Depression and anxiety are common mental health problems affecting around one in six adults. Treatments include therapy, telephone or group-based activities delivered by therapists. Currently, treatment uses a “stepped care” model, where most patients start with very brief treatments. If they remain unwell after this, they access longer and more intensive therapy. This model does not always work, as only one out of two patients fully recover.

We have used artificial intelligence to develop a tool called “StratCare”. It is a computerised system that guides therapists on how to assess each patient and offer the best available treatment. It asks a few questions about their symptoms, personality, and background, then makes a recommendation about which treatment might be most effective for that person. This is either starting with brief therapy or starting with intensive therapy. The treatments are already used with depression in the NHS. The patient can discuss with their therapist and decide whether to accept the recommendation or consider other options. The first StratCare study found that StratCare can help more people to recover from depression compared to the usual stepped care model.

In the StratCare-2 study, we will investigate if the StratCare tool works on a large scale in the NHS and if it helps patients in the long-term. We will run a trial with a recruitment target of 1252 patients using NHS Talking Therapies services. Half will use the StratCare tool to make a treatment recommendation, and the other half will follow the stepped care approach. We will contact patients in the trial after 6, 12 and 18 months to see if their mood and quality of life has improved. We will also interview therapists and patients to see what they think about treatment being guided by the StratCare tool.

The study is led and managed by the Clinical Trials Research Unit at the University of Sheffield

The study is sponsored by Rotherham, Doncaster and South Humber NHS Foundation Trust (RDaSH)

We are aiming to recruit 1,252 participants across 16 Talking Therapies teams in England

This study is funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme.

Screening and Enrolment

Computer-Guided Treatment Recommendation

Follow-up Questionnaires

Participants are helping us to learn which method makes better treatment recommendations. This will help patients using Talking Therapies services in the future. Some participants may receive a treatment recommendation based on prior research, which might benefit some patients by helping them decide on what treatment is right for them. Some patients will not receive a treatment recommendation, and might benefit from the usual procedures at Talking Therapies to select treatment.

We do not expect that taking part in the trial will lead to any significant disadvantages or risks to any patients. The only difference between the methods is that the StratCare method uses a computer programme to recommend a treatment. All participants are offered an appropriate treatment option available in the Talking Therapies service, and will talk through current waiting times which might change depending on the treatment selected. The therapist discusses the options with participants to jointly select a treatment.