scholarly journals Mental health services for young people: matching the service to the need

2013 ◽  
Vol 202 (s54) ◽  
pp. s1-s2 ◽  
Author(s):  
Max Birchwood ◽  
Swaran P. Singh
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Health Problems ◽  
Public Mental Health ◽  
Health Problems ◽  
Adult Services ◽  
Service Engagement ◽  
Policy Frameworks

SummaryIt is now known that the onset of severe and recurring mental health problems begins for the most part before the age of 25: this provides a clear focus for preventive strategies and public mental health that are a feature of many health policy frameworks. The present distinction between child and adolescent mental health services and adult services at 16 or 18 does not fit easily with these data and the now well-documented problems of transition suggest that a fundamental review of services for young people is overdue. This supplement provides an overview of the epidemiological, conceptual and service structures for young people with emergent and existing mental health problems, and asks the question, ‘How should we design services for young people to promote prevention and service engagement, and to improve outcomes?’

Young service users from refugee backgrounds: their perspectives on barriers to accessing Australian mental health services

2017 ◽  
Vol 10 (1) ◽  
pp. 68-80 ◽  
Author(s):  
Madeleine Claire Valibhoy ◽  
Josef Szwarc ◽  
Ida Kaplan
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Health Professionals ◽  
Mental Health Problems ◽  
Health Problems ◽  
Explanatory Models ◽  
Service Users ◽  
Content Type

Purpose The purpose of this paper is to examine barriers to accessing mental health services, from the perspective of young people of refugee background who have been service users, and to suggest strategies to improve access to mental health services. Design/methodology/approach A qualitative study was conducted with 16 young people (aged 18-25), who had been refugees and who had attended mental health professionals in Australia. Interview transcripts were analysed thematically to examine participants’ perspectives on what hinders initial access to mental health services. Findings Stigma about mental health problems was particularly prominent. Many believed a high level of disturbance was the threshold for entering services, and for some there was no knowledge of such services’ existence. Options for assistance other than mental health services were often preferred, according to young people’s explanatory models. Apprehension was expressed that sessions would be uncomfortable, distressing or ineffective. The desire to be self-reliant functioned as a further barrier. Finally, structural obstacles and social exclusion deterred some young refugees from accessing services. Practical implications Implications include the need for service providers to be equipped to provide culturally sensitive, responsive services that ideally offer both practical and psychological assistance. Potential referrers, including health professionals and community leaders, could facilitate increased access if trained to recognise and address barriers. Finally, findings indicate potential content for awareness-raising initiatives for young refugees about mental health problems and services. Originality/value This paper is original in its sample, method, topic and findings; being drawn from the first known qualitative research exploring views of young mental health service users who have been refugees about barriers to accessing mental health services.

Mental Health of Adolescents in Custody: The Use of the ‘Adolescent Psychopathology Scale’ in a Tasmanian Context

2002 ◽  
Vol 36 (5) ◽  
pp. 603-609 ◽  
Author(s):  
Rosie Bickel ◽  
Alistair Campbell
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Health Problems ◽  
Adolescent Psychopathology ◽  
Structured Interview ◽  
Health Problems ◽  
Individual Therapy ◽  
Interview Format

Objective: To investigate the incidence of mental health problems based on the DSM-IV [ 1 ] among adolescents in custody in Tasmania, using the Adolescent Psychopathology Scale (APS) [ 2 ]. Methods: The APS was administered to 50 adolescents admitted consecutively to a youth detention centre in Tasmania, Australia, using a structured interview format. Results: In this sample 46% scored positively for a mood disorder, 36% for posttraumatic stress disorder (PTSD), and 32% for an anxiety disorder excluding PTSD. Conclusions: Tasmania is no exception to the rule that adolescents in custody have a high proportion of mental health problems. This study confirmed findings of previous studies that detained adolescents had a roughly equivalent level of mental health problems as young people referred to mental health services and five times more than adolescents in the community. Therefore, all detained adolescents should be assessed for mental health problems as their risk is equivalent to that of young people referred to mental health services in the community. Youth detention centres are able to provide significant opportunities for individual therapy and group programmes for young people with mental health problems. However, to achieve a realization of this potential, detention facilities need to develop philosophies and procedures, which facilitate the development of therapeutic, as opposed to ‘punishing’, environments.

“Walking wounded or wounded healer?” Does personal experience of mental health problems help or hinder mental health practice? A review of the literature

2014 ◽  
Vol 18 (1) ◽  
pp. 35-44 ◽  
Author(s):  
Catherine Conchar ◽  
Julie Repper
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Peer Support ◽  
Personal Experience ◽  
Mental Health Problems ◽  
Health Problems ◽  
Review Of The Literature ◽  
Wounded Healer ◽  
Content Type

Purpose – A systematic review of the literature on “wounded healers” was undertaken to identify, define and interpret the term and its application within the mental health environment. The paper aims to discuss these issues. Design/methodology/approach – Eight key medical/social sciences databases were interrogated. In total, 835 papers were identified in the systematic database search and abstracts were obtained for each to determine whether they met the inclusion criteria. In total, 237 sources were retrieved for critical reading, to assess relevance and value to the review, and 125 documents were subsequently included. Through thematic analysis a number of themes and sub themes were identified Findings – The archetypal image of the wounded healer originates in ancient mythology and crosses many cultures. There are many interpretations and applications of the belief that having healed their own wounds a person is in a better position to heal others, however, the evidence to support this is not so robust. Of more direct relevance to contemporary practice are reports of supporting staff with mental health problems to make a contribution to mental health services, most recently through the employment of peer support workers. Originality/value – As peer support workers are increasingly being employed in mental health services, it is helpful to consider the many existing staff who bring personal experience of mental health problems. This paper explores the evidence that their lived experience makes a difference to the way that they work and considers their employment support needs.

Autistic spectrum disorder without intellectual impairment in adult mental health services – fostering new perspectives and enhancing existing services

2018 ◽  
pp. 1-7
Author(s):  
N. Crowley ◽  
H. O’Connell ◽  
M. Gervin
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Autistic Spectrum Disorder ◽  
Mental Health Problems ◽  
Health Problems ◽  
Spectrum Disorder ◽  
Intellectual Impairment ◽  
Autistic Spectrum ◽  
Adult Mental Health

Autistic spectrum disorder (ASD) is a neuro-developmental disability with multi-systemic impacts. Individuals with ASD without intellectual impairment (DSM-V) or Aspergers (DSM-IV) are often particularly vulnerable to mental health problems such as anxiety disorders including social phobia and generalised anxiety disorder, depressive disorders and psychosis. Adults with ASD without intellectual impairment suffer higher rates of physical and psychiatric morbidity, display a poorer ability to engage with treatment and have a lower chance of recovery compared with the general population. It is widely acknowledged that adults with suspected ASD without intellectual impairment and co-morbid mental health problems are often not best supported through adult mental health services and often require more tailored supports. This review seeks to (a) increase awareness in the area of undiagnosed cases of ASD without intellectual impairment in adult mental health settings and (b) highlights the importance of identifying this population more efficiently by referring to best practice guidelines. The value of future research to examine the benefit of having a team of specialist staff within adult mental health teams who have received ASD training and who are supported to work with the ‘core difficulties’ of ASD is discussed and a model for the same is proposed. It is proposed that a specialist team could form a ‘hub’ for the development of expertise in ASD, which when adequately resourced and funded could reach across an entire region, offering consultancy and diagnostic assessments and interventions.

scholarly journals Digital cognitive behaviour therapy for insomnia (CBTi) for adolescents with mental health problems. Results from a feasibility open trial. (Preprint)

2019 ◽  
Author(s):  
Bethany Cliffe ◽  
Abigail Croker ◽  
Megan Denne ◽  
Jacqueline Smith ◽  
Paul Stallard
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Health Problems ◽  
Anxiety And Depression ◽  
Severity Scale ◽  
Sleep Condition ◽  
Condition Indicator ◽  
Insomnia Severity

BACKGROUND Insomnia in adolescents is common, persistent, and associated with poor mental health including anxiety and depression. Insomnia in adolescents attending child mental health services is seldom directly treated and the effects of digital CBTi on the mental health of adolescents with significant mental health problems is unknown. OBJECTIVE This paper reports an open study assessing the feasibility of adding supported online CBT for insomnia to the usual care of young people aged 14-17 years attending specialist child and adolescent mental health services. METHODS Thirty-nine adolescents aged 14-17 attending specialist child and adolescent mental health services with insomnia were assessed and offered digital CBTi. The digital intervention was Sleepio, an evidence based, self-directed, fully automated CBTi that has proven effective in multiple randomized controlled trials with adults. Self-report assessments of sleep (Sleep Condition Indicator, Insomnia Severity Scale, online sleep diaries), anxiety (Revised Child Anxiety and Depression Scale) and depression (Mood and Feelings Questionnaire) were completed at baseline and post-intervention. Post-use interviews assessed satisfaction with digital CBTi. RESULTS Average baseline sleep efficiency was very poor (52.9%) with participants spending an average of 9.6 hrs in bed but only 5.1 hrs asleep. All scored <17 on the Sleep Condition Indicator with 36/39 (92.3%) scoring ≥15 on the Insomnia Severity Scale, suggesting clinical insomnia. 36 (92.3%) scored ≥ 27 on the Mood and Feelings Questionnaire for major depression and 20 (51.3%) had clinically elevated symptoms of anxiety. The majority (76%) were not having any treatment for their insomnia, with the remaining 24% receiving medication. Sleepio was acceptable with 77% (30/39) activating their account and 67% (21/30) completing the program. Statistically significant pre-post improvements were found in weekly diaries of sleep efficiency (p=.005) and sleep quality (p=.001) and on measures of sleep (SCI; p=.001: ISI; p=.001), low mood (MFQ; p=.024) and anxiety (RCADS; p=.015). Satisfaction was high; with 89% finding Sleepio helpful, 94% would recommend it to a friend with 39% expressing a definite preference for a digital intervention. CONCLUSIONS Our study has a number of methodological limitations, particularly the small sample size, absence of a comparison group and follow-up assessment. Nonetheless, our findings are encouraging and suggest that digital CBTi for young people with mental health problems might offer an acceptable and an effective way to improve both sleep and mental health. CLINICALTRIAL N/a

scholarly journals Deployment, Mental Health Problems, Suicidality, and Use of Mental Health Services Among Military Personnel

2016 ◽  
Vol 4 (3) ◽  
pp. 243-250 ◽  
Author(s):  
Carol Chu ◽  
Ian H. Stanley ◽  
Melanie A. Hom ◽  
Ingrid C. Lim ◽  
Thomas E. Joiner
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Military Personnel ◽  
Mental Health Problems ◽  
Health Problems

“When other people try to understand”: exploring the experiences of people with intellectual disabilities, who also have mental health problems

2020 ◽  
Vol 14 (3) ◽  
pp. 91-101
Author(s):  
Sasha Martine Mattock ◽  
Kieron Beard ◽  
Amy Baddeley
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Focus Group ◽  
Health Services ◽  
Intellectual Disabilities ◽  
Mental Health Problems ◽  
Health Problems ◽  
Content Type ◽  
The People ◽  
People With Intellectual Disabilities

Purpose Recent guidelines from the National Institute of Health and Care Excellence highlight that service users (SUs) with intellectual disabilities and co-occurring mental health problems rarely get the opportunity to share their experiences of mental health services. Over the past 20 years, policy documents have stated that these individuals (SUs) must be included in decisions about their care. Research suggests that often this is not the case. Therefore, this paper aims to create a space for SUs to share their experiences of mental health services, and what they found helpful. Design/methodology/approach A focus group was held with five SUs, two psychologists and two researchers. The audio recording of the discussion was transcribed and analysed using thematic analysis. Findings Three main themes were identified, namely, “relationships with others”, “inclusion and communication” and “challenges”. This focus group highlighted that although some SUs felt supported, they reported having little control in their lives and wanted to be listened to. Research limitations/implications Including a SU in the planning and facilitation of the focus group would have made this research more inclusive. Practical implications The implications of this research suggest that by listening to and involving SUs and developing more person-centred services, recovery rates may increase as the services provided would be more targeted. Originality/value Very little research has previously been conducted to explore SUs’ experiences. This paper highlights the value of being heard and the knowledge that is often lost if the authors do not take the time to listen to the people for whom a service is designed.

scholarly journals Professionals’ perceptions of the establishment of a specialized brief therapy unit in a district psychiatric centre - a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hilde V. Markussen ◽  
Lene Aasdahl ◽  
Marit B. Rise
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Service Provision ◽  
Mental Health Problems ◽  
Brief Therapy ◽  
Longitudinal Research ◽  
Health Problems ◽  
Outpatient Clinics ◽  
Short Term Treatment

Abstract Background Increasing mental health problems and scarce treatment resources put pressure on mental health services to make innovations in service provision, such as developing differentiated services adapted to different needs. One innovation in differentiated service provision is brief or short-term treatment to patients with moderate mental health problems. Implementing a new unit in an organization usually faces many potential barriers and facilitators, and knowledge on how the professionals providing the services perceive the implementation of innovative approaches in mental health services is scarce. The aim of this study was therefore to explore the professionals’ perceptions of how the establishment of a specialized brief therapy unit had affected the organization, especially the everyday work in the outpatient clinics. Methods Eleven professionals, five men and six women, took part in individual interviews. All participants were between 40 and 60 years old and had leading or coordinating positions in the organization. Their professional backgrounds were within psychology, nursing and medicine, most of them specialists in their field. Data was analyzed according to Systematic text condensation. Results The professionals’ experiences represented four main themes: (1) The brief therapy unit was perceived as successful and celebrated. (2) The general outpatient clinics, on the other hand, were described as “forgotten”. (3) The establishment process had elucidated different views on treatment in the outpatient clinics - and had set off (4) a discussion regarding the criteria for prioritizing in mental health services. Conclusion Providing targeted treatment to patients with moderate mental health problems, while having a concurrent aim to solve broader problems in mental health services, entails a discussion regarding resource use and the appropriate level of treatment provision. Professionals should be more involved when innovative efforts are implemented, and the criteria for success must be conceptualized and evaluated. Longitudinal research on the implementation of innovative efforts in the services should include professionals’ and service users’ perspectives.

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