scholarly journals Using Digital Technologies to Facilitate Care Coordination Between Youth Mental Health Services: A Guide for Implementation

2021 ◽  
Vol 1 ◽  
Author(s):  
Frank Iorfino ◽  
Sarah E. Piper ◽  
Ante Prodan ◽  
Haley M. LaMonica ◽  
Tracey A. Davenport ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Service ◽  
Health Services ◽  
Dynamic Simulation ◽  
Care Coordination ◽  
Youth Mental Health ◽  
Simulation Modelling ◽  
Dynamic Simulation Modelling

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.

scholarly journals The effect of a youth mental health service model on access to secondary mental healthcare for young people aged 14–25 years

2018 ◽  
Vol 43 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Sarah Maxwell ◽  
Obianuju Ugochukwu ◽  
Tim Clarke ◽  
Brioney Gee ◽  
Emmet Clarke ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Young People ◽  
Health Service ◽  
Health Services ◽  
Mental Healthcare ◽  
Youth Mental Health ◽  
Service Model ◽  
Youth Service

Aims and methodThe Norfolk Youth Service was created in 2012 in response to calls to redesign mental health services to better meet the needs of young people. The new service model transcends traditional boundaries by creating a single, ‘youth friendly’ service for young people aged 14–25 years. The aim of this study was to investigate the effect of the transition to this new model on patterns of referral, acceptance and service use. We analysed routinely collected data on young people aged 14–25 years referred for secondary mental healthcare in Norfolk before and after implementation of the youth mental health service. The number of referrals, their age and gender, proportion of referrals accepted and average number of service contacts per referral by age pre- and post-implementation were compared.ResultsReferrals increased by 68% following implementation of the new service model, but the proportion of referrals accepted fell by 27 percentage points. Before implementation of the youth service, there was a clear discrepancy between the peak age of referral and the age of those seen by services. Following implementation, service contacts were more equitable across ages, with no marked discontinuity at age 18 years.Clinical implicationsOur findings suggest that the transformation of services may have succeeded in reducing the ‘cliff edge’ in access to mental health services at the transition to adulthood. However, the sharp rise in referrals and reduction in the proportion of referrals accepted highlights the importance of considering possible unintended consequences of new service models.Declaration of interestsNone.

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.

scholarly journals Youth Mental Health Tracker: protocol to establish a longitudinal cohort and research database for young people attending Australian mental health services

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e035379
Author(s):  
Cathrin Rohleder ◽  
Yun Ju Christine Song ◽  
Jacob J Crouse ◽  
Tracey A Davenport ◽  
Frank Iorfino ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Mental Disorders ◽  
Health Services ◽  
Physical Health ◽  
Youth Mental Health ◽  
Severe Illness ◽  
Trajectory Data

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.

Measuring parent satisfaction in youth mental health services

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Aileen O’Reilly ◽  
Alanna Donnelly ◽  
Jennifer Rogers ◽  
Olive Maloney ◽  
Gillian O’Brien ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Parent Satisfaction ◽  
Youth Mental Health ◽  
Service Development ◽  
Content Type ◽  
Growth And Change

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.

scholarly journals Development of a satisfaction scale for young people attending 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 ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Youth Mental Health ◽  
Satisfaction Scale

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 Young People’s Satisfaction With the Online Mental Health Service eheadspace: Development and Implementation of a Service Satisfaction Measure (Preprint)

2018 ◽  
Author(s):  
Debra Rickwood ◽  
Alison Wallace ◽  
Vanessa Kennedy ◽  
Shaunagh O’Sullivan ◽  
Nic Telford ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Young People ◽  
Health Service ◽  
Health Services ◽  
Youth Mental Health ◽  
Potential Outcomes ◽  
Service Satisfaction ◽  
Satisfaction Questionnaire ◽  
Service Contact

BACKGROUND Online youth mental health services are an expanding approach to meeting service need and can be used as the first step in a stepped-care approach. However, limited evidence exists regarding satisfaction with online services, and there is no standardized service satisfaction measure. OBJECTIVE This study implemented an online youth mental health service satisfaction questionnaire within eheadspace, an online youth mental health service. The aims were to test the questionnaire’s psychometric properties and identify current levels of satisfaction among service users, as well as to identify client and service contact characteristics that affect satisfaction. METHODS Data were collected from 2280 eheadspace clients via an online questionnaire advertised and accessed through the eheadspace service platform between September 2016 and February 2018. Client and service contact characteristics, potential outcomes, and session and service feedback data were collected. RESULTS The service satisfaction questionnaire demonstrated high internal consistency for the overall satisfaction scale (alpha=.95) and its three subscales: session satisfaction, potential outcomes, and service satisfaction. A three-factor model was the best fit to the data, although including a higher order unidimensional construct of overall satisfaction was also a reasonable fit. Overall, young people were very satisfied with eheadspace (mean 3.60, SD 0.83). Service characteristics, but not client characteristics, were significantly associated with satisfaction. Young people were more satisfied with eheadspace when they had greater engagement as evident through receiving esupport rather than briefer service provision, having a longer session and greater interaction with the clinician, and not previously attending a face-to-face headspace center. CONCLUSIONS The online youth mental health service satisfaction questionnaire developed for and implemented in eheadspace showed good psychometric properties. The measure is brief, has good internal consistency, and has a clear factor structure. The measure could be adapted for use in other online youth mental health services. The young people using eheadspace and completing the feedback survey were highly satisfied. Greater engagement with the online service was shown to be associated with greater satisfaction. No specific client demographic groups were shown to be more or less satisfied.

scholarly journals Who is in the transition gap? Transition from CAMHS to AMHS in the Republic of Ireland

2015 ◽  
Vol 32 (1) ◽  
pp. 61-69 ◽  
Author(s):  
F. McNicholas ◽  
M. Adamson ◽  
N. McNamara ◽  
B. Gavin ◽  
M. Paul ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Service ◽  
Health Services ◽  
Young Person ◽  
Republic Of Ireland ◽  
Transition Boundary ◽  
The Republic ◽  
Service Need

ObjectiveThe ITRACK study explored the process and predictors of transition between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) in the Republic of Ireland.MethodFollowing ethical approval, clinicians in each of Ireland’s four Health Service Executive (HSE) areas were contacted, informed about the study and were invited to participate. Clinicians identified all cases who had reached the transition boundary (i.e. upper age limit for that CAMHS team) between January and December 2010. Data were collected on clinical and socio-demographic details and factors that informed the decision to refer or not refer to the AMHS, and case notes were scrutinised to ascertain the extent of information exchanged between services during transition.ResultsA total of 62 service users were identified as having crossed the transition boundary from nine CAMHS [HSE Dublin Mid-Leinster (n=40, 66%), HSE South (n=18, 30%), HSE West (n=2, 3%), HSE Dublin North (n=1, 2%)]. The most common diagnoses were attention deficit hyperactivity disorder (ADHD; n=19, 32%), mood disorders (n=16, 27%), psychosis (n=6, 10%) and eating disorders (n=5, 8%). Forty-seven (76%) of those identified were perceived by the CAMHS clinician to have an ‘on-going mental health service need’, and of these 15 (32%) were referred, 11 (23%) young people refused and 21 (45%) were not referred, with the majority (12, 57%) continuing with the CAMHS for more than a year beyond the transition boundary. Young people with psychosis were more likely to be referred [χ2 (2, 46)=8.96, p=0.02], and those with ADHD were less likely to be referred [χ2 (2, 45)=8.89, p=0.01]. Being prescribed medication was not associated with referral [χ2 (2, 45)=4.515, p=0.11]. In referred cases (n=15), there was documented evidence of consent in two cases (13.3%), inferred in another four (26.7%) and documented preparation for transition in eight (53.3%). Excellent written communication (100%) was not supported by face-to-face planning meetings (n=2, 13.3%), joint appointments (n=1, 6.7%) or telephone conversations (n=1, 6.7%) between corresponding clinicians.ConclusionsDespite perceived on-going mental health (MH) service need, many young people are not being referred or are refusing referral to the AMHS, with those with ADHD being the most affected. CAMHS continue to offer on-going care past the transition boundary, which has resource implications. Further qualitative research is warranted to understand, in spite of perceived MH service need, the reason for non-referral by the CAMHS clinicians and refusal by the young person.

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