Nottingham Specialist Depression Service

This service aims to treat depression that has not improved with previous help. We use a combined approach from psychiatrists and psychotherapists. This is the most helpful way to improve someone's mood. We will work with other mental health problems if depression is the main focus. Individuals accessing the service need to be open to specialist mental health services and a local mental health team.

Accessing our service

  • Depression needs to be the main problem.
  • You will only be assessed by the service if you are referred by a professional.
  • Referrals are mostly within Nottinghamshire Healthcare Trust.
  • Funded placements can be arranged for patients not currently being treated within Nottinghamshire Healthcare Trust.
  • You must be over 18 to be referred to the service.

Help in a crisis

Contact the duty service at your community mental health team or crisis team. 

Outside of office hours please contact your GP service, NHS 111, or in an emergency attend your local Accident and Emergency (A&E) department.

Information for health professionals

Referral Criteria

  • Main current problem is depression of at least 6 months duration where key features in the clinical presentation are one or more of the below mentioned:
  • Persistent depression despite a period of treatment in secondary care
  • Recurrent depressive episodes
  • Bipolar with depression as the major problem will also be considered
  • A review of pharmacological treatments has taken place in the LMHT by a Consultant Psychiatrist with consideration given to next step pharmacological strategies (including combination and augmentation).   
  • To have been considered and received psychological interventions in primary care e.g., Improving Access to Psychological Therapies (IAPT) or local mental health team (LMHT) e.g., Nurse Led Clinic; Step 4 Psychology, mindfulness, group work etc
  • A diagnosis of bi-polar disorder will be considered for assessment if the current problem is depression and the referrer believes the depression pathway is the most appropriate route to follow.
  • The person must remain open to the LMHT throughout the patient’s time in the Specialist Depression Service as they may require additional intervention best provided by the LMHT. The NSDS is a small service, and we cannot provide Crisis or duty support, which must be provided by the LMHT and crisis resolution and home treatment team (CRHT).
  • Referrals will be considered from peri-natal care and in-patient care, provided that they are being transferred or are already under a LMHT, the LMHT are in agreement with the referral, are happy to provide duty/crisis care and all core assessments have been completed.


Assessment Pathway

Once a person has been accepted for an assessment/ consultation process, they will usually be offered a series of appointments; initially jointly and then individually, with an accredited cognitive behavioural psychotherapist and a psychiatrist. At the conclusion of the assessment there will be a joint meeting to agree formulation and diagnosis; and to confirm whether any treatment will be offered. Owing to limited capacity within the NSDS, it may at times, be necessary to defer any offered treatment but this will be communicated to the referring team.

The referring team will receive communication from the NSDS throughout any assessment and subsequent treatment periods (and progress notes will be available through Rio). As above, it will remain essential throughout all involvement with the NSDS that the person is kept open to the referring team with an agreement to routine care, when necessary, at the end of treatment.


Referrals for Second Opinion from Medic only with advice and or consultation

These referrals may be sent directly to the consultant psychiatrist, (Dr Nixon) and may be for direct advice to the referrer, to offer a one-off consultation or a series of consultation’s, following which they will be passed back to the referrer.

These referrals do not need to follow the same criteria as those being referred into treatment. Referrals will therefore be considered from any team within the trust.

If, following the consultation period it is felt by the consultant psychiatrist and referrer that collaborative treatment (including psychiatry and CBT) under NSDS might be beneficial, then this would require further discussion and agreement at the Team referral meeting with reference to the general referral criteria specified above.  


Out of Area Assessments

The NSDS offers out-of-area assessment and treatment where there is local secondary care support and funding agreement with the local CCG. Any referrals received will be expected to meet the same criteria as those for local referral and acceptance will need to be agreed through the NSDS Team.



If you have any queries regarding the Nottingham Specialist Depression Service or referral pathway, please contact

Clinical Lead, Kathryn Reeveley-King
Consultant Psychiatrist, Dr Neil Nixon


Tel: 0115 844 0547 

St Ann’s House
114 Thorneywood Mount



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