Last week The Times has published a report showing that last year 7.3 million people were given at least one antidepressant prescription in England. This figure includes more than 70,000 under 18s and almost 2,000 children of primary school age. Yet some experts think that such pills rarely work in children – with one saying that doctors were “medicalising adolescence”. There was also a bias towards giving such pills to the elderly… and this was termed “prescribing pills to combat loneliness”.
This Times piece led to media discussions suggesting that GPs were either “lazy” in giving out such pills… or that they had no option given the wait for “talking therapies”. At least two doctors wrote to The Times to explain that such drugs are mostly effective… and that 70,000 out of about 15 million children was not a big number (e.g. Asthma prescriptions were given to over 100,000 children.)
The BBC covered the follow-on news here saying – “The number of antidepressants prescribed to children in England, Scotland and Northern Ireland has risen over the past three years…In England, there was a 15% rise. Scotland saw a 10% increase. And in Northern Ireland the number rose by 6%. …Experts have linked the rise to waits for specialist mental health services”
Now, it may be that that other therapies including Mindfulness Based Cognitive Therapy (MBCT) could offer a chance to reduce the level of prescribing (and addiction) – and ironically, the NHS often advises suffers to read the Mark Williams and Danny Pennman book “Mindfulness – a practical guide to finding peace in a frantic world” while waiting their turn for talking therapies; yet such services are very stretched. My advice to sufferers is to find a therapist and pay to get help asap… especially when it is your own child. It is not right… but it is pragmatic to do so.
(In the interest of openness, I point out that we at Carina Sciences are shortly to launch our REZL app to build resilience in all of us – so that we are better able to meet life’s challenges – by using Mindfulness Based Conative Therapy.)
But, let’s go back and think about the 70,000 children given antidepressants last year. My own belief is that this number is, in fact, on the low side!
The 2014 UK Adult Psychotically Morbidity Survey showed that 1 in 4 of us will suffer from a common mental disorder such as anxiety and/or depression in our lifetimes… and that in 3 out of 4 cases these problems begin in childhood or adolescence (<= 18 years). So this suggests that 3/16 (about 18%) of children under 18 years old will have experienced the start of such problems. Indeed the government’s statistics show that 10% of school children have a diagnosable common mental disorder .
So if we assume that these problems are entirely developed linearly between say 14 and 18 of which there are around 3.6 million young people in UK ( – as the Times said only 2,000 of the 70,000 were of primary school age) … then we might reasonably expect that there are about 350,000 under18s who have a “common mental disorder” problem.
Yet the piece in The Times says that ONLY 70,000 are being given drugs in England …which can be scaled to about 80,000 across the UK… So we are using antidepressants for ONLY 80,000 of the 350,000 suffers.
The real questions this raises are: why are 18% of our children developing these problems? What are we doing to help them? And, what are we doing to avoid such problems in the first place?
The simple answers are that:
- Ignorance and stigma (…in parents as well as children) mean that many children will soldier on and fail to get early help as their problems develop – and it may be that domestic breakdown, pressure from exams, unrealistic materialistic expectations or social media pressures are all making things worse for our children.
- We are doing little to help – the CAMHS (child and adolescence mental health services) is a “silent catastrophe” say the Association of Child Psychotherapists (see The Guardian piece here)
- There are no preventative initiatives in place in UK.
So everyone is worked up about 70,000 children and young people being given antidepressants – yet I am astonished the figure is not 5 times higher… 70,000? …it is the tip of an iceburg.
The Guardian goes on to point out that not only are the CAMHS services scarce but they are often very poor: “This year, the NHS watchdog, the Care Quality Commission, rated 39% (26 services) of specialist Camhs as requiring improvement. Those surveyed by the Association of Child Psychotherapists were asked whether they could see any evidence of the government’s claim of making “one of the biggest expansion of services in Europe” – 93 % of respondents said they saw no evidence of this.”
…
Of course it is good that everyone is getting concerned about mental health problems in childhood…. (I wrote last month about the denial and lack of leadership shown by our universities in failing to take responsibility for supporting students with problems …yet it seems there is a similar lack of support for the under 18s.
IMO we should expect more from our government… we are long way from having CAMHS of the right scale and quality… so sadly I expect we will have to wait until antidepressants are prescribed to our children at a level where minsters will finally have to sort this out.