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Evidence based practice in mental health

BMJ 1997; 315 doi: (Published 06 December 1997) Cite this as: BMJ 1997;315:1483

New journal acknowledges an approach whose time has come

  1. John Geddes, Senior clinical research fellow (,
  2. Shirley Reynolds, Academic Course Organiserb,
  3. David Streiner, Professorc,
  4. Peter Szatmari, Professord
  1. a Centre for Evidence Based Mental Health, Department of Psychiatry, University of Oxford, Oxford OX3 7JX
  2. b Clinical Psychology Doctorate Programme, School of Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ
  3. c Departments of Clinical Epidemiology and Biostatistics and Psychiatry, McMaster University, Hamilton, Ontario, Canada
  4. d Department of Psychiatry, McMaster University and Center for the Study of Children at Risk, Hamilton, Ontario, Canada

    Why has it proved so difficult to narrow the gap between research and practice in psychiatry and mental health? The provision of mental health services is determined by many factors, including government policy, public demand, the behaviour of general practitioners and mental health professionals, and the financial pressures under which purchasers and providers of services work. These groups often have widely disparate views about the nature of mental disorder and the most appropriate services, and many forces exist to keep their views apart. Now is the time for a different approach based on the optimum application of the available evidence—heralded by the publication early next year of a new journal, Evidence- Based Mental Health. This approach will not provide easy answers and there will still be room for discussion about interpretation of even the very best evidence. Nevertheless, an approach that, firstly, acknowledges that mental health services should be fundamentally evidence based and, secondly, helps define what constitutes the best available evidence should clarify decision making.

    The …

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