Latest evidence casts further doubt on the effectiveness of headspace

In reply: We thank Rickwood and colleagues1 for their interest in our article.2 Given limited resources to meet the increasing need for psychiatric care, services should focus on people with clinically significant symptoms and deliver sustained improvements that are clinically, as well as statistically, significant. There should also be adequate follow‐up so that results are generalisable. We therefore used headspace's own definitions of follow‐up (90 days post‐treatment) and clinically significant improvement (only possible if presenting symptoms are of clinical severity).3,4,5 In all the cited studies,3,4,5,6 follow‐up was very low and so it is legitimate to highlight that they represent a small, unrepresentative proportion of overall headspace attendees.6