescription Scheme allows GPs and others to prescribe high quality self-help books from a list of books recommended by psychologists, counsellors and psychotherapists in recent surveys
• Many therapists 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 help, or in addition to prescribed medication or counselling
• Most of the books included in the scheme are written by leading psychologists and many present self-help versions of established treatment programmes
• Problems addressed by the books in the scheme include depression, panic, stress, anger, low self-esteem, eating disorders, obsessional-compulsive problems, social anxiety, the aftermath of sexual abuse as well as parenting difficulties

Acknowledgement to Prof. Neil Frude of the Cardiff & Vale NHS Trust.

The North Inner City Book Prescription Scheme is a collaboration between the HSE North Inner City Partnership in Primary Care and Dublin City Public Libraries.