Australian & New Zealand Journal of Psychiatry | 2021
21st year of the 21st century: And still, we need guidelines?
Abstract
Australian & New Zealand Journal of Psychiatry, 55(1) The announcement of new guidelines is usually met with a lukewarm reception at best. At worst, there is open criticism, either because they are thought to be irrelevant, or because they are seen as restricting the practices of whomsoever they apply to. But one of the many lessons we have learnt in 2020 is that timely and wellfounded guidance can be essential and, when adhered to, can bring significant benefits. The past year gave rise to a wide diversity of opinion as to the best management strategy to combat the COVID-19 pandemic, and different approaches have resulted in vastly different infection rates and deaths. Some took the view that the virus should be allowed to spread, rationalising that, once the majority of the community had been infected, the population as a whole would have herd immunity. Others, underestimating its impact, thought that the virus could be managed by allowing it to spread in stages. Currently, the most successful approach appears to have been that adopted by both New Zealand and Australia: restricting community spread and containing the virus until its ability to be transmitted was lost. This approach has saved lives, but has had profound effects on work, travel and leisure. Nonetheless, to date, it seems the resulting adverse economic impact has been lower than in countries where the virus spread widely. Eliminating community spread has required simple measures, such as limiting contact, regular handwashing, social distancing and wearing facial masks. In this regard, what I found most astounding was the extent to which people needed to be reminded to wash their hands and, in many cases, had to be taught how to wash their hands. Guidance, and even the most basic advice, is sometimes necessary. The mood disorders guidelines (Malhi et al. 2021) in this issue are not intended to encroach upon the autonomy of clinicians. The recommendations they make are proffered for consideration. My hope is that they will prove useful to all those seeking to manage and minimise the harms associated with mood disorders.