The largest national study of children’s mental health treatment has been developed by researchers at Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) to explore opportunities for increasing access to treatment.
The £2.1 million trial is investigating how training more health professionals – including qualified nurses and those starting out on their careers – can support young people aged 11-17 years with depression.
“Depression and mood disorders can be devastating for young people and their development. There are significant waiting lists for young people to access treatment, and the demand is rising,” explains CPFT’s consultant child and adolescent psychiatrist Dr Anupam Bhardwaj. “The number of young people seeking help with mental health has also increased significantly in recent years for a number of reasons, and local authorities and social care providers are under pressure. We need to look at how we can train more health professionals to treat more young people as soon as they need help and in a cost-effective way.”
Anupam and consultant psychologist Dr Clare White are co-investigators for the trial, named BAY (Behavioural Activation for Young people with depression in specialist child and adolescent mental health services). Together with colleagues at the University of Manchester, they have developed a manual which forms the basis for an intensive training and assessment process that staff must undergo before delivering behavioural activation (BA) techniques for the trial participants.
BA is a simpler and more cost-effective alternative to cognitive behavioural therapy and can be delivered by more junior mental health practitioners or those at the start of their career, such as new psychology graduates. It relies upon helping individuals with depression to take simple, practical steps towards enjoying life again; by engaging in fulfilling or healthy activities people feel good and are therefore more likely to keep participating in those activities.
We want to deliver treatments and therapies as soon as possible, and in a cost-effective way, so it’s important to know the type of treatment which works. The BAY study looks at how effective this manualised form of behavioural activation therapy can be as a treatment for children with depression,
The BAY study is also one of the first trials to look at hybrid delivery of BA, so patients can choose either in-person or remote (on-line) support. The team has developed a bespoke online tool which facilitates activities and interactive work during remote sessions. The activities are chosen by the young person, based on their values and interests.
The study has completed its pilot phase and teams have been given the green light to progress the study to more than 500 young people nationally over four years, making it the largest study of children’s mental health treatment in the world.
CPFT is one of six NHS trusts taking part in the study across the UK. It is led by the University of York and is funded by the National Institute for Health and Care Research (NIHR).
Anupam stresses the importance of research in meeting demand for future mental health care:
“Research into treatment for depression in young people is relatively limited. There is a huge need for more studies to develop safe, effective and efficient treatment for children and young people’s mental health difficulties. Training clinicians and staff takes time, and increasing capacity alone to meet demand is not enough. We must embed research in our work to improve patient outcomes.”
There is not only a longer-term strategic impact to research, but also more immediate benefits. Clinical teams who participate in research achieve better patient outcomes, have higher patient satisfaction, and greater staff morale and retention. Research is an essential aspect of our day-to-day work.