Clinical Practice Guidelines in Mental Health. a Guide to their use in Improving Care Paula Whitty, Martin Eccles (eds) Oxford: Radcliffe, 2004, £24.95 pb, 128 pp. ISBN: 1-85775-837-4

This is a book stimulated as much as anything by the emergence of National Institute for Clinical Excellence (NICE) guidelines into the mental health arena. Formal National Health Service (NHS) guidelines concerning the induction of labour, electronic foetal monitoring and management of post-myocardial infarction have all been in circulation since early 2001. Published guidelines that refer to mental health are more recent: for the management of schizophrenia in December 2002, eating disorders in January 2004, self-harm in July 2004, anxiety and depression in December 2004, and violence in February 2005.

The book reviews the topic from several perspectives, including discussions of guideline development, the legal status of clinical practice guidelines, the activities of the mental health technology appraisal and clinical guidelines programmes of NICE and of the National Collaborating Centre for Mental Health. There is also useful coverage of the tensions between a healthcare management system, such as the NHS, and the perspective of an individual practitioner encountering a unique and individual patient. There are useful discussions of the use of mental health guidelines in the NHS from the point of view of the specialist mental health trust, and from the point of view of primary care. There is an appendix that outlines completed NICE mental health technology appraisals and guidelines, but sadly this is already significantly out of date.

It is a readable paperback. The authors have all made significant contributions to one aspect of guideline development or another and write with authority. The result is a helpful contribution that sets clinical guidelines in an appropriate context; neither explicit prescriptions for application within a particular service organisation nor simply central managerial control over clinical practice; instead an honest attempt to assemble and assess the quality of available evidence and base recommendations upon it. This is as valuable a contribution to mental health practice as it is in any other area. Mental health services are notoriously variable, idiosyncratic and all too frequently based upon opinion rather than evidence. A series of guidelines that oblige practitioners of all persuasions, service managers and commissioners to acknowledge and respect a common evidence base cannot but improve upon this. This book is an effective way of communicating these values.