A multi-stakeholders perspective on how to improve psychological treatments for depression in young people

Meta-analyses of the effectiveness of psychological treatments typically report standardized mean differences (SMD), which can be problematic as they do not necessarily translate into clinically significant change. Cuijpers et al.’s meta-analysis [1] reported instead on response and recovery rates, clinically significant change and deterioration. The meta-analysis found that only 39% of young people receiving psychotherapy for depression responded to treatment (defined by ≥ 50% symptom reduction) compared to 24% of those who did not receive psychotherapy. These sobering findings make it clear that innovative approaches are needed to reduce the personal and societal burden of depression.

Research could explore various avenues to generate more effective interventions, we believe that some of the most promising avenues include: developing interventions that target key mechanisms which drive and maintain depression [2]; better understanding who might benefit from which type of intervention [3]; and working with young people to design and implement new treatments [4]. More specific ‘key questions’ for research have also been outlined by several James Lind Alliance (JLA) priority-setting partnerships, which have been funded to co-develop priorities for depression research (e.g., https://www.jla.nihr.ac.uk/priority-setting-partnerships/depression/top-10-priorities/) and youth mental health research more broadly (https://mcpin.org/priorities-for-research-in-children-and-young-peoples-mental-health/). Here, we report on our approach to translating some of these priorities into meaningful future directions for research and clinical practice.