The news from NHS Quality Improvement Scotland that anti-depressants are being prescribed at a far higher rate than previously should come as no surprise (Prozac Nation: alarm at huge rise in anti-depressant use, November 9). For many people with the depression and other mental health problems that affect about one in four of us, pills are the only option.

This is despite the fact that current clinical guidelines recommend talking therapies as the first line of treatment for most cases of depression. Research from the Mental Health Foundation and others has also demonstrated the positive effects of exercise, arts therapies and improved diet on mental wellbeing. It's time people had ready access to these treatment options alongside drug therapy, which may, of course, be needed in some cases.

The government has given promising indications that it understands the importance of these issues, in particular through the implementation of its Delivering for Mental Health strategy and the recent review of the role of mental-health nurses. However, far more needs to be done if the government is to reach its own target of reducing the yearly increase in anti-depressant use to zero by 2009/10. A financial commitment to improving access to talking therapies, such as that seen south of the border recently, would be the best sign yet that the government is serious about giving the public - and mental-health practitioners - more options.

Isabella Goldie, Head of Mental Health Programmes Scotland, Mental Health Foundation, 30 George Square, Glasgow.

THERE should be no surprise at the increase in prescribed anti-depressants. We have, after all, been running an extremely good mental health and wellbeing programme for some years and such programmes tend to give people the awareness to seek medical help for the condition that a particular health initiative highlights. Plus, the World Health Organisation predicts that by 2020 depression will be the second most debilitating and life-threatening condition next to heart disease.

As a society we are rather casual and perhaps flippant as to the effect drinking or drug-taking has on our mental health and it is well known medically that both cause depression and psychosis. Depression is a complicated condition and its triggers are just as complex. Without doubt, social deprivation is a massive contributing factor but it should not be forgotten that depression affects all areas of society as well as being a side-effect symptom of many physical illnesses/conditions such as Parkinson's or MS etc. Regardless of social status, the suffering depression causes and its inherent life-threatening dangers must never be underestimated or belittled.

Along with eating healthily, exercise and holistic treatments, cognitive behaviour therapy and talking therapies are recognised as key components in helping with mental distress, as is medication if it is thought it would be beneficial. The reality is that there is such a shortage of psychologists and counsellors that in some areas it may take 18 months to get an appointment. In no other area of medicine would waiting times such as these have been tolerated and it is an issue that should have been addressed much earlier than it was.

Until we have a counsellor/psychologist assigned to each GP practice for such time-consuming treatments, it should be no wonder that our already overstretched GPs have no alternative but to reach for the prescription pad in order to relieve their patients' immediate mental suffering.

Jean Johnston, Brincliffe, West Dhuhill Drive, Helensburgh.