What science has shown can help young people with anxiety and depression
This report summarises what we’ve learned about the evidence for ‘active ingredients’ of effective interventions for youth anxiety and depression – these are the aspects of interventions that make a difference in preventing or managing anxiety and depression.
- brief introduction to Wellcome’s approach in searching for these active ingredients
- findings from 30 reviews we commissioned in 2020 which examined the evidence for 27 active ingredients; these include approaches from the cellular level (such as circadian rhythms and reduced inflammation in the body) to the societal (such as neighbourhood cohesion and urban access to green space)
- broad reflections on the key insights that we have taken from this work.
Who this is for
- researchers from any field relevant to mental health.
Since 2020, Wellcome has been commissioning research teams from across the world to review the evidence for different active ingredients deemed to help prevent, treat and manage anxiety and depression in 14 to 24-year-olds globally.
Looking across the results, we highlight several key insights:
- There is evidence to support many of the active ingredients reviewed, from the cellular to the societal. But we do not see the emergence of clear front runners; instead, many ingredients have small effects.
- No one active ingredient is likely to be enough or effective for everyone. It is likely that different people in different global contexts will need a range of ingredients in different combinations.
- Active ingredients interact as part of a complex system. For example, social connection can be directly or indirectly targeted via other ingredients, such as engagement with the arts, access to green space, use of antidepressant medication, or reducing inflammation in the body.
- There are considerable limitations in the existing evidence base:
- the vast majority of existing work has taken place in high-income countries, and it is unclear how applicable the findings are to low- and middle-income contexts
- many studies are underpowered or at risk of bias, limiting the conclusions that can be drawn, specifically around what works, for whom, and in what contexts
- there is limited understanding of the mechanisms of efficacy
- there is a lack of dismantling trials or similar designs that can tease apart the relative efficacy of different active ingredients.
We hope these reviews will inspire researchers to develop proposals for well-powered studies to tease out the mechanisms for effective interventions, so we can develop more personalised interventions for young people.