UKCP campaign urging NICE to update outdated anxiety guideline

We support UKCP with its campaign calling for the National Institute for Health and Care Excellence (NICE) to urgently update its anxiety guideline. We have signed the joint statement that UKCP are sending to NICE.

 

The current guideline for Generalised Anxiety Disorder and Panic Disorder in Adults was first published in 2011 and has not been meaningfully updated for over a decade. In that time, major developments have been made in mental health treatment, but these have not been reflected in NICE’s recommendations.

Meanwhile, the NICE depression guideline was comprehensively updated in 2022, introducing clearer clinical guidance, expanded patient choice, and a more collaborative approach. The anxiety guideline, by contrast, remains out of date, restrictive, and inconsistent with both modern practice and NICE’s own depression guideline.

(NICE guidelines apply to England and Wales. The equivalent in Scotland is SIGN. In practice, some NICE guidelines are used in Scotland.)

 

Why this matters

Anxiety is one of the most common mental health issues in the UK.

• According to the Mental Health Foundation, 60% of UK adults experienced anxiety that interfered with their daily lives over a two-week period in 2023.
• In 2022–23, NHS Talking Therapies received nearly 500,000 complaints relating to anxiety or stress, with more than 250,000 cases of generalised anxiety disorder recorded.

The outdated NICE guideline is having a direct impact on patients and services. Among the key problems identified are:

• Lack of patient choice – the guideline effectively limits therapy options to CBT or applied relaxation.
• Exclusion of evidence – NICE’s evidence review applies inconsistent standards, misclassifies therapies, and over-relies on randomised controlled trials, while ignoring service-user perspectives, practice-based evidence, and long-term studies.
• Barriers to access – the guideline fails to account for the needs of marginalised groups, unlike the updated depression guideline.
• Contradictory recommendations – the anxiety and depression guidelines conflict on how comorbid anxiety and depression should be treated.

 

What the campaign is calling for

UKCP are calling for NICE to:

1. Meet with key stakeholders from the coalition to discuss the concerns raised by the campaign and agree on next steps.
2. Conduct a multistep review of the whole guideline that includes a representative range of stakeholders and evidence.
3. Make changes to the guideline so that it is up to the standard of the depression guideline.

We believe that patient choice and access to a full range of talking therapies are fundamental to effective mental health care. NICE must ensure its guidelines reflect the realities of practice and the needs of those experiencing anxiety.

 

Read More

Read more on the UKCP website.