INTRODUCTION The prevalence of depressive disorder among young people is 3–8% in community samples, 1 and 20% among young people attending their family doctor. 2 Of young people who are depressed at the time of GP consultation, over 50% have not recovered 6months later. 3 There is an association between even mild-to-moderate depression in young people and impaired social functioning and high rates of affective disorderinadultlife. 4 Mentaldistressseems to persist in a considerable proportion of young people, and ‘it is insufficient to brush aside traumas and hurt and rely on a time healing process only’. 5 It is possible, therefore, that early intervention in mild-to- moderate depression, as well as in more severe depression in the teenage years, might alter the experience of mental ill- health in adult life. Over 50% of registered young persons consulttheirGPeachyear. 6 Whiledepressive disordersarecommonamongyoungpeople attending general practice, these individuals typically seek help for physical symptoms. Behavioural or emotional complaints account for only 2% of presentations. 2 Although GPs believe that depressive presentations among young people are becoming increasingly common, 7 they tend toidentifyandreactonlytothosewithsevere psychological symptoms, 8 and fail to identify a significant number with less-severe depressive disorders. 3 This could be explained by the fact that they find it difficult to separate mild-to-moderate depression from ‘normal’ moodiness. GPs spend less time in consultation with young people than with adults. 9 Many GPs feel that young persons differ from adults in the way they use general practice and that they are harder to communicate with, 10 and GPs also worry about over-medicalising young people’s lives. 11,12 A reluctance to discuss psychological problems with young people, even when GPs perceive such problems to be present, contributes to low rates of identification. 8,13 Even following identification, many young people with psychological disorders receive no specific management or follow-up, 8 perhaps because health professionals hesitate to address issues when they lack confidence in their own skills, or in the treatments available. 14 An authoritative statement that (in this age group) symptoms of depression are common and often resolve without psychological or medical intervention may have influenced practitioners. 15 While there has been considerable emphasis on training GPs to identify and manage adult psychiatric disorders, little work has addressed psychopathology in SIliffe, FRCGP, FRCP, professor of primary care, Department of Primary Care and Population Health, University College London. CGallant, BSc, primary care mental health worker, Central and NW London NHS Foundation Trust/Brent PCT, London. TKramer, MRCPsych, senior lecturer in child & adolescent psychiatry; JGledhill, MRCPsych, senior lecturer in child & adolescent psychiatry; ABye, BSc, research assistant; VFernandez, DrSpPsych, specialist registrar in child & adolescent psychiatry; MVila, DrSpPsych, specialist registrar in child & adolescent psychiatry; MEGarralda, MD, FRCPsych, professor of child & adolescent psychiatry, The Academic Unit of Child and Adolescent Psychiatry, Imperial College School of Medicine, London. LMiller, MRCGP, GP, Lonsdale Medical Centre, London. Addressforcorrespondence Professor Steve Iliffe, Research Department of Primary Care and Population Health, UCL, Royal Free Campus, Rowland Hill Street, London, NW32PF. E-mail: s.iliffe@ucl.ac.uk Submitted: 12 June 2011; Editor’sresponse: 7 July 2011; finalacceptance: 26 October 2011. ©BritishJournalofGeneralPractice This is the full-length article (published online 27 Feb 2011) of an abridged version published in print. Cite this article as: BrJGenPract2012; DOI:10.3399/bjgp12X630061 Therapeuticidentificationofdepressionin youngpeople: lessons from the introduction of a new technique in general practice Steve Iliffe, Ceri Gallant, Tami Kramer, Julia Gledhill, Amanda Bye, Victoria Fernandez, Mar Vila, Lisa Miller and M Elena Garralda Research Abstract Background Mild-to-moderate depression in young people is associated with impaired social functioning and high rates of affective disorder in adult life. Earlier recognition of depression in young people has the potential to reduce the burden of depression in adulthood. However, depression in teenagers is underdiagnosed and undertreated. Aim To assess the usability and usefulness of a cognitive-behavioural-therapy-based technique for Therapeutic Identification of Depression in Young people (TIDY). Designandsetting A qualitative study of four group practices in northwest London. Method Face-to-face semi-structured interviews were conducted with practitioners who had been trained in the use of the TIDY technique. Results Twenty-five GPs and six nurses were interviewed. The key themes that emerged from the interviews were: practitioners were ‘making sense of teenage depression’ when interpreting signs and symptoms; the training in the technique was variable in its impact on practitioners’ attitudes and practice; and time factors constrained practitioners in the application of the technique. Conclusion The TIDY technique is usable in routine practice, but only if practitioners are allowed to use it selectively. This need for selectivity arises partly from concerns about time management, and partly to avoid medicalisation of psychological distress in young people. The perceived usefulness of the TIDY technique depends on the practitioner’s prior knowledge, experience, and awareness. Keywords depression; general practice; intervention, psychological; screening; teenagers. e174 BritishJournalofGeneralPractice, March 2012