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Walker SC, Wissow L, Gubner NR, Ngo S, Szatmari P, Servili C. Scale-up of Global Child and Youth Mental Health Services: A Scoping Review. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01400-3. [PMID: 39105972 DOI: 10.1007/s10488-024-01400-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2024] [Indexed: 08/07/2024]
Abstract
Numerous influential policy and scientific bodies are calling for more rapid advances in the scale-up of child and youth mental health services (CYMHS). A number of CYMHS innovations hold promise for advancing scale-up but little is known about how real-world efforts are progressing. We conducted a scoping review to identify promising approaches to CYMHS scale-up across the globe. Searches were completed in six databases (Academic Search Complete, CINAHL, MEDLINE, PsychInfo, PubMed, and Web of Science). Article selection and synthesis were conducted in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist. A second search focused on low-and-middle-income countries (LMIC) was conducted based on the Cochrane Library recommended search filters of the World Bank listed LMIC countries. Authors used a double coding strategy during the title/abstract and full-text review. Twenty-eight articles meeting the eligibility criteria were identified that described 22 initiatives (in 11 different countries). Our review found the majority of published scale-up studies in CYMHS were not informed by scale-up frameworks in design or reporting. The methods and outcomes used in the identified articles were highly variable and limited our ability to draw conclusions about comparative effectiveness although promising approaches emerged. Successes and failures identified in our review largely reflect consensus in the broader literature regarding the need for strategies to better navigate the complexities of system and policy implementation while ensuring CYMHS interventions fit local contexts.
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Affiliation(s)
- Sarah Cusworth Walker
- University of Washington, 4333 Brooklyn Ave NE, Box 359457, Seattle, WA, 98195-9457, USA.
| | - Lawrence Wissow
- University of Washington, 4800 Sand Point Way NE, MS OA.5.154, Seattle, WA, 98105, USA
| | - Noah R Gubner
- University of Washington, 4333 Brooklyn Ave NE, Box 359457, Seattle, WA, 98195-9457, USA
| | - Sally Ngo
- University of Washington, 4333 Brooklyn Ave NE, Box 359457, Seattle, WA, 98195-9457, USA
| | - Peter Szatmari
- University of Toronto, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
| | - Chiara Servili
- World Health Organization, Avenue Appia 20, 1201, Geneva, Switzerland
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2
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Sullivan E, Bartik W. What do rural young people want from their mental health service. Aust J Rural Health 2023; 31:1072-1082. [PMID: 37485652 DOI: 10.1111/ajr.13018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/05/2023] [Accepted: 07/06/2023] [Indexed: 07/25/2023] Open
Abstract
INTRODUCTION Rural young people have high rates of mental illness and low rates of help-seeking making it crucial to extend research about service improvement in rural and remote Australia. OBJECTIVE To describe what rural young people want from their headspace service, and what rural headspace clinicians understand they provide. DESIGN This study used a qualitative methodology with reflexive thematic analysis to analyse participant interviews and systematically derive common themes. FINDINGS Thirteen participants were interviewed comprising young people aged 16 to 18 years who had accessed one of three rural headspace services, together with clinicians working in those services. Key themes for both young people and clinicians comprised accessibility, flexibility, engagement, safety, youth-focus, and evidence-based treatment although there were some differences of emphasis amongst themes. There was also an additional theme for young people of awareness, and for clinicians of caring. DISCUSSION The results supported that what young people were seeking was largely consistent with what headspace clinicians were providing. There were however some specific issues relevant to service provision in a rural context such as increased awareness of services, the need to focus on evidenced based interventions, and better promotion in schools and the local community. Service gaps such as unmet needs for young people with higher risk who might fall outside of agency requirements were also identified. CONCLUSION Results of this study help inform better service delivery and increased awareness for mental health of young people in rural communities to improve access and outcomes.
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Affiliation(s)
- Erin Sullivan
- University of New England, Armidale, New South Wales, Australia
| | - Warren Bartik
- University of New England, Armidale, New South Wales, Australia
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3
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Tuaf H, Orkibi H. Community-based programs for youth with mental health conditions: a scoping review and practical implications. Front Public Health 2023; 11:1241469. [PMID: 38026340 PMCID: PMC10651729 DOI: 10.3389/fpubh.2023.1241469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Background Approximately 14% of all adolescents globally cope with mental health conditions. However, community-based psychosocial services for adolescents with mental health conditions are scarce and under-researched. Scant scholarly attention has been paid to leisure and/or social activities in community-based rehabilitation services for adolescents with mental health conditions. Objectives To begin to fill this gap, we chose a bottom-up framework to probe the following questions: Which community-based programs for adolescents with mental health conditions exist worldwide? What common characteristics do they present? What is their range of services? Method We systematically searched three leading academic databases, reference lists, and worldwide websites in English. Eligibility criteria Programs with information in English that provide services in a community setting, service content that includes leisure and/or social activities, cater to users aged 10-18, and content explicitly targets adolescents with mental health conditions. Results Twenty-seven psychosocial programs that provide leisure and/or social activities and encourage the promotion of adolescent mental health in the community were identified. We mapped and categorized the programs into three groups: integrated recovery, leisure recovery, and advocacy recovery. Conclusion Practical implications for implementation are suggested based on the findings. Specifically, service providers should attend to the psychological needs of adolescents by prioritizing peer interaction and offering suitable social and leisure activities. These activities can also boost adolescent participation in community-based rehabilitation programs and address the treatment gap. Comprehensive studies and uniform terminology in the field are needed.
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Affiliation(s)
- Hila Tuaf
- Drama & Health Science Lab, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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Perspectives of French adolescents with ADHD and child and adolescent psychiatrists regarding methylphenidate use. Sci Rep 2023; 13:4040. [PMID: 36899043 PMCID: PMC10006242 DOI: 10.1038/s41598-023-30921-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 03/03/2023] [Indexed: 03/12/2023] Open
Abstract
Many studies have demonstrated the short-term efficacy and tolerability of methylphenidate treatment adolescents with attention deficit hyperactivity disorder (ADHD). Qualitative literature on this matter focused on school outcomes, long-term side effects, family conflicts, personality changes and stigmatization. Yet, no qualitative study has crossed the perspectives of child and adolescent psychiatrists (CAPs) prescribing methylphenidate and adolescents with ADHD. This French qualitative study followed the five stages IPSE-Inductive Process to analyze the Structure of lived Experience-approach. Fifteen adolescents with ADHD and 11 CAPs were interviewed. Data collection by purposive sampling continued until data saturation was reached. Data analysis, based on a descriptive and structuring procedure to determine the structure of lived experience characterized by the central axes of experience, produced two axes: (1) The process of methylphenidate prescription, highlighting how this prescription was motivated from the exterior, experienced as passive by the adolescents and required commitment from the CAPs; and (2) the perceived effects of methylphenidate treatment, in three domains: at school, in relationships and in the sense of self. Findings raised both the issues of the epistemic position and social representation of the adolescents about ADHD and methylphenidate within this specific French context, and the self-awareness and perception of the adolescents with ADHD. We conclude that these two issues need to be regularly addressed by the CAPs prescribing methylphenidate to avoid epistemic injustice and prevent the harmful effects of stigmatization.
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Gaudreau H, Radziszewski S, Houle J, Beaudin A, Boisvert LP, Brouri S, Charrette M, Côté L, Coulombe S, Labelle R, Louka E, Mousseau B, Phaneuf N, Rickwood D, Tremblay PH. Self-Management Strategies in Youth With Difficulties Related to Anxiety or Depression: What Helps Them Feel Better. JOURNAL OF ADOLESCENT RESEARCH 2023. [DOI: 10.1177/07435584231154840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Anxiety and depressive disorders are the most prevalent mental health problems in adolescents, however, little is known about the strategies they use to deal with their difficulties and regain power over their symptoms. This exploratory study documented the self-management strategies used by adolescents to recover from difficulties related to anxiety and/or depression. Individual interviews were conducted in Montreal, Canada with 49 participants aged 11 to 18 years (28 girls, 20 boys, and 1 non-binary person from various cultural origins) after approval by the Institutional Review Board. Young people were questioned about the self-management strategies they put in place when they felt stressed, sad, or anxious. The data were coded according to the thematic analysis method using an inductive approach. Participants reported 73 self-management strategies, regrouped in four broad themes: (a) I think through; (b) I surround myself with people/animals; (c) I feel and manage my emotions; (d) I continue my daily activities. Their strategies emphasize the role played by their social network and the place of social media as a support in their recovery. Self-management is an empowering process that allows adolescents to take responsibility and to make decisions that foster their recovery.
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Affiliation(s)
| | | | | | - Annie Beaudin
- Peer Researcher, Laboratoire Vitalité, Université du Québec à Montréal, Montréal, QC, Canada
- Relief, Montréal, QC, Canada
| | - Louis-Philippe Boisvert
- Direction des services en santé mentale volet jeunes, Ministère de la Santé et des Services sociaux, Montreal, QC, Canada
| | - Syphax Brouri
- Peer Researcher, Laboratoire Vitalité, Université du Québec à Montréal, Montréal, QC, Canada
| | - Mathieu Charrette
- Peer Researcher, Laboratoire Vitalité, Université du Québec à Montréal, Montréal, QC, Canada
| | - Laurent Côté
- Peer Researcher, Laboratoire Vitalité, Université du Québec à Montréal, Montréal, QC, Canada
| | | | | | - Elissa Louka
- Peer Researcher, Laboratoire Vitalité, Université du Québec à Montréal, Montréal, QC, Canada
| | - Benjamin Mousseau
- Peer Researcher, Laboratoire Vitalité, Université du Québec à Montréal, Montréal, QC, Canada
| | - Noémie Phaneuf
- Peer Researcher, Laboratoire Vitalité, Université du Québec à Montréal, Montréal, QC, Canada
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Kroes S, Myers K, McLoughlan G, O'Connor S, Keily E, Petrakis M. Coproduction in evaluating a dual diagnosis tool with youth in a residential mental health service. ADVANCES IN DUAL DIAGNOSIS 2022. [DOI: 10.1108/add-06-2022-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Purpose
The purpose of this study was to utilise a lived experience (LE) informed/co-designed approach to explore the service-user experience of using the reasons for use package (RFUP) within a youth residential rehabilitation mental health setting.
Design/methodology/approach
LE researchers (those who have lived through mental illness or distress), Master of social work students, a community of mental health service manager, community of mental health researchers, dual diagnosis service researchers and university-based researchers collaborated on the project. The study used an exploratory, qualitative approach of semi-structured interviews to invite young people's experiences of the resource. The research team conducted a collaborative thematic analysis drawing on the range of perspectives.
Findings
Through five interviews with young people, key themes identified included: client factors and extra-therapeutic events, relationship factors, technique/model factors/delivery and outcomes/things noticed.
Practical implications
The RFUP was a useful clinical tool with the young people in this pilot as it improved awareness of reasons for drug use and impact on mental health, service user to staff relationship, quality of the resource, mode of delivery and participant self-knowledge.
Originality/value
Young people valued the supportive role that the RFUP played in facilitating positive relationships with their workers.
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The Impact of Community Mental Health Programs for Australian Youth: A Systematic Review. Clin Child Fam Psychol Rev 2022; 25:573-590. [PMID: 35171386 PMCID: PMC8853061 DOI: 10.1007/s10567-022-00384-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 11/27/2022]
Abstract
Australia has undergone significant youth mental health reform over the past 10 years, leading to numerous studies examining the effects of community-based mental health care programs for Australian youth. However, no synthesis of this literature currently exists. Therefore, this systematic review aimed to: (1) describe the types of community-based mental health programs that have been delivered to Australian youth in the past 10 years; and (2) examine their impact in improving young people’s mental health symptomology and psychosocial functioning. A systematic search of the peer-reviewed literature was conducted. Studies were included if they evaluated the extent to which such programs improved mental health symptomology (e.g., depression, anxiety, substance use) and/or psychosocial outcomes (e.g., social functioning, school engagement, employment) for Australian youth aged 10–25 years. Thirty-seven studies were included. Four types of community-based youth mental health care programs were identified: therapy (n = 16), case management (n = 9), integrated ‘one-stop-shop’ (n = 6) and lifestyle (n = 6) programs. The majority of therapeutic programs were effective in reducing mental health symptomology. Case management and integrated approaches consistently yielded significant improvements in both symptomology and psychosocial outcomes. Lifestyle programs were effective in alleviating depressive symptoms, but inconclusive for other outcomes. This review provides support for youth-friendly, systemic, multidisciplinary and integrated assertive outreach models of community mental health care to improve outcomes for young Australians experiencing mental health concerns. Several recommendations for future research are provided to strengthen the local evidence-base supporting community mental health programs to ultimately enhance young people’s life trajectory.
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Filia K, Menssink J, Gao CX, Rickwood D, Hamilton M, Hetrick SE, Parker AG, Herrman H, Hickie I, Sharmin S, McGorry PD, Cotton SM. Social inclusion, intersectionality, and profiles of vulnerable groups of young people seeking mental health support. Soc Psychiatry Psychiatr Epidemiol 2022; 57:245-254. [PMID: 34091699 DOI: 10.1007/s00127-021-02123-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 06/02/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND headspace centres provide enhanced primary mental healthcare for young people. A priority is to provide services for all young people irrespective of a range of social disadvantages or social exclusion. The aims of this study were to: (i) delineate extent of social inclusion across domains of housing, studying/employment, functioning, alcohol, and other drug use; and (ii) map profiles of young people deemed vulnerable to experiencing additional barriers to accessing services based on their social inclusion domains (e.g., those living in unstable housing, not in employment/education, and/or experiencing intersecting or multiple forms of disadvantage or difficulties), including detailing their clinical characteristics. METHODS Young people were recruited from five headspace centres. Data relevant to social inclusion were examined. Multivariate logistic regression models were used to determine overlap between vulnerable groups, functional, social, clinical, and behavioural factors. RESULTS 1107 young people participated, aged 12-25 years (M = 18.1 years, SD = 3.3), most living in stable housing (96.5%) and engaged in studying/employment (84.8%). Specific vulnerabilities were evident in young people with NEET status (15.2%); in unstable accommodation (3.5%); of culturally diverse backgrounds (CALD) (12.2%); living in regional areas (36.1%); and identifying as lesbian, gay, bisexual, transgender, intersex, queer/questioning, and asexual plus (LGBTIQA+; 28.2%). Higher levels of distress, substance use, functional impairment, and lower social support were reported by those who were NEET and/or in unstable housing. LGBTIQA+ status was associated with high distress, depressive symptoms, and suicidal ideation. CONCLUSIONS Most participants reported good social support, stable housing, and engagement in work or education. Those deemed vulnerable were likely to experience social exclusion across multiple domains and reported more mental health problems. The co-occurrence of mental ill-health and social exclusion highlights the importance of integrated mental healthcare.
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Affiliation(s)
- K Filia
- Orygen, Locked Bag 10, 35 Poplar Road, Parkville, VIC, 3052, Australia.
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia.
| | - J Menssink
- Orygen, Locked Bag 10, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - C X Gao
- Orygen, Locked Bag 10, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Department of Epidemiology and Preventative Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - D Rickwood
- headspace National Youth Mental Health Foundation, Melbourne, VIC, Australia
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - M Hamilton
- Orygen, Locked Bag 10, 35 Poplar Road, Parkville, VIC, 3052, Australia
| | - S E Hetrick
- Orygen, Locked Bag 10, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - A G Parker
- Orygen, Locked Bag 10, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia
| | - H Herrman
- Orygen, Locked Bag 10, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - I Hickie
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - S Sharmin
- Orygen, Locked Bag 10, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - P D McGorry
- Orygen, Locked Bag 10, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - S M Cotton
- Orygen, Locked Bag 10, 35 Poplar Road, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
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Glogowska M, Stepney M, Rocks S, Fazel M. Implementation of significant mental health service change: perceptions and concerns of a mental health workforce in the context of transformation. J Health Organ Manag 2022; 36:66-78. [PMID: 35147380 PMCID: PMC9627961 DOI: 10.1108/jhom-06-2021-0205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Purpose As part of an evaluation of the nationally mandated Child and Adolescent Mental Health Services (CAMHS) “transformation” in one foundation NHS trust, the authors explored the experiences of mental health staff involved in the transformation. Design/methodology/approach The authors employed a qualitative methodology and followed an ethnographic approach. This included observation of mental health staff involved in the transformation and informal interviews (80 h). The authors also undertook semi-structured interviews with key staff members (
n
= 16). Data were analysed thematically. Findings The findings fall into three thematic areas around the transformation, namely (1) rationale; (2) implementation; and (3) maintenance. Staff members were supportive of the rationale for the changes, but implementation was affected by perceived poor communication, resulting in experiences of unpreparedness and de-stabilisation. Staff members lacked time to set up the necessary processes, meaning that changes were not always implemented smoothly. Recruiting and retaining the right staff, a consistent challenge throughout the transformation, was crucial for maintaining the service changes. Originality/value There is little published on the perceptions and experiences of mental health workforces around the CAMHS transformations across the UK. This paper presents the perceptions of mental health staff, whose organisation underwent significant “transformational” change. Staff demonstrated considerable resilience in the change process, but better recognition of their needs might have improved retention and satisfaction. Time for planning and training would enable staff members to better develop the processes and resources necessary in the context of significant service change. Developing ways for services to compare changes they are implementing and sharing good practice around implementation with each other are also vital.
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Affiliation(s)
- Margaret Glogowska
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Melissa Stepney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Stephen Rocks
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Mina Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
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Siebert S, Leopold K, Baumgardt J, von Hardenberg LS, Burkhardt E, Bechdolf A. Specialized inpatient treatment for young people with early psychosis: acute-treatment and 12-month results. Eur Arch Psychiatry Clin Neurosci 2022; 272:1-14. [PMID: 35141809 PMCID: PMC9508217 DOI: 10.1007/s00406-022-01379-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 01/09/2022] [Indexed: 01/02/2023]
Abstract
The objective of the study was to investigate the development of clinical outcomes of young people with early psychosis in a specialized inpatient treatment and assess the feasibility of such an intervention in an inpatient setting. The study was a prospective cohort study of patients with early psychosis treated at the specialized inpatient treatment "Fühinterventions-und Therapiezentrum, FRITZ" (early intervention and therapy center) in Berlin, Germany. The primary outcomes were attitudes towards psychiatric medication and patient satisfaction with treatment after 6 weeks. Secondary outcomes were clinical symptoms, functioning, remission, recovery, all-cause treatment discontinuation, and rehospitalisation at 6 and 12 months after inpatient treatment. We recruited 95 inpatients with early psychosis. Attitudes towards psychiatric medication (Δ6weeks = 3.00, d6weeks = 0.55; Δ6mo = 2.15, d6mo = 0.35; Δ12mo = 3.03, d12mo = 0.52) and patient satisfaction (Δ6weeks = 0.21, d6weeks = 0.40; Δ6mo = 0.32, d6mo = 0.43; Δ12mo = 0.13, d12mo = 0.17) changed with medium effect sizes at six weeks up to a 6- and 12-month follow-up. Clinical outcomes changed significantly with medium-to-large-effect sizes over 12 months CGIΔ12mo = 1.64, d12mo = -1.12; PANSS totalΔ12mo = 20.10, d12mo = -0.76; GAFΔ12mo = 19.58, d12mo = 1.25). The all-cause treatment discontinuation rate was 13.69% (n = 13) at a 6-month and 35.79% (n = 34) at a 12-month follow-up. The rehospitalization rate was 30.53% (n = 29) at a 6-month and 43.16% (n = 41) at a 12-month follow-up. Patients with specialized inpatient treatment for early psychosis showed improvements in attitude towards psychiatric medication, patient satisfaction, symptoms, and functioning for up to 12 months.Trial registration: DRKS00024351, 2021/02/11 retrospectively registered.
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Affiliation(s)
- Stefan Siebert
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating FRITZ and soulspace, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin, Dieffenbachstraße 1, 10967, Berlin, Germany
| | - Karolina Leopold
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating FRITZ and soulspace, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin, Dieffenbachstraße 1, 10967, Berlin, Germany
| | - Johanna Baumgardt
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating FRITZ and soulspace, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin, Dieffenbachstraße 1, 10967, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Laura-Sophie von Hardenberg
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating FRITZ and soulspace, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin, Dieffenbachstraße 1, 10967, Berlin, Germany
| | - Eva Burkhardt
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating FRITZ and soulspace, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin, Dieffenbachstraße 1, 10967, Berlin, Germany
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine Incorporating FRITZ and soulspace, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin, Dieffenbachstraße 1, 10967, Berlin, Germany.
- Department of Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany.
- Orygen, Parkville, VIC, Australia.
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Monson K, Herrman H, Moeller-Saxone K, Humphreys C, Harvey C. How can mental health practitioners collaborate with child welfare practitioners to improve mental health for young people in out of home care? Early Interv Psychiatry 2021; 15:1768-1776. [PMID: 33474788 DOI: 10.1111/eip.13118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 11/07/2020] [Accepted: 01/04/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Young people who grow up in out of home care have higher risk of poor mental health outcomes than peers who grow up with their family-of-origin. Interagency collaboration is an important service-level intervention to improve access to mental healthcare. However, few descriptions of collaboration provide guidance about collaboration between individual practitioners. AIM This substudy aimed to contribute to a larger study-the Ripple project-through exploring the experiences of practitioners working across child welfare and mental health services regarding collaboration in the care of young people; and to identify practices that might enhance collaborative work and improve mental health outcomes. METHODS Practitioners from across child welfare and mental health services were purposively sampled and participated in focus groups. Recordings and transcriptions of focus groups were analysed to identify themes within and between groups. A cross-sector expert advisory group was involved in this work. RESULTS Focus groups were convened with 43 practitioners. We identified four themes during analysis, these were: shared understanding of the history and context of problems; specific skills and practices; self-awareness of workers and carers; and involving and supporting carers. CONCLUSIONS A number of practices were identified that might lead to enhanced collaboration between agencies and across interdisciplinary care teams. Supporting mental health practitioners to adopt these might assist interagency and interdisciplinary working.
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Affiliation(s)
- Katherine Monson
- Orygen, Melbourne, Australia.,NorthWestern Mental Health, Melbourne, Australia
| | - Helen Herrman
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | | | - Cathy Humphreys
- Department of Social Work, The University of Melbourne, Melbourne, Australia
| | - Carol Harvey
- NorthWestern Mental Health, Melbourne, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, Australia
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Stubbing J, Gibson K. Can We Build 'Somewhere That You Want to Go'? Conducting Collaborative Mental Health Service Design with New Zealand's Young People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9983. [PMID: 34639289 PMCID: PMC8507894 DOI: 10.3390/ijerph18199983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 11/17/2022]
Abstract
Globally, young people are at high risk of mental health problems, but have poor engagement with services. Several international models have emerged seeking to address this gap by providing youth-specific care designed in collaboration with young people. In this study, 94 young people in New Zealand participated in collaborative workshops exploring their vision of an ideal mental health service. Participants were aged 16-25. Reflexive thematic analysis was used to identify seven themes. These describe the ideal mental health service for these young people as comfortable, accessible, welcoming, embedded in the community, holistic, adaptable, and youth-focused. In addition to describing how services might better serve the needs of youth, this article outlines a method for adapting international principles for youth-friendly care to the specific needs of a population of young people. This article provides supporting evidence that services should consider how to improve their engagement with youth through collaboration with local populations of young people.
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Affiliation(s)
- Jessica Stubbing
- School of Psychology, The University of Auckland, Auckland 1142, New Zealand;
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Fazel M, Rocks S, Glogowska M, Stepney M, Tsiachristas A. How does reorganisation in child and adolescent mental health services affect access to services? An observational study of two services in England. PLoS One 2021; 16:e0250691. [PMID: 33951078 PMCID: PMC8099077 DOI: 10.1371/journal.pone.0250691] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/13/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Child and Adolescent Mental Health Services (CAMHS) in England are making significant changes to improve access and effectiveness. This 'transformation' variously involves easier access to services through a Single Point of Access (SPA), more integrated services within CAMHS and enhanced co-provision across education and third sector or non-profit organisations. METHODS A mixed-methods observational study was conducted to explore the process and impact of transformation over four years in two services. Ethnographic observations and in-depth interviews were conducted and Electronic Patient Records with over one million contacts analysed. Difference-in-differences analysis with propensity score matching to estimate the causal impact of the transformation on patient access was utilised. OUTCOMES Spend and staffing increased across both CAMHS. The SPA had growing rates of self-referral and new care pathways were seeing patients according to expected degree of psychopathology. Third sector partners were providing increasing numbers of low-intensity interventions. Although the majority of staff were supportive of the changes, the process of transformation led to service tensions. In the first year after transformation there was no change in the rate of new patients accessing services or new spells (episodes of care) in the services. However, by year three, the number of new patients accessing CAMHS was 19% higher (Incidence Rate Ratio: 1·19, CI: 1·16, 1·21) and the rate of new spells was 12% higher (Incidence Rate Ratio: 1·12, CI: 1·05, 1·20). INTERPRETATION Transformation investment, both financial and intellectual, can help to increase access to CAMHS in England, but time is needed to realise the benefits of reorganisation.
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Affiliation(s)
- Mina Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, United Kingdom
| | - Stephen Rocks
- Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Oxford, United Kingdom
| | - Margaret Glogowska
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Melissa Stepney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Apostolos Tsiachristas
- Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Oxford, United Kingdom
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Goel C, Shafi RMA, Conner AJ, Waters F, Croarkin PE, McGorry P. A Retrospective Evaluation of a Pilot Youth Community Assessment and Treatment Service. Psychiatr Serv 2021; 72:415-420. [PMID: 33557596 DOI: 10.1176/appi.ps.201900013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Targeted, highly accessible early intervention for youths with emerging and complex psychiatric presentations is increasingly needed. The Youth Community Assessment and Treatment Team (YCATT) multidisciplinary service was established to provide intensive intervention for youths in Perth, Australia. METHODS The authors conducted a retrospective evaluation to examine YCATT's impact on emergency department (ED) visits, psychiatric inpatient admissions, and provision of care for youths in the transition period between adolescent and adult psychiatric services. Demographic, clinical, and service utilization data for all referrals over the pilot period (2016-2017) were collected and analyzed with descriptive statistics. RESULTS During the pilot period, 308 referrals were accepted. All referred youths had a trauma history and presented with acute or complex conditions, and most (66%) were between 16 and 18 years old. The admission rate to a psychiatric inpatient unit was <7%. Of 61 youths specifically referred to YCATT as an alternative to psychiatric admission, 90% were successfully diverted from psychiatric or ED admission. After discharge from YCATT, youths had improved scores on the Health of the Nations Outcome Scale and 10-item Kessler Psychological Distress Scale. CONCLUSIONS These findings suggest that YCATT is an accessible and effective service for the population of transition-age youths. It appears that YCATT, in collaboration with other community services, contributed to diverting psychiatric inpatient admissions, facilitated outpatient treatment, and enabled continuity of care for vulnerable youths. The results underscore the need for more accessible, individualized treatment approaches for youths who transition to adulthood.
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Affiliation(s)
- Chinar Goel
- Fiona Stanley Hospital, Murdoch, Perth, Western Australia (Goel); Cairns and Hinterland Hospital and Health Service, Queensland, Australia (Shafi, Conner); Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Shafi, Croarkin); Clinical Research Centre, Gascoyne House, Graylands Health Campus, Claremont, Perth, Western Australia (Waters); Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne (McGorry)
| | - Reem M A Shafi
- Fiona Stanley Hospital, Murdoch, Perth, Western Australia (Goel); Cairns and Hinterland Hospital and Health Service, Queensland, Australia (Shafi, Conner); Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Shafi, Croarkin); Clinical Research Centre, Gascoyne House, Graylands Health Campus, Claremont, Perth, Western Australia (Waters); Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne (McGorry)
| | - Adrian J Conner
- Fiona Stanley Hospital, Murdoch, Perth, Western Australia (Goel); Cairns and Hinterland Hospital and Health Service, Queensland, Australia (Shafi, Conner); Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Shafi, Croarkin); Clinical Research Centre, Gascoyne House, Graylands Health Campus, Claremont, Perth, Western Australia (Waters); Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne (McGorry)
| | - Flavie Waters
- Fiona Stanley Hospital, Murdoch, Perth, Western Australia (Goel); Cairns and Hinterland Hospital and Health Service, Queensland, Australia (Shafi, Conner); Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Shafi, Croarkin); Clinical Research Centre, Gascoyne House, Graylands Health Campus, Claremont, Perth, Western Australia (Waters); Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne (McGorry)
| | - Paul E Croarkin
- Fiona Stanley Hospital, Murdoch, Perth, Western Australia (Goel); Cairns and Hinterland Hospital and Health Service, Queensland, Australia (Shafi, Conner); Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Shafi, Croarkin); Clinical Research Centre, Gascoyne House, Graylands Health Campus, Claremont, Perth, Western Australia (Waters); Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne (McGorry)
| | - Patrick McGorry
- Fiona Stanley Hospital, Murdoch, Perth, Western Australia (Goel); Cairns and Hinterland Hospital and Health Service, Queensland, Australia (Shafi, Conner); Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Shafi, Croarkin); Clinical Research Centre, Gascoyne House, Graylands Health Campus, Claremont, Perth, Western Australia (Waters); Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Melbourne (McGorry)
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Liddicoat S, Badcock P, Killackey E. Principles for designing the built environment of mental health services. Lancet Psychiatry 2020; 7:915-920. [PMID: 32171432 DOI: 10.1016/s2215-0366(20)30038-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/17/2020] [Accepted: 01/17/2020] [Indexed: 10/24/2022]
Abstract
Although there is an increasing amount of literature on the key principles for the design of mental health services, the contribution of the built environment to outcomes for the service user is a largely neglected area. To help address this gap, we present evidence that highlights the pivotal role of evidence-based architectural design in service users' experience of mental health services. We propose six important design principles to enhance the care of mental health service users. Drawing on research into the delivery of mental health services and best-practice approaches to their architectural design, we outline a holistic conceptual model for designing mental health services that enhance treatment outcomes and experiences, provide benefits to families and the community, and promote community resilience. In this Personal View, we argue that the design of mental health services needs to extend across disciplinary boundaries to integrate evidence-informed practice across individual, interpersonal, and community levels.
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Affiliation(s)
- Stephanie Liddicoat
- School of Design, Faculty of Health, Arts and Design, Swinburne University, Melbourne, VIC, Australia.
| | - Paul Badcock
- Centre of Youth Mental Health, The University of Melbourne, Orygen, Melbourne, VIC, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Eoin Killackey
- Centre of Youth Mental Health, The University of Melbourne, Orygen, Melbourne, VIC, Australia
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Schwarz J, Duve A, Hoffmann S, Heiser P, Pérez GR, Heinze M, von Peter S. Erfahrungen der Stakeholder mit den Modellvorhaben nach § 64b SGB V in der Kinder- und Jugendpsychiatrie und -psychotherapie – eine qualitative Studie. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2020; 48:358-368. [DOI: 10.1024/1422-4917/a000716] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Hintergrund und Fragestellung: Seit 2013 sind in Deutschland die Möglichkeiten für eine integrative Behandlungsform gemäß § 64b SGB (Sozialgesetzbuch) V erweitert worden. Diese sogenannte psychiatrische Modellversorgung (MV) ist in den letzten Jahren sowohl an einzelnen Kliniken der Erwachsenen- als auch der Kinder- und Jugendpsychiatrie und -psychotherapie (KJPP) eingeführt worden. Ziel der MV ist es, eine ambulante, individualisierte und kontinuierliche Behandlung anzubieten. In der vorliegenden Arbeit werden die Erfahrungen der Stakeholder mit dieser innovativen Behandlungsform untersucht. Methodik: An zwei kinder- und jugendpsychiatrischen Kliniken der MV wurden Fokusgruppen durchgeführt, an denen Mitarbeitende, Patientinnen und Patienten sowie Eltern (N = 36) teilnahmen. Es folgte eine qualitativ-inhaltsanalytische Auswertung. Ergebnisse: Aus Sicht aller Akteurinnen und Akteure bildet die ambulante Akut Behandlung (AAB) einen zentralen Modellbestandteil, die eine Behandlung von Patientinnen und Patienten mit akuten Beschwerden im Vorfeld, als Ersatz oder im Nachgang einer (teil)stationären Behandlung ermöglicht. Die Flexibilisierung der Behandlung und eine größere Behandlungs- und Behandlerkontinuität wurden als weitere Vorteile der MV genannt. Schließlich gelingt der Einbezug von Sorgeberechtigten im Rahmen der MV leichter, was für diese Akteursgruppe auch einige Herausforderungen mit sich bringt. Schlussfolgerungen: Die Einführung psychiatrischer MV in der KJPP hat komplexe Auswirkungen auf die Behandlungsabläufe und das Erleben aller beteiligten Akteurinnen und Akteure und wird von diesen als bedürfnisorientierte Ausweitung therapeutischer Unterstützungsmöglichkeiten erlebt.
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Affiliation(s)
- Julian Schwarz
- Medizinische Hochschule Brandenburg, Hochschulklinik für Psychiatrie und Psychotherapie, Immanuel Klinik, Rüdersdorf
| | - Annette Duve
- Vitos Klinik Hofheim für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Riedstadt
| | - Sabine Hoffmann
- Vitos Klinik Hofheim für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Riedstadt
| | - Philip Heiser
- Südharz Klinikum Nordhausen, Klinik für Psychiatrie, Psychotherapie und Psychosomatik des Kindes- und Jugendalters, Nordhausen
| | - Guillermo Ruiz Pérez
- Medizinische Hochschule Brandenburg, Hochschulklinik für Psychiatrie und Psychotherapie, Immanuel Klinik, Rüdersdorf
| | - Martin Heinze
- Medizinische Hochschule Brandenburg, Hochschulklinik für Psychiatrie und Psychotherapie, Immanuel Klinik, Rüdersdorf
| | - Sebastian von Peter
- Medizinische Hochschule Brandenburg, Hochschulklinik für Psychiatrie und Psychotherapie, Immanuel Klinik, Rüdersdorf
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El Oussoul S, Haesebaert J, Leaune E, Haesebaert F. From Knowledge Transfer to Action: An Example of a Community of Practice for First-Episode Psychosis in Lyon, France. Psychiatr Serv 2020; 71:975-978. [PMID: 32460682 DOI: 10.1176/appi.ps.201900568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Despite the proven effectiveness of early intervention services for first-episode psychosis (FEP), these services are poorly implemented in France. This column describes the establishment in 2018 of a community of practice dedicated to the implementation of early intervention services for FEP at the Vinatier Hospital in Lyon, France, in 2019. To evaluate the implementation process, the authors analyzed materials produced during the process of conceiving and developing the community of practice, reviewed participant observation notes, and examined responses to a satisfaction survey completed by community of practice members. Creation of the community of practice network has led to substantial changes in care pathways for FEP patients in Greater Lyon.
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Affiliation(s)
- Sofia El Oussoul
- Centre Hospitalier le Vinatier, Bron, France (El Oussoul, Leaune, F. Haesebaert); Laboratoire HESPER (Health Services and Performance Research), Lyon, France (El Oussoul, J. Haesebaert); Centre de Recherche en Neurosciences de Lyon, Institut National de la Santé et de la Recherche Médicale, Bron, France (Leaune, F. Haesebaert). Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column
| | - Julie Haesebaert
- Centre Hospitalier le Vinatier, Bron, France (El Oussoul, Leaune, F. Haesebaert); Laboratoire HESPER (Health Services and Performance Research), Lyon, France (El Oussoul, J. Haesebaert); Centre de Recherche en Neurosciences de Lyon, Institut National de la Santé et de la Recherche Médicale, Bron, France (Leaune, F. Haesebaert). Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column
| | - Edouard Leaune
- Centre Hospitalier le Vinatier, Bron, France (El Oussoul, Leaune, F. Haesebaert); Laboratoire HESPER (Health Services and Performance Research), Lyon, France (El Oussoul, J. Haesebaert); Centre de Recherche en Neurosciences de Lyon, Institut National de la Santé et de la Recherche Médicale, Bron, France (Leaune, F. Haesebaert). Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column
| | - Frédéric Haesebaert
- Centre Hospitalier le Vinatier, Bron, France (El Oussoul, Leaune, F. Haesebaert); Laboratoire HESPER (Health Services and Performance Research), Lyon, France (El Oussoul, J. Haesebaert); Centre de Recherche en Neurosciences de Lyon, Institut National de la Santé et de la Recherche Médicale, Bron, France (Leaune, F. Haesebaert). Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column
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Malla A, Frampton A, Mansouri BI. Youth Mental Health Services: Promoting Wellness or Treating Mental Illness? CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:531-535. [PMID: 32319321 PMCID: PMC7492887 DOI: 10.1177/0706743720920033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Ashok Malla
- Department of Psychiatry, Douglas Hospital Research Centre,
McGill University, Montreal, Quebec, Canada
- Douglas Hospital Research Centre, ACCESS Open Minds,
Montreal, Quebec, Canada
| | - Alyssa Frampton
- National Youth Council, ACCESS Open Minds, Montreal, Quebec,
Canada
| | - Bilal Issaoui Mansouri
- Department of Psychiatry, Douglas Hospital Research Centre,
McGill University, Montreal, Quebec, Canada
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Rocks S, Glogowska M, Stepney M, Tsiachristas A, Fazel M. Introducing a single point of access (SPA) to child and adolescent mental health services in England: a mixed-methods observational study. BMC Health Serv Res 2020; 20:623. [PMID: 32641117 PMCID: PMC7346657 DOI: 10.1186/s12913-020-05463-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 06/24/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND In many high-income countries, primary care practitioners are the main point of referral for specialist mental health services. In England, Child and Adolescent Mental Health Services (CAMHS) are increasingly adopting a Single Point of Access (SPA) to streamline referrals and introduce self and parent/carer-referrals. This involves a significant shift of responsibility from primary care towards CAMHS who adopt a more active role as gatekeeper for their service. This study evaluates the adoption of a SPA in CAMHS across a large region in England. METHODS We conducted an observational mixed methods study in two CAMHS from January 2018 to March 2019 to evaluate the adoption of a SPA. We collected quantitative data from electronic patient records and qualitative data through ethnographic observation and in-depth interviews of staff and stakeholders with experience of using CAMHS. Additional data on volumes was shared directly from the SPAs and a further snapshot of 1 week's users was collected. RESULTS A similar SPA model emerged across the two services. Staff were positive about what the model could achieve and access rates grew quickly following awareness-raising activities. Despite the initial focus being on a telephone line, online referrals became the more regularly used referral method. Increased access brought challenges in terms of resourcing, including identifying the right staff for the role of call handlers. A further challenge was to impose consistency on triage decisions, which required structured information collection during the assessment process. Similar to GP referrals, those self-referring via the SPA were mainly from the least deprived areas. CONCLUSIONS The introduction of a SPA has the potential to improve young people's access to mental health services. By addressing some of the barriers to access, simplifying where to go to get help and making it easier to contact the service directly, a SPA can help more individuals and families access timely support. However, the introduction of a SPA does not in itself expand the capacity of CAMHS, and therefore expectations within services and across sectors need to be tempered accordingly. SPA services providing different referral approaches can further improve access for the harder to reach populations.
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Affiliation(s)
- Stephen Rocks
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, England
- The Health Foundation, 8 Salisbury Square, London, EC4Y 8AP, England
| | - Margaret Glogowska
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Rd, Oxford, OX2 6GG, England
| | - Melissa Stepney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Rd, Oxford, OX2 6GG, England
| | - Apostolos Tsiachristas
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, England
| | - Mina Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, England.
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Griffin E, McMahon E. Adolescent mental health: Global data informing opportunities for prevention. EClinicalMedicine 2020; 24:100413. [PMID: 32637897 PMCID: PMC7327894 DOI: 10.1016/j.eclinm.2020.100413] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Eve Griffin
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
| | - Elaine McMahon
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
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Tuaf H, Orkibi H. Community-based rehabilitation programme for adolescents with mental health conditions in Israel: a qualitative study protocol. BMJ Open 2019; 9:e032809. [PMID: 31857314 PMCID: PMC6937008 DOI: 10.1136/bmjopen-2019-032809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION In Israel, 12% of adolescents have mental health conditions. Approximately 600 adolescents with mental health conditions are hospitalised each year and about 40% of them return to the hospital and are thus cut-off from their daily lives and peers in the community. In contrast to adults, adolescents with mental health conditions in Israel are not eligible by law for rehabilitation services. Thus, the overarching goal of this qualitative study is to identify best practices for the implementation of community-based psychosocial rehabilitation programme for this population, by examining the first such programme in Israel. Amitim for Youth, which was established in 2018 by the Israel Association of Community Centers in cooperation with the Ministry of Health, the Ministry of Education and the Special Projects Fund of the National Insurance Institute. METHODS AND ANALYSIS Qualitative data will be collected through in depth semi-structured interviews and focus groups. To identify themes and patterns in the data, a six-stage reflexive thematic analysis approach will be used. A triangulation procedure will be conducted to strengthen the validity of the findings collected by different methods and from various stakeholders in the programme: the programme's decision-makers, programme team members, the intended beneficiaries and referring mental health professionals. To insure the trustworthiness of the findings, three strategies will be employed: memo writing, reflexive journaling and member checking. ETHICS AND DISSEMINATION This study was approved by the Ethics Committee for Human Research in the Faculty of Social Welfare and Health Sciences at the University of Haifa (#455-18) and by the Chief Scientist in the Ministry of Education (#10566). All participants will sign an informed consent form and will be guaranteed confidentiality and anonymity. Data collection will be conducted in the next 2 years (2019 to 2020). After data analysis, the findings will be disseminated via publications.
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Affiliation(s)
- Hila Tuaf
- School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Hod Orkibi
- School of Creative Arts Therapies, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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Green R, Mitchell PF, Lee K, Svensson E, Toh JW, Barentsen C, Copeland M, Newton JR, Hawke KC, Brophy L. Key features of an innovative sub-acute residential service for young people experiencing mental ill health. BMC Psychiatry 2019; 19:311. [PMID: 31646990 PMCID: PMC6813091 DOI: 10.1186/s12888-019-2303-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 09/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Numerous studies across international settings have highlighted a need to improve the appropriateness and continuity of services for young people experiencing mental ill health. This paper examines key features of a sub-acute youth mental health residential service model, Youth Prevention and Recovery Care (Y-PARC) service. Y-PARC provides up to 4 weeks care to 16 to 25 year-olds at risk of hospitalisation and to those transitioning out of hospital inpatient units. The research was conducted at one of three Y-PARCs located in Victoria, Australia. METHODS This paper presents findings from analysis of two data sources collected during evaluation of a Y-PARC service in 2015-17. Routinely collected administrative data of Y-PARC residents (n = 288) were analysed and semi-structured interviews were conducted with 38 participants: a) former residents (n = 14); b) family members of group a) (n = 5); key stakeholders (n = 9); and, Y-PARC staff (n = 10 respondents in 3 group interviews). Analysis of the qualitative data was thematic and structured by the interview guide, which covered the key service aims. RESULTS Consistent with the aims of the service, respondents described practice at Y-PARC that aligns with recovery-oriented care. Key features emphasised were: a safe and welcoming environment for residents and families; provision of person-centred care; promotion of autonomy and self-help; informal interactions with staff allowing for formation of naturalistic relationships; time spent with other young people with similar experiences; and, assurance upon exit that the 'door is always open.' High levels of satisfaction were reported. Outcomes described included: improved resilience; better understanding of mental health; the importance of seeking help; and, stronger connections to therapeutic services. Longer and multiple stays were associated with progressive and sustained change. Family members and stakeholders widely reported that the service fills a gap between community services and acute inpatient mental health hospital wards. Some challenging areas of practice identified included: integration of evidence-based psychosocial interventions; provision of care within a model that blends clinical and psychosocial support services; and, negotiation of family-inclusive practice. CONCLUSIONS The Y-PARC service model shows promise with young people experiencing mental ill health, particularly in improving the range and availability of options across a spectrum of need.
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Affiliation(s)
- Rachael Green
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria 3053 Australia
| | - Penelope Fay Mitchell
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria 3053 Australia
| | - Kira Lee
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria 3053 Australia
| | - Ella Svensson
- Orygen, the National Centre of Excellence in Youth Mental Health, 35 Poplar Roadd, Parkville, Victoria 3052 Australia
| | - Jia-Wern Toh
- Orygen, the National Centre of Excellence in Youth Mental Health, 35 Poplar Roadd, Parkville, Victoria 3052 Australia
| | - Carolyn Barentsen
- Peninsula Health, 2 Hastings Road, Frankston, Victoria 3199 Australia
| | - Michala Copeland
- Mind Australia, 86-92 Mount Street, Heidelberg, Victoria 3084 Australia
| | - J. Richard Newton
- Peninsula Health, 2 Hastings Road, Frankston, Victoria 3199 Australia
| | | | - Lisa Brophy
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria 3053 Australia
- Mind Australia, 86-92 Mount Street, Heidelberg, Victoria 3084 Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria Australia
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Malla A, Iyer S, Shah J, Joober R, Boksa P, Lal S, Fuhrer R, Andersson N, Abdel‐Baki A, Hutt‐MacLeod D, Beaton A, Reaume‐Zimmer P, Chisholm‐Nelson J, Rousseau C, Chandrasena R, Bourque J, Aubin D, Levasseur MA, Winkelmann I, Etter M, Kelland J, Tait C, Torrie J, Vallianatos H. Canadian response to need for transformation of youth mental health services: ACCESS Open Minds (Esprits ouverts). Early Interv Psychiatry 2019; 13:697-706. [PMID: 30556335 PMCID: PMC6563151 DOI: 10.1111/eip.12772] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 10/18/2018] [Accepted: 11/04/2018] [Indexed: 01/02/2023]
Abstract
AIM Youth mental health is of paramount significance to society globally. Given early onset of mental disorders and the inadequate access to appropriate services, a meaningful service transformation, based on globally recognized principles, is necessary. The aim of this paper is to describe a national Canadian project designed to achieve transformation of mental health services and to evaluate the impact of such transformation on individual and system related outcomes. METHOD We describe a model for transformation of services for youth with mental health and substance abuse problems across 14 geographically, linguistically and culturally diverse sites, including large and small urban, rural, First Nations and Inuit communities as well as homeless youth and a post-secondary educational setting. The principles guiding service transformation and objectives are identical across all sites but the method to achieve them varies depending on prevailing resources, culture, geography and the population to be served and how each community can best utilize the extra resources for transformation. RESULTS Each site is engaged in community mapping of services followed by training, active stakeholder engagement with youth and families, early case identification initiatives, providing rapid access (within 72 hours) to an assessment of the presenting problems, facilitating connection to an appropriate service within 30 days (if required) with no transition based on age within the 11 to 25 age group and a structured evaluation to track outcomes over the period of the study. CONCLUSIONS Service transformation that is likely to achieve substantial change involves very detailed and carefully orchestrated processes guided by a set of values, principles, clear objectives, training and evaluation. The evidence gathered from this project can form the basis for scaling up youth mental health services in Canada across a variety of environments.
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Affiliation(s)
- Ashok Malla
- Department of PsychiatryMcGill UniversityMontréal, QuébecCanada
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Prevention and Early Intervention Program for Psychosis (PEPP)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Douglas Mental Health University InstituteMontréal, QuébecCanada
| | - Srividya Iyer
- Department of PsychiatryMcGill UniversityMontréal, QuébecCanada
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Prevention and Early Intervention Program for Psychosis (PEPP)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Douglas Mental Health University InstituteMontréal, QuébecCanada
| | - Jai Shah
- Department of PsychiatryMcGill UniversityMontréal, QuébecCanada
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Prevention and Early Intervention Program for Psychosis (PEPP)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Douglas Mental Health University InstituteMontréal, QuébecCanada
| | - Ridha Joober
- Department of PsychiatryMcGill UniversityMontréal, QuébecCanada
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Prevention and Early Intervention Program for Psychosis (PEPP)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Douglas Mental Health University InstituteMontréal, QuébecCanada
| | - Patricia Boksa
- Department of PsychiatryMcGill UniversityMontréal, QuébecCanada
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Douglas Mental Health University InstituteMontréal, QuébecCanada
| | - Shalini Lal
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Douglas Mental Health University InstituteMontréal, QuébecCanada
- School of Rehabilitation, Faculty of MedicineUniversité de MontréalMontréal, QuébecCanada
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM)Montréal, QuébecCanada
| | - Rebecca Fuhrer
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontréal, QuébecCanada
| | - Neil Andersson
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Department of Family Medicine, Community Information and Epidemiological Technologies (CIET) Institute and Participatory Research at McGill (PRAM)McGill UniversityMontréal, QuébecCanada
- McGill University Institute for Human Development and Well‐beingMontréal, QuébecCanada
| | - Amal Abdel‐Baki
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Department of PsychiatryUniversité de MontréalMontréal, QuébecCanada
- Centre hospitalier de l'Université de Montréal (CHUM), CRCHUMMontréal, QuébecCanada
| | - Daphne Hutt‐MacLeod
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Eskasoni Mental Health ServicesEskasoni, Nova ScotiaCanada
| | - Ann Beaton
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- School of Psychology, Faculty of Health Sciences and Community ServicesUniversité de MonctonMonctonNew BrunswickCanada
| | - Paula Reaume‐Zimmer
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Mental Health and Addictions ServicesBluewater Health and Canadian Mental Health AssociationLambton Kent, OntarioCanada
| | - Jessica Chisholm‐Nelson
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
| | - Cécile Rousseau
- Department of PsychiatryMcGill UniversityMontréal, QuébecCanada
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Centre de recherche SHERPA, Institut Universitaire au regard des communautés culturellesCentre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre‐Ouest‐de‐l'Île‐de‐MontréalMontréal, QuébecCanada
| | - Ranjith Chandrasena
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Schulich School of MedicineWestern UniversityLondonOntarioCanada
| | - Jimmy Bourque
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Faculty of EducationUniversité de MonctonMonctonNew BrunswickCanada
| | - Diane Aubin
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Dans La Rue and Réseau d'intervention de proximité auprès des jeunes de la rue (RIPAJ)‐Montréal/Homeless Youth NetworkMontréal, QuébecCanada
| | - Mary Anne Levasseur
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- ACCESS Open Minds Family and Carers Council, Douglas Mental Health University Institute, MontréalQuébecCanada
| | - Ina Winkelmann
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
| | - Meghan Etter
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Counselling ServicesInuvialuit Regional CorporationInuvik, Northwest TerritoriesCanada
| | - Jill Kelland
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Young Adult and Cross Level Services, Addiction and Mental Health, Edmonton Zone, Alberta Health ServicesEdmontonAlbertaCanada
| | - Caroline Tait
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Department of PsychiatryUniversity of SaskatchewanSaskatoonSaskatchewanCanada
| | - Jill Torrie
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Public Health DepartmentCree Board of Health and Social Services of James BayMistissini, QuébecCanada
| | - Helen Vallianatos
- ACCESS Open Minds (Pan‐Canadian Youth Mental Health Services Research Network)Douglas Mental Health University InstituteMontréal, QuébecCanada
- Department of AnthropologyUniversity of AlbertaEdmontonAlbertaCanada
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Rickwood D, Paraskakis M, Quin D, Hobbs N, Ryall V, Trethowan J, McGorry P. Australia's innovation in youth mental health care: The headspace centre model. Early Interv Psychiatry 2019; 13:159-166. [PMID: 30311423 PMCID: PMC6585724 DOI: 10.1111/eip.12740] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 08/07/2018] [Accepted: 08/30/2018] [Indexed: 11/28/2022]
Abstract
AIM headspace is Australia's innovation in youth mental healthcare and comprises the largest national network of enhanced primary care, youth mental health centres world-wide. headspace centres aim to intervene early in the development of mental ill-health for young people aged 12 to 25 years by breaking down the barriers to service access experienced by adolescents and emerging adults and providing holistic healthcare. Centres have been progressively implemented over the past 12 years and are expected to apply a consistent model of integrated youth healthcare. Internationally, several countries are implementing related approaches, but the specific elements of such models have not been well described in the literature. METHOD This paper addresses this gap by providing a detailed overview of the 16 core components of the headspace centre model. RESULTS The needs of young people and their families are the main drivers of the headspace model, which has 10 service components (youth participation, family and friends participation, community awareness, enhanced access, early intervention, appropriate care, evidence-informed practice, four core streams, service integration, supported transitions) and six enabling components (national network, Lead Agency governance, Consortia, multidisciplinary workforce, blended funding, monitoring and evaluation). CONCLUSION Through implementation of these core components headspace aims to provide easy access to one-stop, youth-friendly mental health, physical and sexual health, alcohol and other drug, and vocational services for young people across Australia.
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Affiliation(s)
- Debra Rickwood
- headspace National Youth Mental Health FoundationMelbourneVictoriaAustralia
- Faculty of HealthUniversity of CanberraCanberraAustralian Capital TerritoryAustralia
| | - Marie Paraskakis
- headspace National Youth Mental Health FoundationMelbourneVictoriaAustralia
| | - Diana Quin
- headspace National Youth Mental Health FoundationMelbourneVictoriaAustralia
| | - Nathan Hobbs
- headspace National Youth Mental Health FoundationMelbourneVictoriaAustralia
| | - Vikki Ryall
- headspace National Youth Mental Health FoundationMelbourneVictoriaAustralia
| | - Jason Trethowan
- headspace National Youth Mental Health FoundationMelbourneVictoriaAustralia
| | - Patrick McGorry
- Orygen: The National Centre of Excellence in Youth Mental HealthMelbourneVictoriaAustralia
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