Research projects

Ensuring guideline-concordant monitoring of suicidal thinking and behaviour after initiation of antidepressant treatment in 12-to 25-year-olds with depression

Principal researcher

Dr Sarah Hetrick1
Professor Jane Gunn2
Associate Professor Lena Sanci2
Professor Deborah Rickwood3


1 Orygen Youth Health Research Centre
2 University of Melbourne
3 University of Canberra



Award type

National Priority Driven Research Program

Project completion year


Project brief

The project aimed to:

  • facilitate implementation of Recommendation 8 of the Clinical Practice Guidelines for Depression in Adolescents and Young Adults (1). It states that ‘young people should be monitored for the onset of or increase in suicidal thinking following initiation of SSRIs’. There are also several good practice points related to careful monitoring of young people being treated for depression.
  • test the feasibility and utility of an online self-monitoring tool as a strategy to facilitate implementation of Recommendation 8 for young people aged 12 to 25 being treated for a depressive disorder
  • assess the trajectory of depression symptom severity and suicidal ideation during treatment of depression and particularly from the point of antidepressant medication initiation in this group.

Main messages

  • The online self-monitoring tool improved the quality of routine monitoring of depression symptoms and side effects, including suicidal ideation of young people being treated for depression via use of validated and recognised scales providing more comprehensive information.
  • Client’s depression symptoms and suicidal ideation improved at the same time and to a similar degree over time.
  • Both clinicians and young people found the online self-monitoring tool easy to use and useful, with the overwhelming majority liking the tool.
  • Clinicians reported the online self-monitoring tool as particularly useful for gaining a quick understanding of their client’s risk with regard to suicidal ideation as well as their treatment progress, meaning they could more quickly focus on the client’s needs in their treatment sessions.
  • Clinicians reported that the online monitoring tool helped with engaging their clients because their clients seemed more willing to share how they were feeling in terms of symptoms, side effects and, importantly, their suicidal ideation online, meaning the clinician could address these issues. This highlights the potential for the online self-monitoring tool to improve outcomes for young people because clinicians are provided with more complete information and therefore the opportunity to make changes to their treatment plan in response to client’s online sharing of symptoms, side effects and suicidal ideation.
  • If fully incorporated into clinical practice, the refined tool has the potential to enable clinical practice that is in line with the Beyond Blue guidelines for the management of depression.


Download the final report


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