Acupuncture as treatment for depression in primary care: current position and future hopes Carolin Hagelskamp MSC Amy Scammell MA Battersea Research Group, Bolingbroke Hospital, London, UK Shun Au The Whole Clinic, Leytonstone, London, UK Gerard Leavey R&D Department, Barnet, Enfield and Haringey Mental Health Trust, St Ann’s Hospital, London, UK Introduction In recent years in the UK, there has been a consider- able increase in the popularity and use of comple- mentary and alternative medicine (CAM) amongst the general public. It has been reported that 25% of the British population has used some form of CAM and as many as 80% of users of CAM therapies were satisfied with the services compared to 60% with ‘orthodox medicine’. 1 Vincent and Furnham cite patients’ per- ceptionof‘failure’ofWesternmedicineasoftenbeing the strongest motive for those seeking CAM, and a positive experience with CAM as encouraging users to continue with it. 2 Users of alternative medicine are said to prefer CAM’s holistic approach to health with its emphasis on well-being, and the full attention and commitment of the practitioner. In addition many CAM users also like the active part they play in choos- ing an alternative therapy. 1 Interestingly though, the enthusiasm for CAM is gaining in popularity not just with the public but also within the medical commu- nity itself. Recent studies report that 65% of British hospital doctors believe that CAM has a place in main- stream medicine. Moreover 93% of British general practitioners (GPs) have suggested a referral to CAM, and two out of three local authorities are purchasing at least one form of CAM. 3,4 These figures illustrate that CAM is making increasing inroads within main- stream health service provision. However, there are considerable obstacles that CAM must overcome if it is to become more integrated into traditional medical practice in the UK. Clinicians within the NHS and central government strongly emphasise the need to develop a sound clinical evi- dence base for different types of CAM in relation to particular illnesses, disorders and problems and the need to improve professional organisation of CAM therapies and practitioners. 5,6 While these are longer- term goals they are not insurmountable and should help CAM gain greater acceptance in mainstream medicine. The government is thus encouraging re- search and development (R&D) within CAM. In June 2002, the National Co-ordinating Centre for Research Capacity Development (NCC RCD) at the Department of Health and Social Care (DHSC) invited expressions of interest from higher education institutions in host- ing CAM R&D. In addition, funding has been made available to support post-doctoral and doctoral CAM R&D at successful host sites. Other agencies includ- ing the Foundation of Integrated Medicine and Mind and the Mental Health Foundation, for example, have welcomed these developments and support the need to address issues of underfunding, lack of networks, infrastructure and training, and the need to develop rigorous methodologies, to change orthodox attitudes and to investigate CAM philosophies. 7,8 While there are many different forms of CAM, the main therapies have been cited as acupuncture, homeopathy, herbal medicine and osteopathy. 9 The DHSC has prioritised acupuncture and herbal medicine in the creation of clinical governance and research infrastructure, as these therapies and attached research are relatively advanced in other Western countries and in China. While the authors welcome these moves, we also feel that there is a need to support the development 14 Invited Review Primary Care Mental Health (2002) 1: 000–000 & 2003 Radcliffe Medical Press