In 2003 Kent County Council was one of the first library services in the country to set up a pilot bibliotherapy scheme in response to the Government’s drive towards closer partnership working in order to improve public health. A pioneering Book Prescription initiative had recently been developed in Cardiff by Dr. Neil Frude and had been well-received by patients and health professionals. His approach was based on sound clinical research and reflects the professional guidelines issued by NICE (the National Institute for Clinical Excellence) which recommends the use of self-help books to treat common psychological problems, particularly depression and anxiety. These disorders affect large numbers of the UK population, estimated at 10% or 15% at any one time. There is very limited specialist help available and front-line health services are unable to meet the demand for access to psychological therapy.

Kent is a large county of contrasting populations, including in its psychological morbidity. The eastern and coastal sections show high levels of health poverty in this respect, up to and including the highest national quintile (South East Public Health Observatory 2005). Health has been recorded as one of the most frequently used sections of non-fiction within Kent libraries and it represents a developing area of work.

This project contributes towards improving health and wellbeing and links closely with other health promotion work undertaken by Kent Libraries and Archives in partnership with other Kent County Council colleagues, voluntary organisations, Health Action teams and Primary Care Trusts.

Improved health and quality of life is one of the seven goals of Kent County Council listed in the ‘Towards 2010’ strategy document.

Existing local networks and personal contacts between professionals in libraries and health allowed Kent to make an early start on work, which has recently been spreading in varying forms across the country. The first links were set up with Primary Care Trusts (PCTs) in three districts: Ashford, Shepway and Dover. Twenty-one copies of each title, selected by practitioners, were purchased and added as collections to the stocks of participating libraries. Funding for “prescription pads” and information leaflets was obtained from the PCTs. The pilots were evaluated after a year, using feedback from users, health practitioners (referrers) and library staff.

Following this evaluation, the scheme was extended to 37 public libraries and 1 prison library, across every district of the county. In response to feedback, the referral form was redesigned and a Books Can Help bookmark was produced in partnership with the East Kent PCT. The scheme is directly promoted to health professionals and publicised in different ways in libraries, being featured in separate displays or as part of health promotion events.

National studies have shown that the use of self-help books is effective as a treatment option. A survey and informal feedback from partners have demonstrated that mental health professionals value Books Can Help. Issues of relevant titles can be tracked through the library service’s data management systems. All these measures show that users are enabled to make use of self help books provided by Books Can Help to aid their own recovery.

In addition the project resulted in:

• raised awareness of libraries’ contribution to the health agenda, both within the local authority and by partner organisations
• recognition of libraries as places within the local community that can host events and provide information on behalf of other agencies
• stronger links between professionals with shared priorities in terms of mental health promotion

• Kent Libraries and Archives
• Eastern and Coastal Kent Primary Care Trust
• West Kent Primary Care Trust

Key factors that helped make the project successful included:

• sustainability is key. It was built into the project from the start but is a constant issue in the current financial climate
• staff needed to be able to use their own creativity – flexibility is important, so that they can respond to local needs with local solutions
• the strength of the collections selected
• regular review and the capacity to respond to review findings
• embedding the scheme into the work programmes of the service
• a firm evidence base, to make the case for further development

Take a wider approach to book selection, particularly considering the views of users and the need for information in different media. Work with a wider range of partners, particularly voluntary groups and community organisations that share the same agenda.