Debate: Gold standard or go for gold? The pros and cons of waiting for gold standard evidence of effectiveness for adolescent depression and self-harm interventions versus acting with the precautionary principle in current political times.

Abstract

There is increasing concern about the prevalence of depression and self-harm among children adolescents in many countries. Governments who commission and fund psychological interventions to address these difficulties want to know what is effective. The techniques available for synthesising gold standard evidence are increasingly sophisticated, but there are many criticisms of being completely reliant on this approach. A precautionary approach, where public policy decision-makers acknowledge that where the evidence is limited, the benefits of certain interventions are thought to outweigh the risks, including the risk of doing nothing. This later element may be particularly important in the domain of depression and self-harm, as both are associated with elevated risk of death by suicide.