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Treatment of Depression

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TREATMENT OF DEPRESSION 1

What are specialist mental health clinician attitudes to guideline recommendations for the treatment of depression in young people?
Bernard Brown
PSY326: Research Methods
Professor Mahaliah Bowman-Campbell
November 25, 2013

TREATMENT OF DEPRESSION 2
Thesis Statement There is a high prevalence of depressive disorders in children and adolescents up to 18 years of age and these disorders have a significant negative impact on social and occupational functioning. What are specialist mental health clinician attitudes to guideline recommendations for the treatment of depression in young people?

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Sarah E. Hetrick, Magenta Simmons, Andrew Thompson, and Alexandra G. Parker conducted a study and researched the question of “What are specialist mental health clinician attitudes to guideline recommendations for the treatment of depression in young people?” and published the results of the research in Australian & New Zealand Journal of Psychiatry, Date: November 1, 2011. The research took place at Orygen Youth Health (OYH). OYH is the public youth mental health service for young people aged 15 – 24 living in the north-western metropolitan area of Melbourne, Australia.
The research required a method to determine whether to conduct the study as a qualitative research, that is defined as a more descriptive approach that attempts to gain a deep understanding of particular cases and contexts or quantitative research, which is defined as a more descriptive approach that attempts to gain a deep understanding of particular cases and contexts(Newman, M. (2011)).
The research was conducted as a qualitative study adopting a social constructionist perspective using focus groups. The focus groups, conducted with all clinicians (medical and allied health), were audiotaped, transcribed and thematic analysis was undertaken. Clinicians were asked about the barriers to implementing four key recommendations from the National Institute for Health and Clinical Excellence (NICE) guidelines. Focus groups were held with six clinical programme teams and with a group of psychiatrists who worked with different teams. All clinicians (psychiatrists approximately 29%, nurses approximately 14%, allied health professionals including psychologists approximately 32%, occupational therapists approximately 14%, and social workers approximately
TREATMENT OF DEPRESSION 4
12%) from OYH who gave informed consent were eligible for inclusion in the study. Each clinical team consists of a slightly different mix of clinicians with IMYOS, PACE, HYPE, YMC and PACE made up of allied health professionals, while YAT has approximately 50% nurses and 50% allied health professionals and EPPIC has approximately 15% nurses and 85% allied health professionals. Clinicians had between 0.5 and 18 years’ experience in youth mental health.
The area of psychology that this study applies to is the area of clinical psychology. It is an applied field focused on understanding the best ways to treat psychological disorders. It is typically defined as the study of best practices for understanding, treating, and preventing distress and dysfunction which is what this research applies. It sought to examine potential barriers to the use of evidence-based guidelines for youth depression in a tertiary specialist mental health service, as part of an initiative to implement evidence based practice within the service.
Results: “Barriers existed at (i) the individual clinician level; (ii) the clinical level in terms of the presentation of young people; and (iii) the service level. The key individual clinician level barrier was a stated belief that the guidelines were not relevant to the young people presenting to the service, with little evidence to guide practice. Related, the main barrier with regard to the clinical presentation was the severity and complexity of this presentation, often making the delivery of interventions like cognitive behavioural therapy (CBT) difficult. At the service level, a lack of integration with primary and secondary level care meant sequencing interventions according to guideline recommendations was difficult. Conclusions: There is a clear imperative to develop the evidence base to ensure that effective treatments for young people aged up to 25 years with
TREATMENT OF DEPRESSION 5 severe and complex disorders that include comorbid conditions, suicide risk and psychosocial difficulties are investigated and disseminated. Furthermore, this work has highlighted the need for greater investment in models of care that ensure integration between existing primary and secondary care and enhanced specialist early intervention mental health services for young people. (PsycINFO Database Record (c) 2012 APA, all rights reserved)”( Hetrick, S. E., Simmons, M., Thompson, A., & Parker, A. G. (2011). What are specialist mental health clinician attitudes to guideline recommendations for the treatment of depression in young people?. Australian And New Zealand Journal Of Psychiatry, 45(11), 993-1001. doi:10.3109/00048674.2011.619161).
I conclude that the results of the research study are conclusive to my liking and I would not take away nor at this time add any related issues without further and more in-depth research.

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References
Hetrick, S. E., Simmons, M., Thompson, A., & Parker, A. G. (2011). What are specialist mental health clinician attitudes to guideline recommendations for the treatment of depression in young people?. Australian And New Zealand Journal Of Psychiatry, 45(11), 993-1001. doi:10.3109/00048674.2011.619161
Newman, M. (2011). Research methods in psychology. San Diego, CA: Bridgepoint Education, Inc.

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