The proposals have been made in response to a large increase in the numbers of children and young people reporting mental health symptoms since the pandemic
“There is an increased need for child and young people’s mental health services that have become even greater due to the Covid-19 pandemic. Technologies like these could help children and young people get wider access to support.” Mark Chapman, interim director of medical technology, NICE
Games, videos and quizzes based on cognitive behavioural therapy (CBT) should be offered to children as young as five, as part of an early value assessment pilot recommended by the National Institute for Health and Care Excellence (NICE).
The pandemic seems to have driven a rise in mental health problems among children and young people. One in six children in England aged between six and 16 have a probable mental health condition – an increase from one in nine in 2017, according to figures from NHS Digital.
The proposals from NICE have been sent out for consultation. They are aimed at children and young people with symptoms of mild to moderate anxiety.
The five self-guided products offer games, videos and quizzes, based on CBT principles, to help children and young people learn techniques to better understand and manage their symptoms. They are to be offered in conjunction with the support of a mental health practitioner, NICE said. Some children would also be given face-to-face counselling.
Mark Chapman, interim director of medical technology at NICE, said: “There is an increased need for child and young people’s mental health services that have become even greater due to the Covid-19 pandemic. Technologies like these could help children and young people get wider access to support.”
The NICE committee that produced the draft proposals said that the privacy and convenience of smartphone applications might make them particularly appealing to children.
The technologies in the draft guideline include an internet-based psychological intervention for children aged five to 12 with symptoms of anxiety. It has three components: a parents’ website, a clinician case management website and an optional game app for children called Monster’s Journey: Facing Fears, which includes interactive worksheets, videos and quiz.
Another programme, Lumi Nova: tales of courage, is aimed at those between seven and 12 with mild to moderate anxiety, combining evidence-based therapeutic content (exposure therapy, a form of CBT) and psychoeducational content within an intergalactic role-playing game.
Chapman said: “We understand that for some children and young people, technologies will not replace face-to-face interventions. What is promising about all the technologies we have conditionally recommended today is the way they bring together digital interventions with clinical support.
“By driving innovations like these into the hands of clinicians we can improve care for patients and help the service recover following the pandemic.”
If the recommendations are confirmed after consultation, the technologies could be offered to thousands of children and young people identified as having mild-to-moderate symptoms of anxiety or low mood by a mental health practitioner.
The objective of the new Early Value Assessments from NICE is to identify the most promising technologies in health and social care where there is an unmet need, and to enable earlier conditional use of the technologies in the NHS, while further evidence is generated.
The steep rise in mental health disorders amongst children since the pandemic is putting enormous pressure on NHS services. NICE’s proposal for a pilot programme in which children are offered CBT-based videogames to address mild mental health problems such as anxiety is an attempt to alleviate some of that pressure. There is some evidence that appropriate digital therapies can help ease mild symptoms, and our own research has shown that smartphone apps are viewed positively by adults with mental health problems. We believe that this pilot could potentially mark the start of a long-term switch to a less resource-intensive method of supporting children with symptoms of anxiety.