Dec 2023: Australia's first evidence-based guideline for anxiety in children

CPG News Dec 2023

In October 2023, the Campus Mental Health Strategy published an evidence-based clinical practice guideline for anxiety in children and young people.
You can read the full guideline here.

Anxiety in children and young people

Anxiety disorders are among the most common mental health problems in children and young people.  The most recent survey of child and adolescent mental health, Young Minds Matter, found that around 7 per cent of Australian children and adolescents suffer from a diagnosable anxiety disorder.

Though anxiety is recognised as a normal part of development, anxiety disorders can be distinguished by their intensity and duration. Often anxiety disorders can cause a disruption of daily life and overall wellbeing.

Previously there has been a gap in consistent clinical guidance in the management of anxiety in children and young people. Guidelines have been developed for use in the care of adults with anxiety, but children and young people can express symptoms differently.

Many children experience occasional fears or worries, and this is considered normal. This makes it difficult to discern when these behaviours indicate a clinically significant condition, often resulting in misinterpretation and underdiagnosis.

Recognising the need for a specialised approach to anxiety in this age group, experts from Melbourne Children’s Campus came together to develop this guideline.

Developing an evidence-based guideline

Clinical practice guidelines are documents developed for healthcare professionals, offering a standardised framework to diagnose, treat, and manage a particular health condition or disorder. They do this by providing a set of recommendations to address various aspects of care. High quality guidelines should be informed by reliable evidence and clinical research.

This guideline was developed using an internationally recognised framework for the development of evidence-based clinical practice guidelines, called GRADE. This integrates available evidence, clinical expertise, and lived experience perspectives into the recommendations.

After collecting evidence, a guideline development group met to interpret and discuss how the evidence can be adapted and used in practice. The development group included mental health clinicians, social and support workers, researchers and lived experience advisers to ensure a variety of experiences and expertise. The development groups drafted the 63 recommendations included in the guideline over the course of six months.

Recommendations and accompanying text were reviewed by external stakeholders to ensure the guidelines are accurate and relevant in a real-world clinical context prior to publication.

What is included?

Recommendations included in the guideline follow the path of care for anxiety including identification and assessment, care planning, making initial treatment choices, psychological therapies, medications, care review, and monitoring progress.

Highlighted within each section, is the need for individualised care, active involvement of support systems and ongoing awareness for each step of a person’s care. The guideline emphasizes the importance of holistic care, encouraging healthcare professionals to consider the impact of anxiety on a child's overall wellbeing and quality of life, including their families. This includes not only diagnosis and management of anxiety symptoms but also addressing other health and social issues.

What is next?

Now the guideline has been published, it is important to encourage use in practice across the Melbourne Children’s Campus and beyond. Further resources are being developed to adapt the recommendations into a real-world setting.

These resources aim to provide comprehensive support not only for healthcare professionals but also for children, young people, and their support people. By empowering families with information and resources, we extend the network of care beyond clinical settings, creating a more supportive environment for children and young people struggling with anxiety.

Acknowledgement of Country

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At Mental Health Central we acknowledge the traditional custodians of the land on which we live, gather and work. We recognise their continuing connection to land, water and community. We pay respect to Elders past, present and emerging.

We acknowledge all people with a lived or living experience of mental ill-health and recovery. At the Campus, we particularly acknowledge children, young people, families, carers, and supporters. We recognise their vital contribution and value the courage of those who share this unique perspective for the purpose of learning and growing together to achieve better outcomes for the Campus, staff, sector, and all people of lived experience.

Proudly supported by the Royal Children’s Hospital Foundation