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Young A, Levitt A, Kodeeswaran S, Markoulakis R. 'Just because we're younger doesn't mean our opinions should be any less valued': A qualitative study of youth perspectives on a Youth Advisory Council in a mental healthcare context. Health Expect 2023; 26:1883-1894. [PMID: 37326418 PMCID: PMC10485308 DOI: 10.1111/hex.13794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/25/2023] [Accepted: 06/04/2023] [Indexed: 06/17/2023] Open
Abstract
INTRODUCTION Recognition of the importance of youth engagement in youth mental health and/or addiction (MHA) service design and delivery is increasing. Youth Advisory Councils embedded in MHA organizations represent one strategy that allows youth to be involved in MHA at the individual, organization and systemic levels. This level of involvement can facilitate positive outcomes for both the youth and the organization. As these councils become more common, it is important that organizations are prepared to partner with the participating youth. This study uses a descriptive qualitative approach to understand the motivations and expectations of youth with lived experience with MHA concerns who were beginning to work on a Youth Advisory Council in an MHA setting in the Greater Toronto Area. METHODS Semistructured interviews were conducted with each youth, ages 16-26, on the advisory council (N = 8) to understand their motivations, expectations and goals coming into the work. Interviews were transcribed verbatim and analysed using a reflexive thematic analysis. RESULTS Analysis resulted in five overarching themes: providing opportunities for youth learning and growth, platforming youth, empowering youth, embracing youth leadership and promoting youth-driven change. The findings illustrate that these youth came into the Youth Advisory Council motivated to create positive change in the mental health system, take on leadership roles and had high expectations for organizational support. Our analyses provide insight for organizations planning and implementing Youth Advisory Councils in the MHA sector with the goal of best supporting youth in driving positive change across the system. CONCLUSION Youth want to be provided authentic opportunities for their engagement to make a difference. MHA organizations must embrace youth leadership and move towards listening to youth experience and acting on youth recommendations to enhance service design and implementation to improve access and to better meet the needs of youth utilizing these services. PATIENT OR PUBLIC CONTRIBUTIONS This study incorporated service users, including youth ages 16-26 with lived experience of MHA concerns who served on the Youth Advisory Council at the Family Navigation Project, Sunnybrook. Youth Advisory Council members contributed to two relevant research activities: (1) youth reviewed the draft interview guide before data collection, and their feedback was prioritized in the final version and (2) youth contributed to knowledge translation through contributing to academic conference presentations.
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Affiliation(s)
- Adrienne Young
- Sunnybrook Research InstituteTorontoOntarioCanada
- York University School of Social WorkTorontoOntarioCanada
| | - Anthony Levitt
- Sunnybrook Research InstituteTorontoOntarioCanada
- Sunnybrook Health Sciences CentreTorontoOntarioCanada
- Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
| | | | - Roula Markoulakis
- Sunnybrook Research InstituteTorontoOntarioCanada
- Department of Occupational Science and Occupational Therapy, Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
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Simmons MB, Chinnery G, Whitson S, Bostock S, Braybrook J, Hamilton M, Killackey E, Brushe M. Implementing a combined individual placement and support and vocational peer work program in integrated youth mental health settings. Early Interv Psychiatry 2023; 17:412-421. [PMID: 36683278 DOI: 10.1111/eip.13387] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 10/23/2022] [Accepted: 01/01/2023] [Indexed: 01/24/2023]
Abstract
AIM To describe the implementation and outcomes of a combined individual placement and support (IPS) and vocational peer work program for young people with mental ill-health. METHODS This uncontrolled pilot study co-located IPS workers and vocational peer workers within two integrated youth mental health services (provided to clients aged 15-25 years old). Employment outcomes included job placements (working 15 hours or more per week in a paid competitive job in the open employment market) and sustained employment (employed for at least 26 weeks). Participants who required additional assistance also received peer work. RESULTS Of the 326 young people enrolled, 195 (59.8%) achieved competitive employment, including 157 (48.2%) in funder-approved placements. Among those in approved placements, 87 (55.4%) achieved sustained employment. For the 116 participants additionally receiving vocational peer work, 54 (46.6%) worked in funder-approved placements, of whom 27 (50.0%) achieved sustained employment. Among 210 participants who did not receive peer work, 103 (49.0%) worked in funder-approved placements, of whom 60 (58.3%) achieved sustained employment. CONCLUSIONS The program achieved positive vocational outcomes and good fidelity to the IPS model. Approximately half of young people had employment placements, with a relatively high proportion maintained over time. The similar proportion of placements for those who did and did not receive peer work was encouraging given the IPS team determined that the former group needed additional support. Recommendations include upskilling the workforce, a data linkage system to obtain placement evidence, and using implementation science methodologies to understand how IPS programs are successfully embedded. This demands a coordinated effort between governments and funders, policymakers, services, and professional bodies.
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Affiliation(s)
- Magenta B Simmons
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Sarah Whitson
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | | | | | - Matthew Hamilton
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Eóin Killackey
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Mary Brushe
- Telethon Kids Institute, University of Western Australia, Adelaide, South Australia, Australia.,School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
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Sacca L, Markham C, Hernandez B, Shegog R, Peskin M, Craig Rushing S, Warren H, Tsosie M. The Impact of COVID-19 on the Delivery of Educational Programs in Native American Communities: Qualitative Study. JMIR Form Res 2022; 6:e32325. [PMID: 35348464 PMCID: PMC9004623 DOI: 10.2196/32325] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 03/02/2022] [Accepted: 03/18/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Despite the availability of culturally responsive sexual health educational programs for American Indian and Alaska Native (AI/AN) youth, barriers to their uptake and utilization persist in tribal communities. These challenges were exacerbated by the COVID-19 pandemic, which required flexible program delivery using both in-person and virtual classrooms. OBJECTIVE This exploratory study provides a preliminary understanding of the extent to which pre-existing challenges impact the delivery of culturally responsive sexual health education programs in Native communities and to what extent they were exacerbated by the COVID-19 pandemic. It also highlights the challenges faced by adolescent health advocates when adapting culturally responsive health curricula to online platforms. Finally, this study discloses major socioeconomic, health, and mental challenges experienced by AI/AN youth during the pandemic. METHODS An exploratory, descriptive, qualitative design approach was adopted to carry out 5 individual and 1 collective in-depth key informant interviews. A total of 8 Native and non-Native sexual health educators served as key informants and shared their personal experiences with the delivery of sexual health education programs for youth during the COVID-19 pandemic. The interviews were conducted virtually from October to November 2020 using Zoom to reach participants dispersed across different regions of the United States. We followed the consolidated criteria for reporting qualitative research (COREQ) as a reference for the study methodology. We also used the Braun and Clarke framework (2006) to conduct a thematic analysis. RESULTS Experts' opinions were structured according to 5 main themes: (1) competing community priorities during COVID-19; (2) moving to web-based programming: skills, training, support; (3) recruiting youth; and (4) challenges for implementation in a household environment; and (5) recommendations to overcome implementation challenges. These themes are complementary, connected, and should be considered holistically for the development, dissemination, and implementation of online sexual health programs for AI/AN youth, specifically during the COVID-19 pandemic. The results raised the following points for discussion: (1) Building partnerships with schools and community organizations facilitates program adaptation and implementation, (2) there is a need to adopt a holistic approach when addressing youth sexual health in AI/AN communities, (3) a systematic and culturally responsive adaptation approach ensures effective virtual program delivery, and (4) community and youth engagement is essential for the success of virtual sexual health programs. CONCLUSIONS Findings can provide recommendations on actions to be taken by sexual health educators and guidelines to follow to ensure cultural sensitivity, effective adaptation, and successful implementation when setting out to advocate for online sexual health programs for AI/AN youth.
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Affiliation(s)
- Lea Sacca
- Center for Health Promotion and Disease Prevention, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Christine Markham
- Center for Health Promotion and Disease Prevention, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Belinda Hernandez
- Center for Health Promotion and Prevention Research, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Ross Shegog
- Center for Health Promotion and Disease Prevention, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Melissa Peskin
- Center for Health Promotion and Disease Prevention, University of Texas Health Science Center Houston, Houston, TX, United States
| | | | - Hannah Warren
- Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Monique Tsosie
- Inter Tribal Council of Arizona, Phoenix, AZ, United States
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Polari A, Street R, Conus P, Finkelstein A, Hartmann JA, Kim SW, McGorry P, Schley C, Simmons M, Stratford J, Thompson A, Yung A, Nelson B, Lavoie S. Patients', carers' and clinicians' attitudes towards alternative terms to describe the at-risk for psychosis state. Schizophr Res 2021; 237:69-75. [PMID: 34507056 DOI: 10.1016/j.schres.2021.08.031] [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] [Received: 09/17/2020] [Revised: 07/16/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Language used in psychiatry is important because it provides an understandable and accurate way of describing clinical and theoretical concepts. The use of labels in psychiatry has often been associated with stigma and reduced engagement with clinical services. This studys aims were to generate new terms for the 'at-risk mental state' (ARMS) concept and to investigate what young people, their caregivers and clinicians thought about them as well as terms commonly used in early intervention clinics. Another aim was to understand participants preference related to the best timing to introduce the at-risk concept and the extent and context of the information presented. METHODS New terms illustrating the at-risk concept have been generated by a youth reference group with lived experience of mental illness: 'pre-diagnosis stage' (PDS), potential of developing a mental illness (PDMI) and disposition for developing a mental illness (DDMI). A specifically designed questionnaire was administered to 46 patients with ARMS, 24 caregivers and 52 clinicians to obtain their feedback on newly proposed terms and on the terms already used in clinical practice and research. RESULTS The preferred terms were PDS, PDMI and ARMS. The least favoured terms were Ultra High Risk and Attenuated Psychosis Syndrome, which were thought to be associated with the most stigma. Most participants agreed that disclosure about diagnosis should be delivered early by the key clinician. CONCLUSIONS Patients generated terms such as PDS, PDMI, alongside ARMS should be considered to be used in clinical practice. They present with low stigma and are illustrative of young peoples difficulties.
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Affiliation(s)
- Andrea Polari
- Orygen Specialist Programs, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
| | - Rebekah Street
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Philippe Conus
- Treatment and Early Intervention in Psychosis Program (TIPP), Département de Psychiatrie CHUV, Université de Lausanne, Lausanne, Switzerland
| | | | - Jessica A Hartmann
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Patrick McGorry
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Magenta Simmons
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Andrew Thompson
- Orygen Specialist Programs, Melbourne, Australia; Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Alison Yung
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Barnaby Nelson
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Suzie Lavoie
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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Simmons MB, Fava N, Faliszewski J, Browne V, Chinnery G, van der El K, Hodges C, Pennell K, Brushe M. Inside the black box of youth participation and engagement: Development and implementation of an organization-wide strategy for Orygen, a national youth mental health organization in Australia. Early Interv Psychiatry 2021; 15:1002-1009. [PMID: 32893475 DOI: 10.1111/eip.13033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 07/10/2020] [Accepted: 08/02/2020] [Indexed: 11/28/2022]
Abstract
AIM The involvement of young people in the development, implementation and evaluation of youth mental health services, policy and research programs is essential to ensure they are appropriate and responsive to the needs of young people. Despite the increasingly central role that youth engagement and participation plays internationally, such activities are rarely described in detail. This article aims to provide a thorough description of the development and implementation of an organization-wide, 3-year Youth Engagement and Participation Strategy for Orygen, a national youth mental health organization in Australia. METHODS A descriptive account of the development and implementation of the Strategy, with detailed examples of programs and initiatives. RESULTS The Strategy was developed based on available evidence, focus groups with key stakeholders and best practice principles. The implementation of the Strategy resulted in a number of programs being delivered that involved a range of young people from across Australia. Despite being successful overall, a number of challenges were experienced. Ongoing considerations include ensuring diversity of partnerships, 'raising the bar' of youth participation and creating meaningful pathways. CONCLUSIONS Youth participation and engagement within a youth mental health context is best seen as an evolving ambition that must remain flexible to the needs of all stakeholders. Despite some challenges and ongoing fine-tuning, it is possible to successfully implement youth participation and engagement across all areas of youth mental health, including service design and delivery, research and translation, and policy.
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Affiliation(s)
- Magenta B Simmons
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | | | | | | | | | | | | | | | - Mary Brushe
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.,School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
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Canas E, Wathen N, Berman H, Reaume-Zimmer P, Iyer SN. Our roles are not at ease: The work of engaging a youth advisory council in a mental health services delivery organization. Health Expect 2021; 24:1618-1625. [PMID: 34240785 PMCID: PMC8483197 DOI: 10.1111/hex.13302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/11/2021] [Accepted: 05/07/2021] [Indexed: 12/01/2022] Open
Abstract
Objectives There is growing policy impetus for including youth voices in health services research and health system reform. This article examines the perspectives of professionals in a mental healthcare organization charged with engaging young people as advisors in service transformation. Methods An institutional ethnography of a youth mental health services organization in Ontario, Canada, was conducted. Fieldwork consisted of twelve months of observation of meetings, interviews with youth advisors and adult service providers, with subsequent text analysis of engagement training and policy materials. The present article reports data from six adult professionals and related field observations. Results Service providers’ efforts to engage youth were observed in three areas: a) supporting youth's development as advisors, b) retaining and deepening youth participation while waiting for organizational change and c) embedding relationships between youth and adults at various levels within the system of care. This work denotes existing tensions between the values and ideals of youth engagement and the everyday demands of services delivery. Conclusion In this setting, a fundamental dimension of this work consisted of negotiating tensions between the policy enthusiasm for engagement and its realization in a health services context. In describing these contextual challenges, we outline implications for consideration by other youth mental health services. Engagement efforts that are authentic and sustained require resources and flexibility, and leadership commitment to instil service users’ perspectives throughout multiple levels within the organization.
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Affiliation(s)
- Eugenia Canas
- Faculty of Information & Media Studies, Western University, London, ON, Canada
| | - Nadine Wathen
- Faculty of Information & Media Studies, Western University, London, ON, Canada.,Centre for Research and Education on Violence Against Women and Children, Western University, London, ON, Canada
| | - Helene Berman
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada.,Centre for Research on Health Equity and Social Inclusion, Western University, London, ON, Canada
| | - Paula Reaume-Zimmer
- Mental Health and Addiction Services, Bluewater Health and Canadian Mental Health Association, Lambton Kent, ON, Canada.,ACCESS Open Minds (Pan-Canadian Youth Mental Health Services Research Network), Douglas Research Centre, Montréal, QC, Canada
| | - Srividya N Iyer
- ACCESS Open Minds (Pan-Canadian Youth Mental Health Services Research Network), Douglas Research Centre, Montréal, QC, Canada.,Department of Psychiatry, McGill University, Montréal, QC, Canada.,Douglas Mental Health University Institute, Montréal, QC, Canada
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Simmons MB, Brushe M, Elmes A, Polari A, Nelson B, Montague A. Shared Decision Making With Young People at Ultra High Risk of Psychotic Disorder. Front Psychiatry 2021; 12:683775. [PMID: 34603094 PMCID: PMC8481955 DOI: 10.3389/fpsyt.2021.683775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/31/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction: While the majority of young people who meet the criteria for being considered at increased risk of psychosis do not go on to develop a psychotic disorder, young people are currently being identified and treated in early intervention services. Ethical concerns have been raised concerning the decision about whether or not to provide treatment, and if so, what type of treatment. This study sought to support young people themselves to make these decisions with support from their clinician through a shared decision-making approach, facilitated by an online decision aid. Methods: This project used the International Patient Decision Aid Standards (IPDAS) to guide the development and piloting of an online decision aid across two phases: (1) qualitative, semi-structured focus groups with young people who were past clients and clinicians from an early psychosis service; and (2) pilot testing of the decision aid with clinicians and young people who were current clients to finalize the development. Results: Issues discussed by clinicians in the focus group were grouped into three main areas: (1) engagement phase; (2) assessment and priorities for treatment; and (3) initial and ongoing decision making. Clients focused on the context in which the decisions were made, including as they experienced initial feelings of resistance, and then acceptance of efforts made to describe and treat their mental health challenges. Clients highlighted the need for collaboration between themselves and their clinician, and the need to be equipped with the knowledge and tools to take care of themselves. These focus group data were used to refine the online decision aid. Pilot testing revealed that while it was overall useful and relevant, important limitations were noted by both clients and clinicians. Discussion: The use of a decision aid to facilitate shared decision making (SDM) in this area is feasible and has utility for both clients and clinicians. Use of such a tool can help to address the need to uphold the rights of young people as decision makers about their own care. Future efforts should embed decision aids within complex SDM interventions, and research to understand issues relating to implementation of these interventions.
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Affiliation(s)
- Magenta Bender Simmons
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Mary Brushe
- Telethon Kids Institute, University of Western Australia, Adelaide, SA, Australia.,School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - Aurora Elmes
- Centre for Social Impact, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Andrea Polari
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Barnaby Nelson
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Alice Montague
- North East London Foundation NHS Trust, London, United Kingdom.,Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
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Christie GIG, Cheetham A, Lubman DI. Interventions for Alcohol and Drug Use Disorders in Young People: 10 Key Evidence-Based Approaches to Inform Service Delivery. CURRENT ADDICTION REPORTS 2020. [DOI: 10.1007/s40429-020-00336-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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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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Simmons MB, Grace D, Fava NJ, Coates D, Dimopoulos-Bick T, Batchelor S, Howe D, Montague AE. The Experiences of Youth Mental Health Peer Workers over Time: A Qualitative Study with Longitudinal Analysis. Community Ment Health J 2020; 56:906-914. [PMID: 31970578 DOI: 10.1007/s10597-020-00554-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 01/18/2020] [Indexed: 11/29/2022]
Abstract
Peer work is a rapidly growing part of the mental health workforce, yet few studies explore the implementation of peer work in youth mental health. Qualitative focus groups were conducted with eight youth peer workers at the commencement of their employment, then at 3-months and 6-months after this time. Data were transcribed verbatim and analysed using thematic and trajectory analysis. The three main findings included: (1) there was a trajectory from fear to hope; (2) there was an improved understanding of benefits and role definition over time; and (3) there was an evolving concept of understanding shared experiences as a primary asset. Known barriers to implementing peer work are likely to occur in youth mental health settings as well. Ensuring that adequate training, change management and tailored support strategies are important to maximise the chances of successful youth peer work programs.
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Affiliation(s)
- Magenta B Simmons
- Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10, Parkville, VIC, 3052, Australia. .,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
| | - Dawson Grace
- Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10, Parkville, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Nicholas J Fava
- Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10, Parkville, VIC, 3052, Australia
| | - Dominiek Coates
- Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | | | - Samantha Batchelor
- Health Promotion, Central Coast Local Health District, New South Wales Health, Gosford, Australia
| | - Deb Howe
- New South Wales Agency for Clinical Innovation, Chatswood, Australia
| | - Alice E Montague
- Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10, Parkville, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
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Settipani CA, Hawke LD, Cleverley K, Chaim G, Cheung A, Mehra K, Rice M, Szatmari P, Henderson J. Key attributes of integrated community-based youth service hubs for mental health: a scoping review. Int J Ment Health Syst 2019; 13:52. [PMID: 31367230 PMCID: PMC6651922 DOI: 10.1186/s13033-019-0306-7] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 07/10/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Community-based, integrated youth service hubs have the potential to address some of the longstanding issues with mental health services for youth, including problems with access and system fragmentation. Better understanding of these approaches, particularly efforts to create a single point of entry to comprehensive, evidence-based services through youth service hubs, is needed to help guide future implementation and evaluation. This scoping review identifies the key principles and characteristics of these models of care, as well as the state of the literature, particularly with regard to implementation and replicability. METHOD Electronic databases and grey literature sources were searched for material from 2001 to 2019, with diverse search terms capturing the concept of "integrated" or "one-stop shop" youth mental health services. Title/abstract and full text review were conducted, as well as additional focused searching. After screening 4891 texts at the title/abstract level and 496 at the full-text level, 110 documents were included for data extraction. RESULTS Several integrated care hub models for youth mental health services and related frameworks were identified internationally, largely in high-income countries. Common principles included an emphasis on rapid access to care and early intervention, youth and family engagement, youth-friendly settings and services, evidence-informed approaches, and partnerships and collaboration. Program characteristics also revealed similarities (e.g., providing evidence-informed or evidence-based services in youth-friendly spaces), with some differences (e.g., care coordination methods, types of service providers), potentially attributable to lack of available information about key ingredients. Outcome research was limited, with few rigorous evaluations of youth outcomes. Moreover, sufficient information for replication, community evaluation of feasibility or actual implementation was rarely provided. CONCLUSION Internationally, integrated youth service hubs were found to share common key principles, while providing comprehensive services to youth with mental health difficulties. There is a great need for common language and measurement framework to facilitate replication, rigorous evaluation of outcomes, knowledge exchange, and dissemination of findings.
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Affiliation(s)
- Cara A. Settipani
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Lisa D. Hawke
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON Canada
- Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Kristin Cleverley
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON Canada
| | - Gloria Chaim
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON Canada
- Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Amy Cheung
- Department of Psychiatry, University of Toronto, Toronto, ON Canada
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON Canada
| | - Kamna Mehra
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON Canada
| | | | - Peter Szatmari
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON Canada
- Department of Psychiatry, University of Toronto, Toronto, ON Canada
- Department of Psychiatry, Hospital for Sick Children, Toronto, ON Canada
| | - Joanna Henderson
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON Canada
- Department of Psychiatry, University of Toronto, Toronto, ON Canada
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Simmons MB, Coates D, Batchelor S, Dimopoulos-Bick T, Howe D. The CHOICE pilot project: Challenges of implementing a combined peer work and shared decision-making programme in an early intervention service. Early Interv Psychiatry 2018; 12:964-971. [PMID: 29230972 DOI: 10.1111/eip.12527] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 09/01/2017] [Accepted: 11/08/2017] [Indexed: 11/30/2022]
Abstract
AIM Youth participation is central to early intervention policy and quality frameworks. There is good evidence for peer support (individuals with lived experience helping other consumers) and shared decision making (involving consumers in making decisions about their own care) in adult settings. However, youth programs are rarely tested or described in detail. This report aims to fill this gap by describing a consumer focused intervention in an early intervention service. METHODS This paper describes the development process, intervention content and implementation challenges of the Choices about Healthcare Options Informed by Client Experiences and Expectations (CHOICE) Pilot Project. This highly novel and innovative project combined both youth peer work and youth shared decision making. RESULTS Eight peer workers were employed to deliver an online shared decision-making tool at a youth mental health service in New South Wales, Australia. The intervention development involved best practice principles, including international standards and elements of co-design. The implementation of the peer workforce in the service involved a number of targeted strategies designed to support this new service model. However, several implementation challenges were experienced which resulted in critical learning about how best to deliver these types of interventions. CONCLUSIONS Delivering peer work and shared decision making within an early intervention service is feasible, but not without challenges. Providing adequate detail about interventions and implementation strategies fills a critical gap in the literature. Understanding optimal youth involvement strategies assists others to deliver acceptable and effective services to young people who experience mental ill health.
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Affiliation(s)
- Magenta B Simmons
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Dominiek Coates
- Central Coast Local Health District, Children and Young People's Mental Health, Gosford, New South Wales, Australia
| | - Samantha Batchelor
- Central Coast Local Health District, Children and Young People's Mental Health, Gosford, New South Wales, Australia
| | - Tara Dimopoulos-Bick
- Central Coast Local Health District, Children and Young People's Mental Health, Gosford, New South Wales, Australia
| | - Deborah Howe
- Central Coast Local Health District, Children and Young People's Mental Health, Gosford, New South Wales, Australia
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Hughes F, Hebel L, Badcock P, Parker AG. Ten guiding principles for youth mental health services. Early Interv Psychiatry 2018; 12:513-519. [PMID: 28402028 DOI: 10.1111/eip.12429] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 10/13/2016] [Accepted: 12/24/2016] [Indexed: 11/30/2022]
Abstract
AIMS Guiding principles are arguably central to the development of any health service. The aim of this article is to report on the outcomes of a youth mental health (YMH) community of practice (CoP), which identified a range of guiding principles that provide a clear point of comparison for the only other set of principles for YMH service delivery proposed to date. METHODS A YMH CoP was established in 2010 as part of the Victorian State Government approach to improving YMH care. An initial literature search was undertaken to locate articles on YMH service delivery. A number of common themes were identified, which the YMH community of practice (YMHCoP) members then elaborated upon by drawing from their collective experience of the YMH sector. The resultant themes were then refined through subsequent group discussions to derive a definitive set of guiding principles. These principles were then augmented by a second literature search conducted in July 2015. RESULTS Fifteen key themes were derived from the initial literature search and YMH CoP discussions. These were refined by the YMH CoP to produce 10 guiding principles for YMH service development. These are discussed through reference to the relevant literature, using the only other article on principles of YMH service delivery as a notable point of comparison. CONCLUSION The 10 principles identified may be useful for quality improvement and are likely to have international relevance. We suggest the timely pursuit of an international consensus on guiding principles for service delivery under the auspices of a peak body for YMH.
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Affiliation(s)
- Frank Hughes
- Centre for Youth Mental Health, Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
| | - Lisa Hebel
- North-Western Mental Health, Melbourne Health, Melbourne, Victoria, Australia
| | - Paul Badcock
- Centre for Youth Mental Health, Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alexandra G Parker
- Centre for Youth Mental Health, Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
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Abstract
To date, Ireland has been a leading light in the provision of youth mental health services. However, cognisant of the efforts of governmental and non-governmental agencies working in youth mental health, there is much to be done. Barriers into care as well as discontinuity of care across the spectrum of services remain key challenges. This editorial provides guidance for the next stage of development in youth mental care and support that will require significant national engagement and resource investment.
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Simmons MB, Elmes A, McKenzie JE, Trevena L, Hetrick SE. Right choice, right time: Evaluation of an online decision aid for youth depression. Health Expect 2017; 20:714-723. [PMID: 27748004 PMCID: PMC5513008 DOI: 10.1111/hex.12510] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Appropriate treatment for youth depression is an important public health priority. Shared decision making has been recommended, yet no decision aids exist to facilitate this. OBJECTIVES The main objective of this study was to evaluate an online decision aid for youth depression. DESIGN An uncontrolled cohort study with pre-decision, immediately post-decision and follow-up measurements. SETTING AND PARTICIPANTS Young people (n=66) aged 12-25 years with mild, mild-moderate or moderate-severe depression were recruited from two enhanced primary care services. INTERVENTION Online decision aid with evidence communication, preference elicitation and decision support components. MAIN OUTCOME MEASURES The main outcome measures were ability to make a decision; whether the decision was in line with clinical practice guidelines, personal preferences and values; decisional conflict; perceived involvement; satisfaction with decision; adherence; and depression scores at follow-up. RESULTS After using the decision aid, clients were more likely to make a decision in line with guideline recommendations (93% vs 70%; P=.004), were more able to make a decision (97% vs 79%; P=.022), had significantly reduced decisional conflict (17.8 points lower (95% CI: 13.3-22.9 points lower) on the Decisional Conflict Scale (range 0-100)) and felt involved and satisfied with their decision. At follow-up, clients had significantly reduced depression symptoms (2.7 points lower (95% CI: 1.3-4.0 points lower) on the Patient Health Questionnaire nine-item scale (range 0-27)) and were adherent to 88% (95% CI: 82%-94%) of treatment courses. DISCUSSION AND CONCLUSIONS A decision aid for youth depression can help ensure evidence-based, client-centred care, promoting collaboration in this often difficult to engage population.
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Affiliation(s)
- Magenta B. Simmons
- OrygenThe National Centre of Excellence in Youth Mental Health
- Centre for Youth Mental HealthThe University of Melbourne
| | - Aurora Elmes
- OrygenThe National Centre of Excellence in Youth Mental Health
- Centre for Youth Mental HealthThe University of Melbourne
| | - Joanne E. McKenzie
- School of Public Health and Preventive MedicineMonash UniversityClaytonVic.Australia
| | - Lyndal Trevena
- School of Public HealthThe University of SydneySydneyNSWAustralia
| | - Sarah E. Hetrick
- OrygenThe National Centre of Excellence in Youth Mental Health
- Centre for Youth Mental HealthThe University of Melbourne
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Dunne T, Bishop L, Avery S, Darcy S. A Review of Effective Youth Engagement Strategies for Mental Health and Substance Use Interventions. J Adolesc Health 2017; 60:487-512. [PMID: 28087268 DOI: 10.1016/j.jadohealth.2016.11.019] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 11/17/2016] [Accepted: 11/17/2016] [Indexed: 11/18/2022]
Abstract
The majority of adult mental health and substance use (MH&SU) conditions emerge in adolescence. Prevention, diagnosis, and treatment programs targeting this age group have a unique opportunity to significantly impact the well-being of the future generation of adults. At the same time, youth are reluctant to seek treatment and have high rates of dropout from interventions. An emphasis on youth engagement in prevention and treatment interventions for MH&SU results in better health outcomes for those youth. This literature review was undertaken to evaluate opportunities to improve youth engagement in MH&SU programs. The intent was to determine best practices in the field that combined community-level improvement in clinical outcomes with proven strategies in engagement enhancement to inform program development at a local level. The results discuss 40 studies, reviews, and program reports demonstrating effective youth engagement. These have been grouped into six themes based on the underlying engagement mechanism: youth participation in program development, parental relationships, technology, the health clinic, school, and social marketing. A broad range of tools are discussed that intervention developers can leverage to improve youth engagement in prevention or treatment programs.
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Affiliation(s)
- Tom Dunne
- Discipline of Family Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Lisa Bishop
- Discipline of Family Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada; School of Pharmacy, Memorial University of Newfoundland, St. John's, NL, Canada.
| | - Susan Avery
- Discipline of Family Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Stephen Darcy
- Discipline of Family Medicine, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
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Dayton L, Buttress A, Agosti J, Aceves J, Kieschnick M, Popejoy A, Robbins R, Farinholt K. Practical Steps to Integrate Family Voice in Organization, Policy, Planning, and Decision-Making for Socio-Emotional Trauma-Informed Integrated Pediatric Care. Curr Probl Pediatr Adolesc Health Care 2016; 46:402-410. [PMID: 27956109 DOI: 10.1016/j.cppeds.2016.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This article explores barriers and strategies to achieving family-driven integrated child health care. Family involvement in health system design and reform has become a guiding principle in national and local efforts to improve children's mental health services. In practice, primary care clinicians, staff, and families continue to describe common barriers to integrating family voice. Drawing from the collective knowledge of the Pediatric Integrated Care Collaborative (PICC) and the National Alliance on Mental Illness (NAMI), we present strategies to overcome these barriers to successfully recruit, sustain, and expand family influence on health systems. Family advocates and clinical leaders from two clinic sites in Albuquerque, New Mexico and Santa Rosa, California share challenges and strategies for building family involvement in system design.
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Affiliation(s)
- Lauren Dayton
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Amelia Buttress
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Jen Agosti
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Javier Aceves
- University of New Mexico Young Children's Health Center, Albuquerque, NM
| | | | - Agatha Popejoy
- University of New Mexico Young Children's Health Center, Albuquerque, NM
| | | | - Kate Farinholt
- National Alliance on Mental Illness (NAMI) Maryland, Baltimore, MD
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Burns J, Birrell E. Enhancing early engagement with mental health services by young people. Psychol Res Behav Manag 2014; 7:303-12. [PMID: 25473320 PMCID: PMC4251759 DOI: 10.2147/prbm.s49151] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
International studies have shown that the prevalence of mental illness, and the fundamental contribution it make to the overall disease burden, is greatest in children and young people. Despite this high burden, adolescents and young adults are the least likely population group to seek help or to access professional care for mental health problems. This issue is particularly problematic given that untreated, or poorly treated, mental disorders are associated with both short- and long-term functional impairment, including poorer education and employment opportunities, potential comorbidity, including drug and alcohol problems, and a greater risk for antisocial behavior, including violence and aggression. This cycle of poor mental health creates a significant burden for the young person, their family and friends, and society as a whole. Australia is enviably positioned to substantially enhance the well-being of young people, to improve their engagement with mental health services, and – ultimately – to improve mental health. High prevalence but potentially debilitating disorders, such as depression and anxiety, are targeted by the specialized youth mental health service, headspace: the National Youth Mental Health Foundation and a series of Early Psychosis Prevention and Intervention Centres, will provide early intervention specialist services for low prevalence, complex illnesses. Online services, such as ReachOut.com by Inspire Foundation, Youthbeyondblue, Kids Helpline, and Lifeline Australia, and evidence-based online interventions, such as MoodGYM, are also freely available, yet a major challenge still exists in ensuring that young people receive effective evidence-based care at the right time. This article describes Australian innovation in shaping a comprehensive youth mental health system, which is informed by an evidence-based approach, dedicated advocacy and, critically, the inclusion of young people in service design, development, and ongoing evaluation to ensure that services can be continuously improved.
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Affiliation(s)
- Jane Burns
- Young and Well Cooperative Research Centre, Abbotsford, VIC, Australia
| | - Emma Birrell
- Young and Well Cooperative Research Centre, Abbotsford, VIC, Australia
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Hughes F, Stavely H, Simpson R, Goldstone S, Pennell K, McGorry P. At the heart of an early psychosis centre: the core components of the 2014 Early Psychosis Prevention and Intervention Centre model for Australian communities. Australas Psychiatry 2014; 22:228-234. [PMID: 24789848 DOI: 10.1177/1039856214530479] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe the core components of the Early Psychosis Prevention and Intervention Centre service model as the template agreed with the Australian Federal Government for national upscaling. The Early Psychosis Prevention and Intervention Centre model of early intervention has two main goals: to reduce the period of time between the onset of psychosis and the commencement of treatment and to bring about symptomatic recovery and restore the normal developmental trajectory as early as possible. CONCLUSIONS The Early Psychosis Prevention and Intervention Centre comprises three elements of service provision for young people experiencing a first episode of psychosis: (i) early detection; (ii) acute care during and immediately following a crisis; (iii) recovery-focused continuing care, featuring multimodal interventions to enable the young person to maintain or regain their social, academic and/or career trajectory during the critical first 2-5 years following the onset of a psychotic illness. It does this via a combination of 16 core components, which provide a flexible, comprehensive, integrated service that is able to respond quickly, appropriately and consistently to the individual needs of the young person and their family. Innovative service reforms, such as Early Psychosis Prevention and Intervention Centre, that recognise the value of early intervention are crucial to reducing the impact of serious mental illness on young people and their families and, ultimately, on our society.
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Affiliation(s)
- Frank Hughes
- Orygen Youth Health Research Centre and the Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Heather Stavely
- Orygen Youth Health Research Centre and the Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Raelene Simpson
- Orygen Youth Health Research Centre and the Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Sherilyn Goldstone
- Orygen Youth Health Research Centre and the Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Kerryn Pennell
- Orygen Youth Health Research Centre and the Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Patrick McGorry
- Orygen Youth Health Research Centre and the Centre for Youth Mental Health, Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
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Byrne L, Wilson M, Burke KJ, Gaskin CJ, Happell B. Mental health service delivery: a profile of mental health non-government organisations in south-east Queensland, Australia. AUST HEALTH REV 2014; 38:202-7. [PMID: 24695001 DOI: 10.1071/ah13208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 01/15/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Non-government organisations make a substantial contribution to the provision of mental health services; despite this, there has been little research and evaluation targeted at understanding the role played by these services within the community mental health sector. The aim of the present study was to examine the depth and breadth of services offered by these organisations in south-east Queensland, Australia, across five key aspects of reach and delivery. METHODS Representatives from 52 purposively targeted non-government organisations providing mental health services to individuals with significant mental health challenges were interviewed regarding their approach to mental health service provision. RESULTS The findings indicated a diverse pattern of service frameworks across the sector. The results also suggested a positive approach to the inclusion of consumer participation within the organisations, with most services reporting, at the very least, some form of consumer advocacy within their processes and as part of their services. CONCLUSIONS This paper offers an important first look at the nature of non-government service provision within the mental health sector and highlights the importance of these organisations within the community sector. What is known about the topic? Non-government organisations make a substantial contribution to the multisectorial provision of services to mental health consumers in community settings. Non-government organisations in Australia are well established, with 79.9% of them being in operation for over 10 years. There is an increasing expectation that consumers influence the development, delivery and evaluation of mental health services, especially in the community sector. What does this paper add? This paper provides a profile of non-government organisations in one state in Australia with respect to the services they provide, the consumers they target, the practice frameworks they use, the use of peer workers and consumer participation, the success they have had with obtaining funding and the extent to which they collaborate with other services. What are the implications for practitioners? This paper provides readers with an understanding of the non-government organisations and the services they provide to people with mental health conditions. In addition, the findings provide an opportunity to learn from the experience of non-government organisations in implementing consumer participation initiatives.
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Affiliation(s)
- Louise Byrne
- Institute for Health and Social Science Research, Central Queensland University, Bruce Highway, Rockhampton, Qld 4702, Australia.
| | - Michael Wilson
- Queensland Alliance for Mental Health, 1/78 Logan Road, Woolloongabba, Qld 4102, Australia.
| | - Karena J Burke
- Institute for Health and Social Science Research, Central Queensland University, Bruce Highway, Rockhampton, Qld 4702, Australia.
| | - Cadeyrn J Gaskin
- Institute for Health and Social Science Research, Central Queensland University, Bruce Highway, Rockhampton, Qld 4702, Australia.
| | - Brenda Happell
- Institute for Health and Social Science Research, Central Queensland University, Bruce Highway, Rockhampton, Qld 4702, Australia.
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