NICE Guidelines there 2005, 2013, 2015

In the UK the National Institute for Health and Care Excellence (NICE) had published guidelines in 2005 for the treatment of depression in young people. These guidelines were updated in 2013 and 2015. After an assessment, if a young person is diagnosed with depression they should be offered therapy. This would usually consist of Cognitive Behaviour Therapy (CBT), Family Therapy or Interpersonal Therapy (IPT). In practise, there is usually a delay of several months for most young people before they can access therapy. 2-3% of all young people/adolescents aged 13-18 years experience depression that would be diagnosed as a moderate or severe depressive episode. Sometimes young people can be diagnosed with dysthymia and a depressive episode. In the USA this might be referred to as double depression. In these situations young people would report feeling depressed for a year or two and would have another episode of a worsening low for a fortnight or more before assessment.

In 2005, the NICE guidelines advised that a young person had therapy by talking for at least 3 months. At that point, if they were still not better then they could be considered for medication by a doctor. In practice, too many young people were left without care prior to seeing a therapist and there would have been many cases of prescribing antidepressant medication before the 3 month mark if young people were regarded as severely depressed.

In 2013, there was a guideline update in which the diagnosis of depression would have to be stated explicitly in the notes and, wherever possible, parents should be involved in the treatment plan. In the recent guidance update of 2015, teams are allowed to prescribe the anti-depressant medication Fluoxetine in the first instance with therapy at the same time. In practice, in the UK for many young people there would still be a delay in starting talking therapy.

In the world of the 3% of young people who have moderate or severe depression, only 25-40% will actually receive any help. Therefore, we need to figure out how to get help to young people more effectively. Online materials may be a way to do this; e.g. at Hertfordshire Foundation NHS Trust they have published a CBT workbook for Depression and Anxiety (PDF).

There are other online materials that are useful. Also, there are useful free apps such as "stayalive" and "mindshift", which can help a young person manage their feelings and crises more effectively. If a young person can engage well in treatment in the first 4-6 weeks they will usually make a good recovery.

In the UK, we definitely need more staff to support young people with depression. We need to help young people get into treatment quickly, without delay.

For details of these NICE guidelines for Depression In Young People check out

Blog Audience: 

Add new comment