Also bear in mind that this is a universal trial, i.e. delivered to everyone regardless of depression, i.e. young people *who are not depressed* are being asked to use a CBT to reduce depression.
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Couldn’t agree more. The other response I’ve seen (alarmingly, endorsed by the then head of research at DHSC) is that we should simply reduce the evidence requirements, specifically, reduce the need to consider the people who dropped out of the trial, as significant.
It's a well established approach in the DHSC. Pushed in the drugs evaluation world for industrial policy purposes (regulatory capture) and now bleeds into other areas of health policy. If data overwhelms your prior - throw away the data. I'm not even sure they realise they have abandoned science.
Interesting, yes I think the Guardian article i question showed exactly that process, I wish I could find it now! God knows what MHRA are up to atm, I’ve lost track of the consultations as been focused elsewhere for a while, but wrote about this (and much related) a few years back.
From what I recall of that article it appeared to me that the drive towards apps was quite deliberately designed to hoover data, strip out pesky doctor gatekeeping of drugs to only actually sick people, & shift the dial on evidence / trial ethics by talking of “labs” & “sandboxes” & ofc “nudges”
For me, these new findings are exceptionally useful for suggesting we should stop universal MH interventions in schools, and focus on one-to-one, targeted and directed interventions instead. @jackandrews.bsky.social and I argue this is more detail below
Lastly: congrats to the authors on what must have been an enormous amount of work (134 schools! 😥), and thank you for the important contribution this will make to the field
One of the issues for us in Aus is that mental health prevention is embedded in our curriculum. We want to replace that with an evidence based option. Universal mental health prevention is happening anyway in our schools. So we need to find something that works!
Thanks - I agree that's so tricky. It's a shame that whoever is making that decision (that universal prevention must be in the curriculum) isn't looking at the evidence. It's sad because it wastes young people's time and they don't want to do it 😔
Thanks Lucy - it is tricky! Our kids need to learn about mental health and how to manage it. It's just working out the best way to deliver it. At the moment, our curriculum does not do it well. I'm hoping we'll get there though!
Yes, and that's not necessarily a bad thing. The research would need to be done (I suspect it already is), but this approach might be helpful if a) people want it and b) they have heightened symptoms. But that's a separate question to whether schools can make young people do it who don't want it
Thanks. I know I shld try to read it, but do you happen to know if they filtered out the participants that did engage & whether there was any beneficial effect there?
THIS. ^^^^ Maybe listen to people when they say words with their mouths. I am school social worker in a regular nyc high school (i.e., anyone can go, it is free) - and 1000% THIS.
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I advocate for an alternative: young people are telling us they don't like or want this, and we should listen to them.
True for drugs and all other health care interventions.
https://doi.org/10.1111/camh.12753
(fin)