If some commentators are to be believed, the UK is in the grip of a disabling and pervasive epidemic of sadness. The high prevalence of anxiety and depression is said to be sapping both individual morale and the economic lifeblood of the country. So what is to be done about this?

‘More therapy,’ has been the cry. If only we could all talk about it more. If only the NHS would prescribe more psychological therapy, the individual and economic benefits would be enormous. For most people in distress, effective talking treatments languish behind impenetrable barriers, suitability checks and service opt-ins. As Lord Richard Layard has pointed out, both the Exchequer and the benefits system pick up the resulting bill.

In response to public disquiet about other areas of the public services, Labour has adopted a reformist, modernising approach, releasing new resources only if they are accompanied by radical service innovations. The police service and traffic management are examples where, rather than employ just a few more traditional workers, new support officers have been developed and deployed in far greater numbers.

These workers are now undertaking activities previously carried out by traditional public service professions – activities which in the past have been thought to be at the core of traditional professional identities. Often implemented against considerable reservations from traditional professional elites, they are now an accepted part of public service delivery, highly popular with the public and a resounding success.

Given the well articulated economic arguments, Labour established a commitment to improve access to psychological therapies in its 2005 election manifesto. It subsequently established two demonstration ‘Layard’ sites. In Newham, a specialist model ensures patients are seen by highly trained elite professionals. In contrast, in Doncaster, the site has been structured explicitly around a reformist platform. At the heart of the Doncaster model are 20 ‘case managers’ – para-professional workers recruited from outside traditional mental health professional elites, and carefully trained to deliver low-intensity psychological therapies and medication management to large volumes of people. They are the community support officers of psychological therapies.

In Doncaster, anxious and depressed people are telephoned by a case manager within 24 hours of seeking help. Each case manager supports 75 patients at any one time through a personalised recovery programme based on guided self-management. If needed, specialist therapists are at hand to assist with more difficult problems.

Treatment is quick and convenient for patients, with 75 per cent of it delivered on the telephone. These workers were recruited from their own communities, working with the community and for the community – a fine example of implementing Labour’s commitment to tackling health inequalities. Within six months of starting work, case managers had provided a new service to more than 2000 Doncaster residents.

As has been observed in other theatres of reform, professional attitudes to these new workers have varied from welcoming to outright hostility. Quality and competence has been confused with traditional professional education and lengthy clinical experience. Actually, people want help which is convenient, acknowledges their own strengths and is culturally appropriate. They also want help when they ask for it, not at some unspecified time in the future. For most people, quality is not access to a specific professional. Quality is sensitive, informed support.

The belief that psychological therapy is only safe in the hands of established professional elites flies in the face of the broader public sector reform movement. The drive behind reform in all other areas has been to improve the quality of core services such as policing, traffic support and teaching, through greater visibility or public access. The time has now come to continue Labour’s progressive approach to social renewal, by confirming these non-traditional workers in psychological therapies as a major national resource to improve the mental health of the UK.

In facing up to the massive personal and economic burden of depression and anxiety, Labour faces a choice. It is a choice between significant investment in a traditional system merely to perpetuate existing inequalities, versus investment in a system which will challenge health inequalities in people’s own communities. It is a choice between investment in a system which has failed us in the past, versus investment in change. It is a choice between investment without reform, versus investment in reform. Case managers – the community support officers of psychological therapy – are the progressive, reform-minded solution to this choice.