Are you aware that 5-year old children are prescribed anti-depressants!

Alarm bells are ringing! There has been a rather worrying increase in the number of children and adolescents taking anti-depressants.

Do we really believe that our failure to address toxic loneliness, unhappiness, depression and isolation in our children and young people (especially during this past 15 months) can be solved by doling out anti-depressants?

Our children and young people need to be listened to and helped to cope with their issues and problems – not just given drugs. They should be given the opportunity to talk, openly, with a professionally-trained person who understands them and who can support them.

Unsurprisingly, the pandemic and repeated lockdowns, school closures, isolation and fear of the COVID-19 virus have all contributed to increasing numbers of children and adolescents who are suffering from various mental health issues, plus “locked-in trauma”.

NHS Digital has updated their survey and their report which looks at the mental health of children and young people in England in July 2020, and the changes since 2017.

Experiences of family life, education and services, and worries and anxieties during the coronavirus pandemic are also examined. as follows:
https://files.digital.nhs.uk/AF/AECD6B/mhcyp_2020_rep_v2.pdf

The number of children taking antidepressants has soared to an all-time high during the pandemic, with a 40 per cent surge in drugs being prescribed to those under the age of 17. This is an extremely worrying trend!

More than 27,000 children were prescribed antidepressants last year, the figures show, with numbers peaking during the first lockdown, and two thirds of cases involving girls. Overall, the figure was 40 per cent higher than five years ago, when 19,739 children were prescribed such drugs.

However, the National Institute for Health and Care Excellence (https://cks.nice.org.uk/topics/depression-in-children/prescribing-information/fluoxetine/) says children should only be given antidepressants alongside talking therapies, following assessment by a mental health specialist:
“Fluoxetine is the preferred antidepressant for treating moderate and severe depression in children (5–11 years) and young people (12–18 years). It is the only antidepressant where the benefits outweigh the risks.

Fluoxetine should only be prescribed to children and young people with moderate to severe depression following an assessment and diagnosis by a child and adolescent psychiatrist.

It should not be offered except in combination with a concurrent psychological intervention. If psychological intervention is declined, antidepressants may still be given, but as the child or young person will not be reviewed at psychological intervention sessions, the prescribing doctor should closely monitor their progress on a regular basis and focus particularly on emergent adverse effects”.

Unfortunately, it seems, NHS figures show a 28 per cent rise in children being referred to mental health services between April and December 2020, amounting to 80,000 more cases – but, earlier this year, a survey of 32 mental health trusts with children’s services found that one in three had children waiting at least a year for their first appointment.

Experts said many children were suffering behavioural problems fuelled by lockdowns, social distancing and fear of infection, with many now anxious about everyday social activities.

What, I believe, is also a cause for significant concern is that suicide-related behaviours (suicide attempt and suicidal thoughts) and hostility (predominantly aggression, oppositional behaviour and anger) were more frequently observed in clinical trials among children and adolescents treated with antidepressants, compared to those treated with a placebo.

NICE guidance on prescribing Fluoxetine for children and young people – last revised in August, 2020 (https://cks.nice.org.uk/topics/depression-in-children/prescribing-information/fluoxetine/) states: Arrangements should be in place to carefully monitor for adverse drug reactions especially increased suicidal thinking and hostility (e.g. weekly for the first four weeks of treatment) and to fully record findings in the clinical notes, but are such arrangements always put in place?

Patients must be carefully monitored for suicidal behaviour, self-harm or hostility and overly-elevated mood, particularly during high risk periods such as at the beginning of treatment and changes of medication.

It seems that many children are being prescribed these drugs simply because waiting times to see a psychologist/psychiatrist or mental health professional are too long.

The number in need of urgent or emergency crisis care, including checks to see if children were so unwell they were putting themselves at risk, rose by 18 per cent, compared with 2019.

A recent report revealed that there are waiting times of up to four years in some parts of the country, amid warnings that 1.5 million children will need mental health treatment as a direct result of the pandemic.

Young people and children need access to appropriate therapies to help them to cope with their mental health issues – and medication should not be routinely prescribed as a substitute for psychological therapy.

Quotes from two young people about the importance of seeing an actual human (professional counsellor, etc) and how difficult this is proving to be:

“I don’t want to do counselling online. My room is not a private space when I can discuss things I may want to, and I know from counselling that I’ve had in the past that the ability to go somewhere separate and talk to someone in person is a big part of why it worked for me.”

“I have been on the CAMHS waiting list for a year and have had nothing come through. Only now that I am suffering worse than before am I getting referred to another service, where I have been put on another waiting list.”

A report by the Young Minds charity dated 4 February, 2021, (https://youngminds.org.uk/media/4350/coronavirus-report-winter.pdf) has highlighted the impact of the Coronavirus on young people with mental health needs.

The Young Minds survey also highlighted significant gaps in mental health support:

“While professionals in the NHS, schools and charities have worked around the clock to adapt and improve services, the reality is that many of those we heard from felt they had not received the level of support they needed.

This is partly for technological reasons. As in our previous research, there were mixed feelings about virtual and digital support: practically and emotionally, this is not a form of help that works for everyone. Any future provision must recognise the value of face to face interaction alongside virtual and digital forms of support.

We also heard about other barriers to support: about long waiting times, including hidden waiting times, where initial support is followed by delays; about school counselling coming to an abrupt end; about young people losing faith in the system after poor experiences. There is also a worrying stigma about seeking mental health support, with many young people concerned about being a burden on services.

While the NHS is providing mental health support to more children and young people than ever before, our research suggests a significant level of unmet need”.

Please take time to listen to your children and young people and, instead of accepting prescription drugs alone, seek help for them from a private counselling service, if necessary, because early intervention to help a child/young person is what they need most.

If they have help to cope with their issues/problems straight away (rather than having to wait for up to a year), then they have every chance of resolving their mental health issues – and without medication being needed.

For anyone who is worried about a child or young person, I am happy to have an initial discussion with you (free initial discussion limited to 30 minutes). Please call me now, either on my landline (01422 321412) or on my mobile (07913 979561), or complete a form on my Contact Page.

Diane Wade RegMBACP, GQHP, CNHC, DipHyp

Counsellor/Psychotherapist and Clinical Hypnotherapist

If you are an adult who is worried about a child or a young person in crisis, who needs immediate help, please follow this guidance from Young Minds (see below):

https://youngminds.org.uk/find-help/get-urgent-help/#are-you-an-adult-worried-about-a-young-person-in-crisis

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