Behavioural and Cognitive Psychotherapy, 2006, 34, 165–177
Printed in the United Kingdom doi:10.1017/S1352465805002663
Can Large-Scale Self-Referral Psycho-Educational Stress
Workshops Help Improve the Psychological Health of the
Population?
June S.L. Brown and Sandra A. Elliott
Institute of Psychiatry, University of London, UK
Clare Butler
South London and Maudsley Trust, London, UK
Abstract. Improving the long-term psychological health of the population is an ambitious but
consistent goal in the National Service Framework for Mental Health (MHNSF). Large-scale
self-referral psycho-educational Stress workshops, run in one geographical area for members
of the general public, had been shown to be effective and to reach those who had not consulted
their GPs about their stress problems. A key aim of this study was to explore whether this
workshop format, which may help achieve the MHNSF goal, can be generalizable to other
areas of differing deprivation. We compared outcome and levels of take-up of Stress workshops
run in three geographical areas, differing in degrees of deprivation, as well as characteristics
of self-referrers, including baseline scores, sociodemographic details and treatment-seeking
patterns. In all three areas, experimental group participants showed less anxiety, stress and
distress at 3-month follow-up compared to waiting list control group participants, with no
geographical differences in effectiveness. No differences in initial stress and anxiety scores
were found. GP consultation rates varied between 50–72%, with the highest consultation rates
in the most deprived area. Surprisingly, enquiries about workshops correlated negatively with
area deprivation indices. Some sociodemographic differences were found. A certain amount
of self-selection for these workshops seems to have occurred; this may be a function of help-
seeking for psychological help in deprived areas being different to that in less deprived areas.
Nevertheless, large-scale Stress workshops have been found to be equally effective for those
who self-referred in areas differing in deprivation, reaching people with stress problems who
may not have consulted their GPs. While they did not reach all groups of people, they may
have the potential to help improve the psychological health of the population.
Keywords: Self-referral, psycho-educational, Stress, public mental health, access, anxiety.
Introduction
A major goal in The National Service Framework for Mental Health (MHNSF) (Department of
Health 1999), a key Government document, is that there should be “a long term improvement in
Reprint requests to June Brown, Psychology Department (PO77), Institute of Psychiatry, De Crespigny Park, London
SE5 8AF, UK. E-mail: june.brown@iop.kcl.ac.uk
© 2005 British Association for Behavioural and Cognitive Psychotherapies