Editorial: Better Treatments and the Importance of Publishing Negative Clinical Trials

We need better treatments for children with mental health problems, particularly those struggling with depression and suicidality. Every reader of this editorial already knows this. Although our best treatments help many children and adolescents, some experience only modest improvements such that they are still burdened with much of the weight of mental illness. And some experience no benefit at all. These conclusions are supported by two recent meta analytic studies. In a comprehensive meta-analysis of the efficacy of treatments for anxiety, attention-deficit/hyperactivity disorder, conduct problems, and depression, outcomes for depression were the "most disappointing," with effect sizes of only 0.29 at posttreatment assessments.¹ Likewise, Ourgin and colleagues'² meta-analysis of efficacy of interventions (pharmaceutical, social, or psychological) in reducing both suicidal and nonsuicidal self-harm in adolescents found promising effects for self-harm but no significant reductions in suicide attempts.