NICE CKS Critique Writing Case Study

Introduction Of NiCE CKS critique writing Case Study

Introduction 

• The publication date of the guideline is 6th July 2022. 
• The guideline is developed by NICE
• The target audience of this guideline is education professionals, commissioners, healthcare practitioners and professionals who have worked in private and community sectors. 
• The purpose of the guideline is to address the causes of depression among students. 
• The guideline is constructed by providing some evidence-based strategies for managing and identifying the reasons for depression. 
• Most of the students have experienced depression which has made an impact on their emotional well-being and academic performance (Liu et al. 2022).

This presentation concentrates on evaluating a guideline that has addressed mental health among students. Depression is always a concern among students. The guideline is prepared for healthcare practitioners, commissioners and education professionals. 

Aim of the review

• The aim of the review is to evaluate the guidelines of NICE addressing depression among students. 
• Discuss how the guideline is effective in addressing the causes and consequences of depression among students. 
• Analyse the clinical relevance, practical application and public health impact of NICE guidelines 
• Figure out any gaps in the guidelines regarding the quality of life and cultural diversity.

This review aims to discuss the effectiveness of the NICE guideline in addressing the impacts and causes of depression among students. This review has the objective to make a strong comparison of NICE guidelines with other guidelines.

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Main Content

Learning about the condition

• NICE CKS guideline on Mental Health in Students provides an extensive range of strategies for caring for the student’s health. Recently there have been growing studies that depression may need to be stressed further (NICE, 2020).
• For example, studies show that students in higher education are slightly more likely to develop depression and anxiety than non-students, perhaps because of academic and financial pressure. Moreover, a survey again found that four in 10 young people from deprived areas find it difficult to get the mental health help they need when needed highlighting variation in availability (Buizza et al., 2022).
• This guideline effectively targets a clinically important problem, i.e. the increasing rate of mental health problems among students. In addition, it speaks to a public health need by encouraging early identification and intervention preceding dropout rates and overall well-being (Campbell et al., 2022).
• Untreated mental health conditions can result in high economic costs and an increase in financial burdens due to poor productivity and high dropout rates.

The guideline needs to be about student mental health because it is about individual and societal well-being. These results indicate a requirement for a redoubling of emphasis on socioeconomic factors and availability of support services to improve student's quality of life and counter social consequences of receiving social healthcare.

Understanding of the guideline 

• The guideline is very simple to understand as everything is highlighted properly. 
• The guideline is not just targeted to healthcare professionals but also commissioners, social care practitioners, young people and their family members.
• The guideline is highly relevant for patients to enhance their awareness significantly.
• The guideline is very simple to navigate
• The guideline does not contain any printable leaflets or visual instructions for patients. 

The guideline is very easy to understand and all information is clearly mentioned. It ensures that the content is accessible not just to healthcare professionals but also to others. It is highly relevant to patients because it allows them to enhance their awareness of mental health, especially depression. However, the guideline is probably structured and it is very easy to navigate. As a result, it is very user-friendly for every individual. The guideline has not included any visual data for patients.

Comparison and Analysis of NICE Guidelines on Depression in Students

• The NICE Clinical Knowledge Summaries (CKS), 'Mental Health in Students' highlight the difficulties students will face if they develop depression.
• The highlighted guidelines stress the early detection of people at risk, such as those under academic pressure, those who are socially isolated, or those in transition to their lives (Chaturvedi et al., 2021).
• In contrast, the more general NICE guidelines on depression include approaches to diagnosis and management of adults in a variety of populations (NICE, 2020).

Key Differences

1. Targeted vs. Generalized Scope: The CKS specifically targets student recommendations based on their own stressors and mental health needs, although NICE guidelines are wider and may be less applicable to a student-specific concern (NICE, 2020).
2. Focus Areas: Although the general guidelines may not emphasise them, the CKS discusses academic-related risk factors and the importance of early interventions in educational settings (Sujarwoto et al., 2023).
3. Approach to Evidence: The guidelines suggest both are based on systematic reviews but the CKS uses studies relevant to students while the general guidelines use more general evidence.

Consequences of Differences

The interpretation of these healthcare provider reports becomes challenging for practical clinical work contexts. The standardized protocols followed by practitioners could overlook individual student difficulties which leads to suboptimal treatment outcomes (Holm-Hadulla et al., 2021). The approach yields student-specific recommendations that both support students early in their treatment journey and minimize their chance of enduring medical complications.

The guidelines present evidence from systematic reviews together with clinical trial research. The interventions adopted by CKS create a context-specific approach which targets the particular needs of students. The targeted methodology provides solutions to gaps in population-specific care identified in general NICE guidelines.

Comparison of NICE CKS on Depression with Other Guidelines

• The NICE mental health guidelines for students continue to match current best practices and existing well-documented depression management approaches.
• According to broader NICE guidelines and international standards (i.e., American Psychological Association), the stepped-care approach to treatment, with comprehensive and early identifications of at-risk students, is emphasised by the CKS (Lipson et al., 2022).
• NICE and APA guidelines recommend individualized evidence-based interventions such as cognitive behavioural therapy (CBT) and pharmacotherapy for individuals. Finally, the CKS acknowledges that students face unique challenges, such as academic burdens and social isolation, and provides specific strategies which relate to those challenges (Kegelaers et al., 2024).
• When they (discrepancies) do exist, they are usually due to cultural differences or resource availability or differences in the system rather than of the basic principles. For example, some guidelines may endorse a systemic approach, while others will emphasise interventions that address individual patient clinical problems.

In total, NICE’s recommendations are very appropriate compared to global standards and thus appropriate, credible, and applicable in practice.

Involvement in NICE Guidelines: Relevance and Comparison

• Through the rigorous evidence-based process, the NICE Clinical Knowledge Summaries on mental health in students including depression are developed (NICE, 2020). The guidelines do an excellent job of pointing to clinical research, expert reviews and best practices, and do not highlight explicit details of patient or student involvement in the formulation of the guidelines.
• The recommendations are geared towards prescribing clinicians, with specialist care in mind, who are physically working in the student population and tasked with identifying, diagnosing, and managing depression (Kegelaers et al., 2024).
• To make guidelines authentic and applicable, major stakeholders must be included like patients, students, and clinicians.
• Involving patients would make it more relevant as it would talk about lived experiences, barriers to accessing care, stigma and many other real-world challenges. The recommendations also receive some clinician input, which ensures that the recommendations are feasible in day-to-day practice (Sujarwoto et al., 2023).
• However, other guidelines (e.g. those of mental health charities or student organizations) may explicitly include patient narratives and community-specific feedback.

However, this difference in approach can make these guidelines more relatable to the target group, but at the price of the systematic rigour found in NICE guidelines. A lack of patient involvement in the development of NICE CKS recommendations could diminish the emotional resonance of the recommendations, however, an evidence and clinician-led approach supports credibility and consistency with best practices.

Improvements and Challenges in Implementing the NICE CKS Guidelines

Several improvements to the applicability and inclusivity of the NICE CKS on mental health in students with a focus on depression could be made. The guidelines are evidence-based and comprehensive however the patient-centered feedback could be more explicit particularly that addresses the diversity of age and social and cultural backgrounds (NICE, 2020). The recommendations would be tailored to reduce stigma be relevant to a large population and reflect issues of accessibility and different degrees of health literacy.

Challenges in Implementation

1. Primary/Secondary Care: Extensive assessments and management strategies will be difficult to implement in primary or secondary care settings in underfunded or understaffed areas where limited resources are available (Ochnik et al., 2021).
2. Global Adaptability: Ideally, following implementation in UK contexts, cultural perceptions of mental health, language barriers and differences in healthcare infrastructure may slow its adaptation to contexts beyond the UK (NICE, 2020).
3. Student-Specific Focus: Student-oriented guidelines may not introduce depression in different age groups in their deprived form and, hence cannot be applied to different individuals or educational institutions.

Improvements

• To show cultural, social and economic variations, rather than ‘one case fits all’.
• Specific guidance for resource-limited settings or tailored recommendations for non-student populations (Kegelaers et al., 2024).

Speaker notes

Early intervention strategies that are improved may reduce long-term healthcare costs, but upfront investments in training, awareness, and resource allocation may be costly. Overall, these improvements would make the guidelines more inclusive, practical and contextable.

Improvement in NICE CKS (Clinical Knowledge Summaries) for the mental health of students particularly for depression is needed to make life better. Although evidence-based and complete, the guidelines could utilize patient-centred feedback and could incorporate different age, social, and cultural backgrounds.

Conclusion and Recommendations

• NICE guidelines have addressed the issue of depression among students by offering clear and evidence-based recommendations. 
• The guideline has addressed some practical strategies to enhance treatment and awareness. 
• The guideline is very simple to navigate and understand but there are no visual advertisements and leaflets. 
• It is recommended to use printable resources to improve the understanding of patients. 
• The guideline should address some quality-of-life factors along with social determinants of health to offer a detailed holistic approach. 
• The guideline can highlight financial execution and allocation of resources to implement in primary and secondary care. 
• Some suggestions are required to reflect the cultural as well as social contexts of students throughout the world (Mirza et al. 2021). 
• The guideline needs to ensure the involvement of patients and medical professionals to increase authenticity and relevance. 

The guideline of NICE offers detailed knowledge in addressing depression among students by offering evidence-based recommendations. It has targeted clinical requirements and public health issues but the guidance is lagging with proper leaflets for patients. It is recommended to enhance the involvement of both patients and medical professionals in developing the guideline. 

References

• Buizza, C., Bazzoli, L. and Ghilardi, A., 2022. Changes in college students mental health and lifestyle during the COVID-19 pandemic: a systematic review of longitudinal studies. Adolescent research review, 7(4), pp.537-550. https://link.springer.com/content/pdf/10.1007/s40894-022-00192-7.pdf
• Campbell, F., Blank, L., Cantrell, A., Baxter, S., Blackmore, C., Dixon, J. and Goyder, E., 2022. Factors that influence mental health of university and college students in the UK: a systematic review. BMC public health, 22(1), p.1778. https://link.springer.com/content/pdf/10.1186/s12889-022-13943-x.pdf
• Chaturvedi, K., Vishwakarma, D.K. and Singh, N., 2021. COVID-19 and its impact on education, social life and mental health of students: A survey. Children and youth services review, 121, p.105866. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7762625/
• Holm-Hadulla, R.M., Klimov, M., Juche, T., Möltner, A. and Herpertz, S.C., 2021. Well-being and mental health of students during the COVID-19 pandemic. Psychopathology, 54(6), pp.291-297. https://karger.com/Article/PDF/519366
• Kegelaers, J., Wylleman, P., Defruyt, S., Praet, L., Stambulova, N., Torregrossa, M., Kenttä, G. and De Brandt, K., 2024. The mental health of student-athletes: A systematic scoping review. International Review of Sport and Exercise Psychology, 17(2), pp.848-881. https://researchportal.vub.be/files/108951069/The_mental_health_of_student_athletes_A_systematic_sco**_review_ACCEPTED_MANUSCRIPT.pdf
• Lipson, S.K., Zhou, S., Abelson, S., Heinze, J., Jirsa, M., Morigney, J., Patterson, A., Singh, M. and Eisenberg, D., 2022. Trends in college student mental health and help-seeking by race/ethnicity: Findings from the national healthy minds study, 2013–2021. Journal of affective disorders, 306, pp.138-147. https://www.sciencedirect.com/science/article/am/pii/S0165032722002774
• Liu, X.Q., Guo, Y.X., Zhang, W.J. and Gao, W.J. (2022). Influencing factors, prediction and prevention of depression in college students: a literature review. World Journal of Psychiatry, 12(7), p.860. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9331452/ 
• Mirza, A.A., Baig, M., Beyari, G.M., Halawani, M.A. and Mirza, A.A. (2021). Depression and anxiety among medical students: a brief overview. Advances in Medical Education and Practice, pp.393-398. https://www.tandfonline.com/doi/pdf/10.2147/AMEP.S302897 
• NICE. (2020). CKS is only available in the UK. [online] Available at: https://cks.nice.org.uk/topics/mental-health-in-students/.
• Ochnik, D., Rogowska, A.M., Kuśnierz, C., Jakubiak, M., Schütz, A., Held, M.J., Arzenšek, A., Benatov, J., Berger, R., Korchagina, E.V. and Pavlova, I., 2021. Mental health prevalence and predictors among university students in nine countries during the COVID-19 pandemic: a cross-national study. Scientific reports, 11(1), p.18644. https://www.nature.com/articles/s41598-021-97697-3.pdf
• Sujarwoto, Saputri, R.A.M. and Yumarni, T., 2023. Social media addiction and mental health among university students during the COVID-19 pandemic in Indonesia. International journal of mental health and addiction, 21(1), pp.96-110. https://link.springer.com/content/pdf/10.1007/s11469-021-00582-3.pdf