When some British doctors see a patient with mild to moderate depression or anxiety, they pull out their pads and prescribe a self-help book.
Doctors say they began prescribing books out of concern that too many depressed people were either being medicated too hastily with antidepressant drugs like Prozac or going untreated.
The state-run health-care system here couldn't afford one-to-one counseling for everyone -- waiting lists can run up to 18 months -- leaving medication or no treatment the remaining options.
The programs, called "bibliotherapy" or "guided self-help," were endorsed by the National Institute for Clinical Excellence, a British health agency, in December.
The agency warned of "overuse" of antidepressants in patients with mild depression and recommended that doctors try guided self-help or other kinds of counseling before medication.
"Until recently the only thing available to a physician was to write a prescription for a drug.
What this does is give the physician two prescribing pads," says Neil Frude, a Cardiff University psychologist who started the self-help-book trend by setting up a program in Wales three years ago.
In nearly 100 physicians' offices in Devon, a county in southwest England, doctors now send mildly to moderately depressed patients down the hall to a mental-health worker, who tries to determine the core problem.
Sami Al-Haboubi, a 23-year-old mental-health worker in Devon, lets patients talk about what's troubling them and asks a list of 14 questions that help score the person's level of depression or anxiety.
The woman had struggled with depression, including suicidal thoughts, in her teens and had taken Prozac but says she didn't want to go on medication again for the panic attacks.
Mr. Al-Haboubi prescribed "Overcoming Anxiety" by Helen Kennerley.