When a child experiences depression or anxiety, it is a hugely worrying time for parents. Their first port of call will inevitably be their GP.
So it concerns me greatly to read the shocking new findings that more than 70,000 UK children were prescribed antidepressants last year, including nearly 20,000 of primary school age.
It’s estimated that 11 per cent of 18-24 years olds are taking prescribed drugs and in the last three years the steepest increase in antidepressant prescriptions is among those aged 12 years and under. Yet we do not know the harm they may wreak on developing brains and bodies
The elevated rate of antidepressant prescribing in children is concerning on many levels, but not least because The National Institute for Health and Clinical Excellence and the NHS website state that the use of antidepressants is only recommended under certain exceptions, namely after a failed response to talking therapies.
These are very high figures, unprecedented, and they demonstrate the urgent need for improved access to a range of psychotherapies delivered by specialist child, adolescent, and family, psychotherapists
It beggars belief that the government’s recent Green Paper on child mental health talks about training for more mental health workers by 2023.
In the UK there are tens of thousands of trained, accredited and regulated psychotherapists available to do this work now, yet numbers working in the NHS now are at a significant low and falling.
Experiencing a low mood may actually be a perfectly understandable reaction to a set of stressful circumstances. Being a child or young person can include significant feelings of shame. Whether it’s divorce, poor exam performance or playground bullying, everyday experiences can have a profound and lasting impact.
Talking with a highly trained professional is most likely to transform lives and unlock potential in long lasting ways. By psychotherapy we don’t mean a short-term ‘one size-fits-all’ approach. It is vital that children have access to highly trained psychotherapists who can tailor their support around that individual child’s needs. For example, a psychotherapist who is trained in family and systemic approaches looks at the whole context for the child.
In 2016 a review by Dr Andrea Cipriani, of Oxford University, found most antidepressants did not help children and teenagers with serious mental-health problems and some could even be unsafe.
His study concluded that the real effectiveness and safety of antidepressants for children and teenagers was unclear because of the poor design and selective reporting of trials, mostly funded by drug companies.
There is also the terrifying cliff edge facing children aged as young as 16, often in a very fragile place, who are forced to leave the CAMHS services they know and trust to enter adult services with unfamiliar clinicians and fresh waiting lists.
For some children, taking medication long term to manage depression may be a necessity but we are certain that only applies to very few.
Are parents and carers receiving enough correct support and education about medication? Any medicine your child takes poses side effects. From aspirin to cough medicine or antibiotics to vitamins – and antidepressants can have side effects too.
There can be emotional side effects, the kind that leave children feeling dulled or different, which makes it hard for them to want to continue treatment.
Then, less commonly, side effects where extreme restlessness and agitation heighten violence toward the self or others, which underlie the worrying evidenceabout the heightened risk of suicide among children using antidepressants. These are very real issues and require attention as a parent.
The National Institute for Health and Clinical Excellence has clear guidelines for administering drugs to children, but we hear all the time that these are not adhered to. With horrifying frequency, I hear that children have to have reached absolute crisis point – be suicidal – in order to access NHS services. This is borne out by the Children’s Commissioner for England’s own findings.
We are medicalising adolescence and all that comes with it, and we do not know what effect that will have on the child in future.
What we do know is that psychotherapy delivered by highly-trained specialists transforms lives and unlocks potential. It offers a child or young person strategies and resources for self-care not just for the short-term, but that can last a lifetime, which is incredibly good news.
At least half of adult depression is caused by factors affecting the child by the age of 14, so we should be looking at how to prevent.
More studies are needed to determine side effects of long-term use and the relationship between the drugs and childhood or adolescent suicide.
Much more research needs to go into epidemiology to ascertain why certain areas such as south Lincolnshire have especially high prescribing rates to children.