Developing Clinical Guidelines for Children and Adolescents

Abstract

This chapter provides an introduction to the work of the National Institute for Health and Clinical Excellence (NICE), which is the main body responsible for the provision of clinical guidance in the United Kingdom. It describes the NICE approach to the development of clinical guidance with its focus on rigorous method, accountability for reasonableness, and cost-effectiveness, as well as clinical effectiveness, transparency, and stakeholder involvement. In this chapter the focus is on the production of clinical guidelines for children and adolescents and describes a number of key aspects of the NICE mental health guideline program developed by the National Collaborating Centre for Mental Health. These include the nature and content of the recommendations for clinical practice, the methods used by guideline development groups, and the range of publications to support implementation. The chapter also discusses the limitations of the evidence base to support the development of clinical guidelines in child and adolescent mental health, including the problem that comorbidity presents for a guideline program, which is diagnosis- or condition-based and the general paucity of evidence in some key areas of child and adolescent mental health. The chapter also describes, with reference to a number of national implementation programs, the positive impact that the NICE guideline program has had on child and adolescent mental health services in the United Kingdom. It concludes with a consideration of the future development of clinical guidelines in mental health. Keywords: NICE; clinical guidelines; child and adolescent mental health; guideline development groups; national implementation programs