Routine screening for bipolar disorder should be ingrained into the NHS, alongside specialist training to help identify the condition and reduce the average nine-and-a-half-year wait to get a diagnosis, experts say.
A report by the Bipolar Commission, which brings together academics and other experts in the field, also recommended appointing a national director of mood disorders to ensure everyone has access to a 12-week psychoeducation course, and a specialist doctor to oversee their prescriptions and ongoing care.
More than 1 million people in the UK are estimated to have bipolar disorder, which leads to extreme changes in mood and energy levels far beyond most people’s experiences of feeling happy or a bit down.
Yet many spend years chasing a diagnosis, or having been misdiagnosed with depression, meaning they cannot access key treatments such as lithium and lamotrigine that help to stabilise mood.
According to the report, which was based on an 18-month programme of interviews, surveys and desktop research, many people face a “dangerous” delay in getting diagnosed, with an average wait of nine and a half years.
During this time, just over one in three people claimed to have attempted suicide, while those who were misdiagnosed were also more likely to be repeatedly admitted to hospital, the report found.
Even once a diagnosis of bipolar disorder is made, the current way most patients are treated – where they are only referred to a psychiatrist if they become seriously unwell – is failing, says Prof Guy Goodwin, emeritus professor of psychiatry at the University of Oxford and co-chair of the commission.
“Psychiatric services see people when they are acutely ill … but, once recovered, people are discharged back to the care of their general practitioner. And that model we simply think doesn’t work,” Goodwin said.
The report called for an immediate restructure to address systemic flaws in the diagnosis and treatment of patients, including ingraining bipolar screening across GP- and hospital-led services and introducing specialist training to increase the accuracy of diagnosis. Once diagnosed, everyone with bipolar disorder should have access to psychological therapy as well as a specialist clinician to oversee their care.
Simon Kitchen, the chief executive of Bipolar UK, said: “Continuity of care is the bedrock of this model, with strong long-term relationships between individual clinicians and patients a critical factor.
“There are currently not enough specialists in bipolar in the UK, which means that the symptoms are often being missed. People living with bipolar have a suicide risk that’s 20 times higher than people without bipolar.
“Not only will these changes improve the quality of life for the million-plus people with bipolar in the UK, they will literally save lives.”
