Mood Clinic

The team offers outpatient hospital appointments in person, by phone or online, depending on preference. 

You can be referred if you have difficulties with mood like difficult to treat depression and:

• Have tried and completed some treatments for depression and have not got better (sometimes this might be because you haven’t found a treatment that works)
• Other mental health conditions are stable
• You’re willing to spend time answering questions about your condition and filling in assessment forms online.

We know that some people find it challenging to use online forms and we will try to help you to access the service in a way that suits. You can be accompanied by a friend or relative to appointments. If you’re more comfortable, or it fits better with your schedule and commitments, you can have appointments by phone or online. Let us know if you need help with an interpreter or filling in forms.

We ask you to complete a lot of online forms before you see one of the team because we want to hear your experience of living with your mood problems. This will help us investigate your symptoms, understand what treatments you’ve tried and what your preferences are when you have your appointment.

If you don’t know what to try next, we’ll offer advice and make suggestions for new treatments that you are happy to try. Recommendations will consider your previous experience of treatment and we’ll work with you to find a good balance between what you would prefer and your goals, to help you get well, along with the input of your GP or psychiatrist.

This clinic is new and different because it uses and tries new technologies for measuring how people’s mood changes over time. It also gives an opportunity to take part in research on new treatments. The clinic is deliberately designed to try to better understand mood problems and to personalise treatments to the person affected.

The clinic focuses on people’s mood symptoms and importantly, will not exclude people purely based on other diagnoses.

The clinic uses a wide variety of questionnaires to collect information about your mood, the impact that your mental health has on your quality of life and how any treatments you have had are working. You will be asked to complete questionnaires before your first appointment. This might seem like a burden but our approach is to have as much information available before you have your appointment, so we can use your time focusing on what to do next.   

Appointments are by referral only. If you live in Cheshire or Merseyside, ask your GP or psychiatrist if they would consider referring you via the referral page. 

Staff at the Mood Clinic

• Psychiatrists
• Nurses
• Pharmacists
• Clinic admin staff
• Mental health researchers

What is the Mood Clinic and why have I been referred?

Mood Clinic has been designed to fill a gap in NHS services for people who experience problems with their mood (often referred to as depression). The clinic is set up to provide a flexible way of accessing a specialist service when first line treatments appear to have not helped. 

Where is the Mood Clinic based?

Mood Clinic is based in Knowsley Resource and Recovery Centre on the Whiston Hospital site. View the full contact details and address to the right of this page.

What happens when I am referred to the Mood Clinic?

1) You will complete assessment information

Before you go to the clinic, you will be asked to complete a comprehensive assessment of your difficulties, symptoms, medical and treatment history – usually this will be a series of online forms and questionnaires. If you find completing these forms difficult, a member of the team can assist you and guide you through the process. We do this to ensure that face to face time with your clinician is not spent collecting data and filling in assessment forms.

2) We will review your assessment information

The Mood Clinic team will review all this information alongside any other medical records available to them. For example, the team might ask your GP for further information to complete any missing information. The team will decide who would be best suited to see you for an appointment.

3) Assessment meeting appointment

You will be offered an assessment meeting with an appropriate clinician – usually this will be someone who the team expect can most effectively help you, given their particular expertise.

4) First meeting

Before your first meeting, the clinician will have reviewed and summarised all the information you have provided before your appointment. The first meeting can then focus on discussing your goals and preferences for treatment. This meeting will be offered face to face or by video call, depending on your preferences and schedule.

5) Mood Clinic team review

After the first meeting, the Mood Clinic team will discuss your case.

If there is enough information to make a recommendation for treatment, this will be drawn up and discussed with other health care professionals for example, your GP, or community mental health team. You will then be invited for a further meeting (face to face, video call or phone) to discuss and prioritise the recommended treatment plan. For example, you may have a preference to try different parts of the recommended plan and these preferences will be given priority.

In some cases, we might need further assessments and investigations or tests. The team will discuss these with you and arrange further meetings as needed.

6) Further reviews by the team

We will repeat the process from Step 5 (above) until there is agreement and a recommendation for treatment.

7) Recommended treatments and interventions

Mood Clinic team will help organise treatments or interventions that have been recommended for you.

Who will make referrals to the clinic?

Clinicians from Mersey Care’s community mental health teams and services and GPs.

Which service users will be prioritised?

Mood Clinic is a new clinic so a small number of service users will be chosen to test the clinic’s processes and operations. These are service users already being treated by Mersey Care’s community mental health teams and services.

In the coming months, Mood Clinic will open to referrals more widely to service users from Mersey Care’s community mental health teams and services as well as some GP surgeries.

What’s the clinic core offer? How many appointments will there be?

The core offer is:

• A team assessment of a patient’s mood difficulties in terms of psychological, medical and social factors
• Treatment recommendations
• Organising and delivering any specialist treatments (depending on the person’s needs and the assessment conducted with them in the Mood Clinic).

All service users referred and accepted, will be offered at least one face to face appointment with a member of the clinical team. However, the number of appointments depends on the specific needs of individuals. As a result, there are no fixed number of appointments and delivering the recommended treatments might mean you remain with the clinic for some time, being reviewed and treatments modified, as we work together to get the best plan and treatment working for you.

What is innovative about the clinic?

Mood problems are often assumed to be best described as a diagnosis of depression. This diagnosis directs clinicians to follow the National Institute for Health and Care Excellence (NICE) guideline for treating depression. Very often, this treatment is directed by your GP. However, for some people, this approach doesn’t lead to improvement in their condition and it is difficult to know what to do next.

In these circumstances, patients should be able to access a specialist service, for example, be referred to a psychiatrist - this is currently difficult to achieve. 

There are a few clinical services that are set up for people with treatment refractory depression but they are not consistently available across England. In addition, the concept of treatment refractory depression tends to focus on whether medical treatments (such as medications) worked or didn’t help and these clinics usually focus on people with an existing diagnosis of depression or recurrent depression.

Recently, the concept of treatment refractory depression has been expanded to a newer, broader concept of difficult to treat depression (or DTD). Using this approach, we consider all factors (psychological, social or medical) that impact on someone’s mood and may be preventing them to get better, irrespective of their established diagnosis. 

For this reason, people seen in the Mood Clinic might be offered a range of treatment options to consider such as addressing social or personal problems, finding psychological or talking therapies that might help, or considering different medications. It all depends on what the assessment - using the DTD approach – reveals, alongside what the service user’s previous experiences and current treatment preferences are.

The Mood Clinic’s aims are to prevent people being “stuck” with mood difficulties that don’t improve and to make access to specialist assessment and treatment easier by removing barriers between primary and secondary care.

What’s the difference between a drop-in centre and the Mood Clinic?

Mood Clinic does not have a drop-in facility – it is appointment only and by referral from a health care professional.

The Mood Clinic collaborates with drop-in facilities operated by Mersey Care, for example, The Life Rooms.

What is the Mental Health Research for Innovation Centre and how is it involved in the Mood Clinic?

The Mental Health Research for Innovation Centre (M-RIC) is a partnership between Mersey Care NHS Foundation Trust and the University of Liverpool. It brings clinicians, academics, industry, service users and carers together to conduct meaningful research in NHS services so we can improve future services and treatments.

One of M-RIC’s research themes is mood disorder care innovations. As part of this theme, we’re trying to find new ways of understanding and treating mood disorders which include the new Mood Clinic.