'Smartphone therapy' for children with depression

Children as young as five should be treated for depression using smartphone therapy, NHS watchdogs have ruled.

The new advice from the National Institute for Health and Care Excellence (Nice) says all children and young people suffering from mild depression should be offered “cognitive behavioural therapy” - delivered via mobile phones and tablets.

The guidance, for identifying and managing depression in children and young people aged five to 18, says online therapy and courses in mindfulness should be the first options for treatment of mild cases.

Nice said the programmes meant children could get faster access to psychological help, avoiding long waiting lists.

GPs will be able to recommend digital CBT programmes, which can be accessed via smartphones, computers and tablets.

Such programmes use interactive games, animations, quizzes, puzzles and interactive games, with questions to identify dysfunctional thinking and tasks to help challenge negative thoughts.

Other modules look at developing coping strategies, setting goals and finding ways to improve self esteem.

Some programmes alert children identified as having potentially suicidal thoughts to go back to their doctor or counsellor for more help.

The new guidance also recommends group cognitive behavioural therapy, and group sessions of mindfulness training as first-line treatments.

Nice said that these, along with digital options, should be offered by GPs and other health professionals if children had continuing symptoms of mild depression, but did not have suicidal thoughts or other significant health conditions.

Children should be given a choice of treatments, officials said.

And Nice said healthcare professionals working in schools as well as at GP practices should be trained to detect symptoms of depression in children as young as five.

The guidance has been fast-tracked amid warnings that the NHS has been left “picking up the pieces” of an epidemic of mental health problems, fuelled by social media.

Official NHS statistics suggest that almost 13 per cent of five to 19-year-olds are suffering from a mental health disorder, along with almost six per cent of pre-school children.

A third of girls and nearly a quarter of boys with mental health disorders were found to spend more than four hours a day on social media. This compared to 12 per cent of other children.

But Nice said there was growing evidence that smartphones, tablets and computers could also be used to help children struggling with depression.

Paul Chrisp, director of the Centre for Guidelines at Nice, said: “We want to ensure children are offered a range of therapies to suit their needs and individual preferences are placed at the heart of their care. The evidence showed digital CBT and group therapy were most effective at reducing depressive symptoms and we have recommend these as first-line options for children and young people with mild depression.”

Claire Murdoch, NHS England’s national mental health director said: "Given how quickly technology is constantly evolving and the fact that young people are usually at the forefront of this change, updating this draft guidance is another step forward. Digital and online interventions can play an effective and important role in treatment, particularly when backed up by face to face support.”

Earlier this month the first UK giudance for parents said children should not be allowed to use screens for an hour before bedtime.

The Royal College of Paediatrics and Child Health said there was no safe amount of total daily screen time, but urged parents to show “tough love” in setting age-appropriate limits.

In particular, the advice says parents should take firm action if time on smartphones and videogames is “displacing” other activities - such as sleep, exercise and face-to-face socialising.

And its experts urged parents to “practise what they preach” - and spend less time of their leisure time glued to tablets and phones.