scholarly journals Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK

2013 ◽  
Vol 202 (s54) ◽  
pp. s30-s35 ◽  
Author(s):  
Patrick McGorry ◽  
Tony Bates ◽  
Max Birchwood
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Disorder ◽  
Age Groups ◽  
Mental Healthcare ◽  
Population Group ◽  
The Uk ◽  
The Impact

SummaryDespite the evidence showing that young people aged 12-25 years have the highest incidence and prevalence of mental illness across the lifespan, and bear a disproportionate share of the burden of disease associated with mental disorder, their access to mental health services is the poorest of all age groups. A major factor contributing to this poor access is the current design of our mental healthcare system, which is manifestly inadequate for the unique developmental and cultural needs of our young people, if we are to reduce the impact of mental disorder on this most vulnerable population group, transformational change and service redesign is necessary. Here, we present three recent and rapidly evolving service structures from Australia, Ireland and the UK that have each worked within their respective healthcare contexts to reorient existing services to provide youth-specific, evidence-based mental healthcare that is both accessible and acceptable to young people.

Adolescent inpatient mental health services in the UK

2021 ◽  
pp. archdischild-2020-321442
Author(s):  
Daniel Hayes ◽  
Jemma Thievendran ◽  
Marinos Kyriakopoulos
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Treatment Plan ◽  
Mental Healthcare ◽  
Inpatient Mental Health ◽  
Adolescent Inpatient ◽  
The Uk ◽  
High Level

Inpatient mental health services are an indispensable part of the mental healthcare for adolescents. They provide comprehensive assessment and treatment for young people severely affected by mental health difficulties whose presentation is associated with high level of risk or where diagnostic clarity and effective intervention cannot be achieved with less intensive community input. In the UK, a range of different mental health units have been developed with the aim to meet the needs of young people requiring admission with the appropriate expertise and in the least restrictive way possible. Although an inpatient admission is necessary and helpful for a number of adolescents, it may also be linked to some adverse effects that need to be carefully assessed and managed when such an option is considered or pursued. Collaborative working between inpatient units, community teams and young people and their families is paramount in ensuring that inpatient interventions form part of a wider treatment plan, are as efficient and effective as possible and are used in a way that fosters engagement, independence and optimal outcomes.

scholarly journals The divide between child and adult mental health services: points for debate

2013 ◽  
Vol 202 (s54) ◽  
pp. s41-s44 ◽  
Author(s):  
Clare Lamb ◽  
Margaret Murphy
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Discussion Paper ◽  
Adult Mental Health ◽  
The Uk

SummaryThis discussion paper outlines our personal views for debate on some of the complexities inherent in the crucial task of improving mental health services for young people in the UK.

scholarly journals Unexpected deaths of children and young people in the UK

2016 ◽  
Vol 40 (2) ◽  
pp. 68-71 ◽  
Author(s):  
Paul Stallard ◽  
Michelle Maguire ◽  
Justin Daddow ◽  
Rosie Shepperd ◽  
Mike Foster ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Child Death ◽  
National Data ◽  
Children And Young People ◽  
National Health Service Trust ◽  
Incident Reports ◽  
The Uk

Aims and methodTo review the deaths of children and young people who took their own life. We conducted a retrospective analysis of serious incident reports from a National Health Service trust and reviews by the child death overview panels of the local safeguarding children boards.ResultsWe identified 23 deaths, with annual rates varying considerably between local authorities and over time. Over half of the children (n = 13, 56%) were not known to specialist child and adolescent mental health services, with 11 having no contact with any agency at the time of their death. Hanging was the most common method (n = 20, 87%) and of these, half (n =11, 55%) were low-level hangings.Clinical implicationsTraining is required to improve awareness, recognition and the assessment of children at risk of taking their own life. Specialist child mental health services should directly assess plans or attempts at hanging and offer advice about the seriousness of attempting this. National data (by age) on children and young people who take their own life should be routinely published to inform clinical and preventive services.

scholarly journals Mapping UK mental health services for adults with attention-deficit/hyperactivity disorder: national survey with comparison of reporting between three stakeholder groups

BJPsych Open ◽  
2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Anna Price ◽  
Astrid Janssens ◽  
Tamsin Newlove-Delgado ◽  
Helen Eke ◽  
Moli Paul ◽  
...  
Keyword(s):  
Mental Health ◽  
Attention Deficit Hyperactivity Disorder ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Attention Deficit ◽  
Full Range ◽  
Hyperactivity Disorder ◽  
Stakeholder Groups ◽  
The Uk

Background UK clinical guidelines recommend treatment of attention-deficit hyperactivity disorder (ADHD) in adults by suitably qualified clinical teams. However, young people with ADHD attempting the transition from children's to adults’ services experience considerable difficulties in accessing care. Aims To map the mental health services in the UK for adults who have ADHD and compare the reports of key stakeholders (people with ADHD and their carers, health workers, service commissioners). Method A survey about the existence and extent of service provision for adults with ADHD was distributed online and via national organisations (e.g. Royal College of Psychiatrists, the ADHD Foundation). Freedom of information requests were sent to commissioners. Descriptive analysis was used to compare reports from the different stakeholders. Results A total of 294 unique services were identified by 2686 respondents. Of these, 44 (15%) were dedicated adult ADHD services and 99 (34%) were generic adult mental health services. Only 12 dedicated services (27%) provided the full range of treatments recommended by the National Institute for Health and Care Excellence. Only half of the dedicated services (55%) and a minority of other services (7%) were reported by all stakeholder groups (P < 0.001, Fisher's exact test). Conclusions There is geographical variation in the provision of NHS services for adults with ADHD across the UK, as well as limited availability of treatments in the available services. Differences between stakeholder reports raise questions about equitable access. With increasing numbers of young people with ADHD graduating from children's services, developing evidence-based accessible models of care for adults with ADHD remains an urgent policy and commissioning priority.

scholarly journals Incidence of anorexia nervosa in young people in the UK and Ireland: a national surveillance study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e027339 ◽  
Author(s):  
Hristina Petkova ◽  
Mima Simic ◽  
Dasha Nicholls ◽  
Tamsin Ford ◽  
A Matthew Prina ◽  
...  
Keyword(s):  
Mental Health ◽  
Anorexia Nervosa ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Young Women ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Surveillance Study ◽  
The Uk

ObjectivesThis study aimed to estimate the incidence of DSM5 anorexia nervosa in young people in contact with child and adolescent mental health services in the UK and Ireland.DesignObservational, surveillance study, using the Child and Adolescent Psychiatry Surveillance System, involving monthly reporting by child and adolescent psychiatrists between 1st February 2015 and 30th September 2015.SettingThe study was based in the UK and Ireland.ParticipantsClinician-reported data on young people aged 8–17 in contact with child and adolescent mental health services for a first episode of anorexia nervosa.Main outcome measuresAnnual incidence rates (IRs) estimated as confirmed new cases per 100 000 population at risk.Results305 incident cases of anorexia nervosa were reported over the 8-month surveillance period and assessed as eligible for inclusion. The majority were young women (91%), from England (70%) and of white ethnicity (92%). Mean age was 14.6 years (±1.66) and mean percentage of median expected body mass index for age and sex was 83.23% (±10.99%). The overall IR, adjusted for missing data, was estimated to be 13.68 per 100 000 population (95% CI 12.88 to 14.52), with rates of 25.66 (95% CI 24.09 to 27.30) for young women and 2.28 (95% CI 1.84 to 2.79) for young men. Incidence increased steadily with age, peaking at 15 (57.77, 95% CI 50.41 to 65.90) for young women and 16 (5.14, 95% CI 3.20 to 7.83) for young men. Comparison with earlier estimates suggests IRs for children aged 12 and under have increased over the last 10 years.ConclusionThese results provide new estimates of the incidence of anorexia nervosa in young people. Service providers and commissioners should consider evidence to suggest an increase in incidence in younger children.Trial registration numberISRCTN12676087.

scholarly journals Children and Young People's Improving Access to Psychological Therapies: inspiring innovation or more of the same?

2015 ◽  
Vol 39 (2) ◽  
pp. 57-60 ◽  
Author(s):  
Sami Timimi
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Mental Health Problems ◽  
Children And Young People ◽  
Psychological Therapies ◽  
Common Mental Health Problems ◽  
Uk Government ◽  
The Uk

SummaryIn 2007 the UK Government announced a substantial expansion of funding for psychological therapies for those presenting with common mental health problems. This ‘Improving Access to Psychological Therapies’ (IAPT) project was widely welcomed, however, evidence backed, economic, and conceptual critiques were voiced from the start and the project remains controversial. In 2011, the UK government announced it was extending the IAPT project to encompass services for children and young people with the aim of ‘transforming’ the way mental health services are delivered to them. Here I critically reflect on the problems associated first with IAPT and then with CYP-IAPT and ponder whether CYP-IAPT is significantly different to the problematic adult IAPT project or more of the same.

scholarly journals Mental healthcare and service user impact of the COVID-19 pandemic: results of a UK survey of staff working with people with intellectual disability and developmental disorders

2020 ◽  
Author(s):  
Rory Sheehan ◽  
Christian Dalton-Locke ◽  
Afia Ali ◽  
Vasiliki Totsika ◽  
Norha Vera San Juan ◽  
...  
Keyword(s):  
Mental Health ◽  
Developmental Disabilities ◽  
Mental Health Services ◽  
Health Services ◽  
Service User ◽  
Mental Healthcare ◽  
Free Text ◽  
Intellectual And Developmental Disabilities ◽  
Health And Social Care ◽  
The Impact

Background Very little is known about the impact of previous epidemics on the care of people with intellectual and developmental disabilities, particularly in terms of mental health services. The COVID-19 pandemic has the potential to exacerbate existing health inequalities as well as expose gaps in service provision for this vulnerable population group. Methods We investigated the responses of 648 staff working in mental healthcare with people with intellectual disabilities and/or developmental disabilities. Participants contributed to a UK-wide online survey undertaken by the National Institute for Health Research Mental Health Policy Research Unit between 22nd April and 12th May 2020. Recruitment was via professional networks, social media and third sector organisations. Quantitative data describing staff experience over three domains (challenges at work, service user and carer problems, sources of help at work) were summarised and differences between groups explored using Chi square tests. Content analysis was used to organise qualitative data focusing on service changes in response to the pandemic. Results The majority of survey respondents worked in the NHS and in community mental health services. One third had managerial responsibility. Major concerns expressed by mental healthcare staff were: difficulties for service users due to lack of access to usual support networks and health and social care services during the pandemic; and difficulties maintaining adequate levels of support secondary to increased service user need. Staff reported having to quickly adopt new digital ways of working was challenging; nevertheless, free text responses identified remote working as the innovation that staff would most like to retain after the pandemic subsides. Conclusions Understanding the experiences of staff working across different settings in mental healthcare for people with intellectual and developmental disabilities during the COVID-19 pandemic is essential in guiding contingency planning and fostering service developments to ensure the health of this vulnerable group is protected in any future disease outbreaks.

scholarly journals Primary care clinical management following self-harm during the first wave of COVID-19 in the UK

2021 ◽  
Author(s):  
Sarah Steeg ◽  
Matthew J Carr ◽  
Laszlo Trefan ◽  
Darren M Ashcroft ◽  
Nav Kapur ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Psychotropic Medication ◽  
Clinical Management ◽  
Practice Nurse ◽  
Self Harm ◽  
The Uk ◽  
The Impact

AbstractBackgroundA substantial reduction in GP-recorded self-harm occurred during the first wave of COVID-19 but effects on primary care management of self-harm are unknown.AimTo examine the impact of COVID-19 on clinical management within three months of an episode of self-harm.Design and settingProspective cohort study using data from the UK Clinical Practice Research Datalink.MethodWe compared cohorts of patients with an index self-harm episode recorded during a pre-pandemic period (10th March-10th June, 2010-2019) versus the COVID-19 first-wave period (10th March-10th June 2020). Patients were followed up for three months to capture psychotropic medication prescribing, GP/practice nurse consultation and referral to mental health services.Results48,739 episodes of self-harm were recorded during the pre-pandemic period and 4,238 during the first-wave COVID-19 period. Similar proportions were prescribed psychotropic medication within 3 months in the pre-pandemic (54.0%) and COVID-19 first-wave (54.9%) cohorts. Likelihood of having at least one GP/practice nurse consultation was broadly similar (83.2% vs. 80.3% in the COVID-19 cohort). The proportion of patients referred to mental health services in the COVID-19 cohort (3.4%) was around half of that in the pre-pandemic cohort (6.5%).ConclusionDespite the challenges experienced by primary healthcare teams during the initial COVID-19 wave, prescribing and consultation patterns following self-harm were broadly similar to pre-pandemic levels. However, the reduced likelihood of referral to mental health services warrants attention. Accessible outpatient and community services for people who have self-harmed are required as the COVID-19 crisis recedes and the population faces new challenges to mental health.

Managing challenging behavior in people with intellectual disabilities in communities and reducing hospital stays: Current and future challenges from an European perspective

2017 ◽  
Vol 41 (S1) ◽  
pp. S598-S599
Author(s):  
B. Perera ◽  
K. Courtenay ◽  
S. Elstner ◽  
K. Krysta
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Disorder ◽  
Challenging Behavior ◽  
Psychiatric Inpatient ◽  
Psychotropic Medications ◽  
Behavior Difficulties ◽  
Specialist Services ◽  
The Uk

Prevalence of intellectual disability (ID) ranges from 0.05 to 1.55%. A total of10–15% of the people with ID present with challenging behavior (CB). This causes a significant strain on mental health services. People with ID; end up staying in psychiatric inpatient units for longer periods. Most people with ID move out of their family home to various care settings due to severity of their behavior difficulties. Few European countries have specialist services for people with ID whereas most countries manage people with ID and CB using adult mental health services. There is ongoing debate whether patients with ID and CB need to be managed by specialist services. There are significant financial implications looking after people with ID and CB. This has often led to over prescribing of psychotropic medications to people with ID without a mental disorder to manage their behaviors. There are significant strains on mental health services to manage people with ID and CB. This presentation discusses. Describe people with CB and ID and their characteristics including mental disorder, use of psychotropic medications, socio demographic factors and financial costs to look after them. Social and health care approach to look after people with CB in the UK, Challenges to develop services for people with CB in ID in Germany and Poland. Do we need specialist services for people with ID and CB? Pros and cons.Disclosure of interestCOI: Bhathika Perera, I have received travel grants from pharmaceutical companies to attend ADHD conferences and I have been a speaker at pharmaceutical company sponsored events on ADHD.

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