Advertisement

NHS to prescribe 'app therapy' for children with mild depression

Children on phones
Under-18s will soon be able to access digital cognitive behavioural therapy via their phones. Photograph: Donald Iain Smith/Getty/Blend Images

Children as young as five will be able to get help for mild depression through apps on their smartphones after the NHS’s treatment advisers recommended the use of such devices in their care.

Under-18s in England and Wales will in future be able to use digital cognitive behavioural therapy (CBT) through mobile phones and computers to help them manage their feelings of low mood. It will help them avoid potentially long delays to see a therapist and reduce the pressure on NHS child and adolescent mental health services (CAMHS), according to new guidance by the National Institute for Health and Care Excellence (NICE).

While CBT is already routinely available to adults with some mental health problems, this is the first time NICE has recommended it as helpful for five-to-eight-year-olds. The institute advises the NHS what treatments are most clinically effective and represent the best value for money.

“Digital CBT is delivered on mobile phones, tablets or computers and can be made readily available, avoiding waiting lists and giving children and young people faster access to psychological help,” NICE said.

It should be used as a first-line treatment – something that doctors think of prescribing routinely – for that condition in that age group.

The agency made clear that “digital CBT can be offered to children or young people, aged five to 18, with continuing symptoms of mild depression who do not have other significant health conditions or suicidal thoughts”.

Its expert advisory panel has also recommended three other forms of treatment – group CBT, group interpersonal psychotherapy and group mindfulness – as also useful for the same age group.

“The evidence showed digital CBT and group therapy were most effective at reducing depressive symptoms and we have recommended these as first-line options for children and young people with mild depression,” said Paul Chrisp, director of NICE’s Centre for Guidelines.

The guidance outlines what factors health professionals should bear in mind when considering which of the four treatments to recommend.

“The child or young person’s history and circumstances should be considered, for example, their family context and how they may function at school. It is also important to consider the level of development and maturity of the child or young person receiving treatment,” NICE said.

Senior doctors welcomed NICE’s move. “This is a positive step and offers two clear advantages,” said Dr Max Davie, officer for health promotion at the Royal College of Paediatrics and Child Health. “Firstly, it will allow young people to access help more swiftly without having to go through conventional CAMHS pathways, and secondly, it is likely to prove beneficial to young people who find it hard to cope with treatment offered within clinic settings.”

But, Davie added, “there are question marks over how this can be made available via the NHS, so I look forward to hearing more detail in due course.”

Dr Bernadka Dubicka, chair of the child and adolescent faculty at the Royal College of Psychiatrists, said: “We know there is a huge demand for treatment, and digital CBT can be one option amongst others. Some young people may find this approach very helpful, but it is important that other options are available as some young people may prefer to have face-to-face treatment.”