Rapid national increases in the hospitalisation of Australian youth due to intentional self-harm between 2008 and 2019

2021 ◽  
pp. 103985622110479
Author(s):  
Sven K Delaney ◽  
Stephen Allison ◽  
Jeffrey CL Looi ◽  
Niranjan Bidargaddi ◽  
Tarun Bastiampillai
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Youth Mental Health ◽  
Sociocultural Factors ◽  
Youth Services ◽  
Key Indicator ◽  
Population Mental Health ◽  
Youth Population ◽  
Self Harm

Objective: Australian youth mental health services have received significant funding over the past 15 years. We analysed data on hospitalisation due to intentional self-harm to determine whether increased youth services were associated with reduction in a key indicator of youth population mental health. Method: Trends in national self-harm hospitalisation data from 2008 to 2019 for youth (<25 years) and adults (>25 years) were analysed using joinpoint regression. Results: Rates of hospitalisation due to intentional self-harm increased significantly in both male (1.1% per annum, 95% CI [0.2%, 1.9%]) and female (3.0% per annum, 95% CI [0.9%, 5.1%]) youth aged <25 years between 2008 and 2019. Female youth had higher rates of hospitalisation than males, and there were average annual increases of 9.1% (95% CI [2.4%, 16.3%]) and 4.0% (95% CI [0.1%, 7.9%]), and absolute increases of 120% and 47.9%, in the rate of hospitalisation of females aged 0–14 and 15–19, respectively. In contrast, there was no overall change in adults (>25 years). Conclusions: Rates of hospitalisation due to intentional self-harm in Australian youth have increased despite significant investment in youth mental health services. This result could be attributable to several sociocultural factors and suggests a critical need for more hospital-based emergency youth mental health services.

Youth services: meeting the mental health needs of adolescents

2014 ◽  
Vol 32 (1) ◽  
pp. 13-19 ◽  
Author(s):  
N. S. Vyas ◽  
M. Birchwood ◽  
S. P. Singh
Keyword(s):  
Mental Health ◽  
Early Intervention ◽  
Mental Health Services ◽  
Health Services ◽  
Youth Mental Health ◽  
Youth Services ◽  
Early Intervention Services ◽  
Youth Service ◽  
Risk Period ◽  
Traditional Service

ObjectivesYouth mental health services are poised for a paradigm shift. Recent epidemiological evidence confirms the seriousness of adolescence as a risk period for mental ill-health - 50% of all adult mental disorders begin before the age of 16% and 75% before the age of 25. Here, we identify issues with transition of care between CAMHS-AMHS service, and effectiveness of early intervention services.MethodsWe provide a selective review providing evidence of adolescence as a risk period, discuss CAMHS-AMHS service transition problems, and discuss avenues for change to implement the early intervention model across youth mental health.ResultsTraditional service structures,with paediatric -adult split at 16–18 years increasingly appear not fit for purpose. A radical redesign of youth mental health services is not only necessary, it is also feasible and achievable, as illustrated by a pilot Birmingham youth service – Youthspace.ConclusionsPilot youth mental projects currently underway can help radically redesign the existing child and adolescent services. This will in turn lead to an improvement in the young people's experience of engagement with the services so that they too have a positive future.

scholarly journals Predicting self-harm within six months after initial presentation to youth mental health services: A machine learning study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243467
Author(s):  
Frank Iorfino ◽  
Nicholas Ho ◽  
Joanne S. Carpenter ◽  
Shane P. Cross ◽  
Tracey A. Davenport ◽  
...  
Keyword(s):  
Mental Health ◽  
Machine Learning ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Prediction Models ◽  
Youth Mental Health ◽  
Net Benefit ◽  
History Of ◽  
Self Harm

Background A priority for health services is to reduce self-harm in young people. Predicting self-harm is challenging due to their rarity and complexity, however this does not preclude the utility of prediction models to improve decision-making regarding a service response in terms of more detailed assessments and/or intervention. The aim of this study was to predict self-harm within six-months after initial presentation. Method The study included 1962 young people (12–30 years) presenting to youth mental health services in Australia. Six machine learning algorithms were trained and tested with ten repeats of ten-fold cross-validation. The net benefit of these models were evaluated using decision curve analysis. Results Out of 1962 young people, 320 (16%) engaged in self-harm in the six months after first assessment and 1642 (84%) did not. The top 25% of young people as ranked by mean predicted probability accounted for 51.6% - 56.2% of all who engaged in self-harm. By the top 50%, this increased to 82.1%-84.4%. Models demonstrated fair overall prediction (AUROCs; 0.744–0.755) and calibration which indicates that predicted probabilities were close to the true probabilities (brier scores; 0.185–0.196). The net benefit of these models were positive and superior to the ‘treat everyone’ strategy. The strongest predictors were (in ranked order); a history of self-harm, age, social and occupational functioning, sex, bipolar disorder, psychosis-like experiences, treatment with antipsychotics, and a history of suicide ideation. Conclusion Prediction models for self-harm may have utility to identify a large sub population who would benefit from further assessment and targeted (low intensity) interventions. Such models could enhance health service approaches to identify and reduce self-harm, a considerable source of distress, morbidity, ongoing health care utilisation and mortality.

scholarly journals Who asked you? Young People and practitioners identify ways to facilitate access to mental health supports

2021 ◽  
Vol 4 ◽  
pp. 74
Author(s):  
Ann Colleran ◽  
Anne O'Connor ◽  
Michael J. Hogan ◽  
Owen M. Harney ◽  
Hannah Durand ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Help Seeking ◽  
Collective Intelligence ◽  
Youth Mental Health ◽  
Help Seeking Behaviour ◽  
Population Mental Health ◽  
Potential Impact

Background: Despite representing the highest level of total population mental health burden, young people are the least likely to seek help from mental health services. It has been suggested that service design can influence the likelihood that young people will look for help, but little is known about how young people would like a service to be designed. This study addresses a gap in research regarding how mental health services can be designed to facilitate access for young people.                          Methods: A collective intelligence, scenario-based design methodology was used to facilitate stakeholders to identify and prioritise ways to improve youth mental health services. In total, 74 15–17-year-olds from three geographically diverse schools in Ireland worked to identify barriers to help-seeking and to generate and prioritise options in response to barriers. Nine practitioners with experience of working in youth mental health services rated all options in terms of both potential impact on help-seeking and feasibility for service implementation. Results: A total of 326 barriers across 15 themes were generated by youth stakeholders, along with 133 options in response to barriers. Through a process of voting, young people identified 30 options as the most impactful for improving access to mental health services. Of these options, 12 were also rated by practitioners as having both high potential impact and high feasibility. These 12 options focused on four areas: making services more familiar and welcoming; providing specialist mental health input in schools; improving parental understanding; and improving the visibility of appropriate supports. Conclusions: The results of the current study inform mental health service innovation and development, in particular, by highlighting potentially impactful and feasible ways to adapt existing mental health services to improve young people’s help-seeking behaviour.

scholarly journals Implementing a digital health model of care in Australian youth mental health services: protocol for impact evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Piper ◽  
Tracey A. Davenport ◽  
Haley LaMonica ◽  
Antonia Ottavio ◽  
Frank Iorfino ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Impact Evaluation ◽  
Digital Health ◽  
Youth Mental Health ◽  
Model Of Care ◽  
Health Service Provision ◽  
Industrial Grade ◽  
The Impact

Abstract Background The World Economic Forum has recently highlighted substantial problems in mental health service provision and called for the rapid deployment of smarter, digitally-enhanced health services as a means to facilitate effective care coordination and address issues of demand. In mental health, the biggest enabler of digital solutions is the implementation of an effective model of care that is facilitated by integrated health information technologies (HITs); the latter ensuring the solution is easily accessible, scalable and sustainable. The University of Sydney’s Brain and Mind Centre (BMC) has developed an innovative digital health solution – delivered through the Youth Mental Health and Technology Program – which incorporates two components: 1) a highly personalised and measurement-based (data-driven) model of youth mental health care; and 2) an industrial grade HIT registered on the Australian Register of Therapeutic Goods. This paper describes a research protocol to evaluate the impact of implementing the BMC’s digital health solution into youth mental health services (i.e. headspace - a highly accessible, youth-friendly integrated service that responds to the mental health, physical health, alcohol or other substance use, and vocational concerns of young people aged 12 to 25 years) within urban and regional areas of Australia. Methods The digital health solution will be implemented into participating headspace centres using a naturalistic research design. Quantitative and qualitative data will be collected from headspace health professionals, service managers and administrators, as well as from lead agency and local Primary Health Network (PHN) staff, via service audits, Implementation Officer logs, online surveys, and semi-structured interviews, at baseline and then three-monthly intervals over the course of 12 months. Discussion At the time of publication, six headspace centres had been recruited to this study and had commenced implementation and impact evaluation. The first results are expected to be submitted for publication in 2021. This study will focus on the impact of implementing a digital health solution at both a service and staff level, and will evaluate digital readiness of service and staff adoption; quality, usability and acceptability of the solution by staff; staff self-reported clinical competency; overall impact on headspace centres as well as their lead agencies and local PHNs; and social return on investment.

Systematic review of youth mental health service integration research

2016 ◽  
Vol 22 (4) ◽  
pp. 304 ◽  
Author(s):  
Irina Kinchin ◽  
Komla Tsey ◽  
Marion Heyeres ◽  
Yvonne Cadet-James
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Methodological Quality ◽  
Service Integration ◽  
Youth Mental Health ◽  
Inclusion Criteria

Quality mental health care is based on the integration of care across organisations and disciplines. The aims of this study were, first, to assess the extent, characteristics and reported outcomes of publications concerned with youth mental health service integration in Australia and internationally; and second, to investigate the study design quality of evaluative interventions and determine whether the studies report on the cost-effectiveness of the integration in order to inform the reform of youth mental health services by Queensland Health. A systematic search of the peer-reviewed literature and a narrative synthesis were undertaken of English language publications from 21 electronic databases. Inclusion criteria were: published 1998–2014 (inclusive); peer-reviewed research; focused on mental health services integration; reported data for youth aged 12–25 years. The methodological quality of evaluative interventions was assessed using the Quality Assessment Tool for Quantitative Studies developed by the Effective Public Health Practice Project (EPHPP). Twenty-five studies met the inclusion criteria: one (4%) was classified as a measurement research, 13 (52%) as descriptive, and 11 (44%) as interventions including five (45%) evaluative interventions. Four out of the five evaluative interventions reported positive effects of youth mental health service integration. Particular problems included ambiguity of definitions, absence of economic or cost analyses and insufficient consumer involvement. The methodological quality of the interventions was variable with, on average, a moderate level of selection bias and study design. Despite a slight increase in the number of studies in the last couple of years, there are important gaps in the evidence base for youth mental health service integration processes. The relatively small number of evaluative studies and lack of economic evaluations point to the need for additional research in this important area.

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