Reading Well – Books on Prescription Evaluation
(Final)
1.
Introduction
1.1
The Reading Well Books on Prescription scheme is delivered by the Reading Agency in
partnership with the Society of Chief Librarians and forms part of the Society of Chief
Librarian’s universal health offer. It aims at helping individuals manage their mental health
and wellbeing by the use of self-help reading. The scheme launched in 2013 with a focus
on common mental health problems including anxiety and depression. The 30 books which
make up the booklist are supported by national bodies including the Department of Health,
Royal College of General Practitioners, Royal College of Psychiatrists, Royal college of
Nursing, British Association for behavioural and cognitive psychotherapists, The British
Psychological Society and MIND.
1.2
The latest Reading Well booklist for 2015 focussing on dementia was nationally launched in
January. The core booklist consists of 25 titles which are endorsed by the appropriate
professional bodies. The books are aimed at those diagnosed with dementia, their carers,
people worried about symptoms and those wanting to find out more about the condition.
1.3
In 2016 the topic for the booklist will be children’s and young people mental health, and in
2017 the topic will be long-term conditions.
1.4
There is evidence from the National Institute for Health and Clinical Excellence (NICE) that
self-help books can help people understand and manage common conditions, including
depression and anxiety. Supporting Reading Well is one way in which Public Health has
supported public mental health which is one of the responsibilities passed to the local
authorities by the Health and Social Care Act 2012.
2.
Background
2.1
Public health supported the purchase of 57 copies of each of the titles in the Reading Well
– Books on Prescription scheme. This has ensured that a copy is available in all of the
Devon libraries including the four mobile services and the three prisons of Exeter,
Channings Wood and Dartmoor. Some titles are also available as ebooks.
2.2
The scheme was launched in 2013 and when nationally evaluated in 2014* it had reached
approximately 275,000 people, (0.7% of the adult population of England).
 91% said the book they had read had been helpful
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79% said it had helped them understand more about their condition
73% said it had helped them feel more confident about managing their symptoms
37% said that their symptoms had reduced or got better
2.3
Just over half (54%) of the people borrowing the books dipped into the relevant sections of
the book with just under half (46%) reading the entire book.
2.4
Local evaluation was completed to assess where the scheme was reaching the targeted
groups of people with common mental health condition.
3.
Evaluation
3.1
The ‘inverse care rule’ where availability of services tends to vary inversely to the needs of
the population often leads to new or additional services being used, but not necessarily by
the groups that the service was intended to be provided for. It is extremely important for
public health that health inequalities are reduced and that services reach those with
greatest need. To understand whether the read well scheme was reaching those for whom
it was intended an evaluation was carried out comparing available data.
3.2
The quality outcome framework (QoF) includes an indicator of depression prevalence which
was used as a comparator to the loans data. Devon County has eight districts and at this
level there was a small correlation between areas of higher level of depression and uptake
of the loan scheme. This was a promising finding although at this level (district population) it
is not sufficiently sensitive to identify which groups are using the read well scheme.
3.3
Further analysis on this data was therefore undertaken at individual borrower postcode
level with the population being divided into quintiles by deprivation. The expected
prevalence of common mental health conditions amongst the most deprived groups is
higher than for the least deprived groups, and it was hoped that the correlation of book
loans seen at a district level would be seen at this population level.
3.4
At this individual level the results showed that the Reading Well scheme was reaching
across all quintiles of deprivation with the book loan rate (shown in Table 1) being slightly
higher in the more deprived quintiles. This provides evidence that the scheme is reaching
the target population groups.
4.
Results
4.1
Table 1: Loans by Population Communities (in quintiles)
Read well loans by IMD Quintile compared to Devon population
40.0%
% of read well loans
% of Devon adult population
35.0%
30.0%
25.0%
20.0%
15.0%
10.0%
5.0%
4.3% 4.8%
20.9% 18.3%
36.2% 36.5%
30.8% 30.4%
7.8% 10.0%
Q1 - Most Deprived
Q2 - Above Average
Q3 - Average
Q4 - Below Average
Q5 - Least Deprived
0.0%
4.2
There have been over 4000 loans of the books within Devon with the most frequently
loaned titles being.
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Overcoming anxiety: a self-help guide
Feel the fear and do it anyway
Overcoming low self-esteem: a self-help guide us
Overcoming anxiety, stress and panic; a five areas
Overcoming depression and low mood: a five areas
Overcoming insomnia and sleep problems : a self -help
4.3
The loan figures only include those people who borrowed the book from their library. It is
likely that there will be a cohort of individuals who purchase the book when recommended it
by their GP.
4.4
The loan figures do not distinguish between individuals who are referred to the scheme by
a practitioner and those who see the books when visiting the libraries.
5.
Conclusions
5.1
Initial evaluation suggests that working in partnership with the libraries is an effective
delivery model to reaches all groups of the population including those in lower
socioeconomic groups.
5.2
The scheme encourages a self-care, non-medical intervention which has been nationally
evaluated.
5.3
Both nationally and locally the scheme is supported by prescribers (GPs)
5.4
There is reasonable evidence that the scheme reaches those where the prevalence of
mental ill health is higher.
6.
Recommendations
6.1
There remains varying levels of update across the county and this needs to be understood.
Promotion of the scheme could be encouraged in areas with lower than anticipated loan
rates.
6.2
In supporting the dementia booklist roll out, there should be promotion targeted at areas
with known higher prevalence of dementia.
6.3
The scheme should be integrated into a range of pathways e.g. whilst waiting for an initial
Improving access to psychological therapies (IAPT) appointment.
Tracey Polak
CONSULTANT/ASSISTANT DIRECTOR OF PUBLIC HEALTH
August 2015