Talking therapy offered by the NHS for people with depression or anxiety appears to be less effective for people aged 16–24 than those aged 25–65, according to a new study led by UCL researchers.

While talking (psychological) therapy services are helpful for young people, the authors of the new The Lancet Psychiatry paper say that more work is needed to tailor mental health services to young people to ensure they are as effective as possible.

Lead author Dr. Rob Saunders (UCL Psychology & Language Sciences) said, “Talking therapy is an effective treatment for depression and anxiety disorders, and particularly tends to be preferred to pharmacological treatment by younger adults. Our analysis shows that talking therapies offered by the NHS are effective for younger adults, but as they are more effective for working-age adults, we believe there is work to be done to improve services for young adults.

“Rates of depression and anxiety in young adults are rising*, so there is an urgent need to ensure we are offering them the best possible mental health care.”

The study used data from 1.5 million people who had attended NHS Talking Therapies for anxiety and depression services in England in 2015–2019, including over 300,000 people aged 16–24. Talking therapies offered by the NHS can include cognitive behavioral therapy (CBT), guided self-help, counseling or interpersonal therapy.

The researchers looked at differences in symptom severity changes following a course of talking therapy, using two commonly used measures (Patient Health Questionnaire 9-item (PHQ-9) and the Generalized Anxiety Disorder Scale 7-item (GAD-7) scales), finding that improvements in symptoms were smaller for young adults than those aged 25-65.

People aged 16-24 years were around 25% less likely to meet the threshold for reliable recovery after having talking therapy, and 17% less likely to meet criteria for reliable improvement than those aged 25-65.

The research team estimated that if talking therapies were as effective for young adults as those over 25, over 20,000 more younger adults would have reliably recovered from their psychological disorder in England across the study period—approximately 5,000 young people each year.

Senior author Professor Argyris Stringaris (UCL Psychiatry) said, “Young people may find it harder to navigate services which have been set up for adults, and are more likely to miss sessions or stop attending altogether. Additionally, the late teens and early 20s are a point of transition for many people, which can involve plenty of stressful life events and changes that may make it more difficult to consistently attend. Working together with young people should help optimize the content of treatment and the ways in which it is delivered.

“Finally, young people may suffer from depression and anxiety problems that may differ somehow in their causes from those affecting adults; early onset depression could have different causes and may require different approaches to treatment. This is an area that requires a lot of new basic and clinical research.”