Rationale
Antidepressants and/or psychological therapy are interventions that are generally not warranted in service users presenting solely with low mood or unhappiness. Assessment options include a cut-off score on an evidence-based questionnaire and/or a clinical diagnosis based on ICD–10 or DSMIV criteria. It is not recommended that decisions be solely based on a questionnaire score without additional information gained from a clinical interview.

Most local areas will already have an antidepressant algorithm that gives a clear indication of the clinical threshold for the commencement of prescriptions. A decision to start a treatment should match the need and preference of the service user. Single, uncomplicated severe depressive episodes may be safely and successfully treated in primary care. Equally, a mild disorder complicated by substance misuse, adverse social factors, suicidality and so on may require multidisciplinary assessment and treatment in secondary care.

Examples of evidence required to meet standard 36:
Local algorithm detailing:
- antidepressant prescribing
- psychological therapies
- other evidence-based interventions
- referral for multidisciplinary assessment and management