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 ◽  
...  

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.

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e035379
Author(s):  
Cathrin Rohleder ◽  
Yun Ju Christine Song ◽  
Jacob J Crouse ◽  
Tracey A Davenport ◽  
Frank Iorfino ◽  
...  

IntroductionMental disorders are a leading cause of long-term disability worldwide. Much of the burden of mental ill-health is mediated by early onset, comorbidities with physical health conditions and chronicity of the illnesses. This study aims to track the early period of mental disorders among young people presenting to Australian mental health services to facilitate more streamlined transdiagnostic processes, highly personalised and measurement-based care, secondary prevention and enhanced long-term outcomes.Methods and analysisRecruitment to this large-scale, multisite, prospective, transdiagnostic, longitudinal clinical cohort study (‘Youth Mental Health Tracker’) will be offered to all young people between the ages of 12 and 30 years presenting to participating services with proficiency in English and no history of intellectual disability. Young people will be tracked over 3 years with standardised assessments at baseline and 3, 6, 12, 24 and 36 months. Assessments will include self-report and clinician-administered measures, covering five key domains including: (1) social and occupational function; (2) self-harm, suicidal thoughts and behaviour; (3) alcohol or other substance misuse; (4) physical health; and (5) illness type, clinical stage and trajectory. Data collection will be facilitated by the use of health information technology. The data will be used to: (1) determine prospectively the course of multidimensional functional outcomes, based on the differential impact of demographics, medication, psychological interventions and other key potentially modifiable moderator variables and (2) map pathophysiological mechanisms and clinical illness trajectories to determine transition rates of young people to more severe illness forms.Ethics and disseminationThe study has been reviewed and approved by the Human Research Ethics Committee of the Sydney Local Health District (2019/ETH00469). All data will be non-identifiable, and research findings will be disseminated through peer-reviewed journals and scientific conference presentations.


2000 ◽  
Vol 34 (4) ◽  
pp. 688-691 ◽  
Author(s):  
Gus Norris ◽  
Roy Laube

Objective: Maladaptive help-seeking behaviour in psychiatric patients is a significant problem for public mental health services, yet it is not addressed in the mainstream literature. We present a report on the successful treatment of a person with schizophrenia who displayed this common dilemma for patients and clinicians. Clinical picture: A 31-year-old man with borderline intellectual functioning had a 10-year history of schizophrenia marked by negative features. He frequently presented in crisis to public mental health services, the local hospital, and his general practitioner; this resulted in excessive use of services, including admissions. Treatment: The patient was reassessed from a cognitive-behavioural perspective rather than a syndromal perspective. Specific behaviours were modified, cognitions were identified, challenged and restructured, and other service providers were provided with an alternative to admission or acute community care. Outcome: At 24 months the maladaptive behaviour remains in remission. Conclusions: Behavioural problems in persons with chronic schizophrenia may be effectively treated by reconceptualising the behaviour as distinct from the major diagnosis.


2021 ◽  
Vol 1 ◽  
Author(s):  
Frank Iorfino ◽  
Sarah E. Piper ◽  
Ante Prodan ◽  
Haley M. LaMonica ◽  
Tracey A. Davenport ◽  
...  

Enhanced care coordination is essential to improving access to and navigation between youth mental health services. By facilitating better communication and coordination within and between youth mental health services, the goal is to guide young people quickly to the level of care they need and reduce instances of those receiving inappropriate care (too much or too little), or no care at all. Yet, it is often unclear how this goal can be achieved in a scalable way in local regions. We recommend using technology-enabled care coordination to facilitate streamlined transitions for young people across primary, secondary, more specialised or hospital-based care. First, we describe how technology-enabled care coordination could be achieved through two fundamental shifts in current service provisions; a model of care which puts the person at the centre of their care; and a technology infrastructure that facilitates this model. Second, we detail how dynamic simulation modelling can be used to rapidly test the operational features of implementation and the likely impacts of technology-enabled care coordination in a local service environment. Combined with traditional implementation research, dynamic simulation modelling can facilitate the transformation of real-world services. This work demonstrates the benefits of creating a smart health service infrastructure with embedded dynamic simulation modelling to improve operational efficiency and clinical outcomes through participatory and data driven health service planning.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Aileen O’Reilly ◽  
Alanna Donnelly ◽  
Jennifer Rogers ◽  
Olive Maloney ◽  
Gillian O’Brien ◽  
...  

Purpose Measuring parent satisfaction is regarded as essential but there is a paucity of research reporting on parental satisfaction with community youth mental health services. This study aims to examine parent satisfaction with Jigsaw – a primary care youth mental health service. Design/methodology/approach A measure of parent satisfaction was developed and administered to parents in 12 Jigsaw services over a two-year period (n = 510, age range: 28 to 70 years) when young people and parents were ending their engagement with these services. Findings Overall, parents had high levels of satisfaction with Jigsaw and their level of satisfaction did not vary depending on the parent or young person’s age and/or gender. Examination of qualitative feedback revealed three overarching themes relating to growth and change in young people, parents and their families; strengths of the service and; suggestions for future service development. Analysis of the psychometric properties of the measure provided evidence for a two-factor structure examining satisfaction with the intervention and outcomes and service accessibility and facilities. Originality/value This study represents one of the first efforts to measure parent satisfaction with primary care youth mental health services. It has resulted in the development of a brief measure that can be more widely administered to parents engaging with primary care youth mental health services.


2013 ◽  
Vol 8 (4) ◽  
pp. 382-386 ◽  
Author(s):  
Magenta B. Simmons ◽  
Alexandra G. Parker ◽  
Sarah E. Hetrick ◽  
Nic Telford ◽  
Alan Bailey ◽  
...  

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243467
Author(s):  
Frank Iorfino ◽  
Nicholas Ho ◽  
Joanne S. Carpenter ◽  
Shane P. Cross ◽  
Tracey A. Davenport ◽  
...  

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.


2021 ◽  
pp. 103985622110479
Author(s):  
Sven K Delaney ◽  
Stephen Allison ◽  
Jeffrey CL Looi ◽  
Niranjan Bidargaddi ◽  
Tarun Bastiampillai

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.


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