A survey by mental health charity, Stem4, found that over one in 10 12- to 18-year-olds have been prescribed antidepressants by their GP without assessment or diagnosis by NHS child and adolescent mental health services (CAMHS).
Current NICE guidelines say that the one antidepressant suitable for children, fluoxetine, should only be prescribed to children and young people after an assessment and diagnosis by a child and adolescent psychiatrist.
Stem4 said that GPs are under increasing pressure to disregard NICE guidelines and prescribe antidepressants to under-18s, either because their young patients are being refused access to NHS CAMHS services and psychological interventions, or because they are stuck on long NHS CAMHS waiting lists.
Mental health referrals
An earlier survey by stem4 reported that that half of the respondents saw a majority of child mental health referrals to CAMHS rejected.
An East of England GP who responded to the survey said: 'CAMHS are completely overwhelmed. Even when a referral is accepted, they rely on primary care to prescribe and follow up whilst patients are waiting for treatment. The waiting lists for treatment are far too long.’
Another respondent reported that a CAMHS service in north-west England, having rejected a self-harming teen for psychological therapy, told the GP to consider starting the patient on antidepressants.
The survey comes against the backdrop of primary care services having to pick up workload from stretched secondary care.
Dr Nihara Krause, consultant clinical psychologist, and chief executive of Stem4 said antidepressants such as SSRIs are effective in treating depression and other mental health conditions under assessment and guidance of a specialist and had to be part of a combination of therapies.
‘Those young patients who have been unable to access treatments and have only been prescribed antidepressants are likely to face still more anguish when trying to come off them,’ said Dr Krause.
She added that the survey findings suggested the UK was 'probably heading towards a deepening mental health crisis which will require more extensive intervention in the long term'.
Dr Krause added: 'The NHS is treating more young people with mental health difficulties than ever before, but if only half of young people who ask for help are able to access effective psychological treatments, then our ambitions aren’t big enough.
'What we need is meaningful investment in secondary care and access to effective mental health support in every school, college and university across the UK as well as specialist mental health practitioners supporting primary care providers.'