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Eapen V, Gerstl B, Ahinkorah BO, John JR, Hawker P, Nguyen TP, Brice F, Winata T, Bowden M. Evidence-based brief interventions targeting acute mental health presentations for children and adolescents: systematic review. BJPsych Open 2024; 10:e78. [PMID: 38602192 PMCID: PMC11060074 DOI: 10.1192/bjo.2024.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 01/29/2024] [Accepted: 02/04/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Brief intervention services provide rapid, mobile and flexible short-term delivery of interventions to resolve mental health crises. These interventions may provide an alternative pathway to the emergency department or in-patient psychiatric services for children and young people (CYP), presenting with an acute mental health condition. AIMS To synthesise evidence on the effectiveness of brief interventions in improving mental health outcomes for CYP (0-17 years) presenting with an acute mental health condition. METHOD A systematic literature search was conducted, and the studies' methodological quality was assessed. Five databases were searched for peer-reviewed articles between January 2000 and September 2022. RESULTS We synthesised 30 articles on the effectiveness of brief interventions in the form of (a) crisis intervention, (b) integrated services, (c) group therapies, (d) individualised therapy, (e) parent-child dyadic therapy, (f) general services, (g) pharmacotherapy, (h) assessment services, (i) safety and risk planning and (j) in-hospital treatment, to improve outcomes for CYP with an acute mental health condition. Among included studies, one study was rated as providing a high level of evidence based on the National Health and Medical Research Council levels of evidence hierarchy scale, which was a crisis intervention showing a reduction in length of stay and return emergency department visits. Other studies, of moderate-quality evidence, described multimodal brief interventions that suggested beneficial effects. CONCLUSIONS This review provides evidence to substantiate the benefits of brief interventions, in different settings, to reduce the burden of in-patient hospital and readmission rates to the emergency department.
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Affiliation(s)
- Valsamma Eapen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; and Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Brigitte Gerstl
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; and Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Bright Opoku Ahinkorah
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; Discipline of Psychiatry and Mental Health, University of New South Wales, Australia; and School of Public Health, University of Technology Sydney, Australia
| | - James Rufus John
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; and Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Patrick Hawker
- Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Thomas P. Nguyen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; Discipline of Psychiatry and Mental Health, University of New South Wales, Australia; and Mental Health Team, School of Medicine, Western Sydney University, Australia
| | - Febe Brice
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia
| | - Teresa Winata
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; Discipline of Psychiatry and Mental Health, University of New South Wales, Australia; and Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Australia
| | - Michael Bowden
- Child and Youth Mental Health, New South Wales Ministry of Health, Australia; Sydney Medical School, University of Sydney, Australia; and Department of Psychological Medicine, Sydney Children's Hospitals Network, Australia
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Eapen V, Gerstl B, Winata T, Jairam R, Barton G, Bowden M. A Study Protocol for Safeguards Child and Adolescent Mental Health Rapid Response Teams ('Safeguards Teams') Service. Int J Integr Care 2023; 23:4. [PMID: 37577140 PMCID: PMC10417910 DOI: 10.5334/ijic.7004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 07/26/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction As the number of children and young people (CYP) presenting to Emergency Departments (ED) with acute mental health (MH) presentations has been steadily increasing over the years and further accelerated by the pandemic, there is an urgent need to develop and evaluate innovative solutions to respond to this growing challenge. Description The evaluation of the Safeguards Teams Program (STP) aims to ascertain the impact, implementation and economic analysis of this acute rapid response recovery-focused, trauma-informed assessment and brief intervention for CYP (aged 0-17 years) presenting in acute MH crisis and their families/caregivers.The STP will support consumers (patients) and their families/caregivers to navigate the complex and often fragmented child and adolescent MH services (CAMHS) landscape, thereby avoiding unnecessary ED presentations or hospitalisations, and facilitating comprehensive assessment and appropriate care pathways for those who present in crisis. Discussion The STP is expected to provide CYP in MH crisis and their support networks with early access to evidence-based specialist care at the right place and time. Conclusion Implementation of the STP will assist with identifying and addressing gaps in acute care for CYP and provide the necessary evidence for service redesign in collaboration with consumers, service providers and other stakeholders.
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Affiliation(s)
- Valsamma Eapen
- Academic Unit of Infant, Child and Adolescent Psychiatry Services (AUCS), SWSLHD and Ingham Institute, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Sydney Australia
| | - Brigitte Gerstl
- Academic Unit of Infant, Child and Adolescent Psychiatry Services (AUCS), SWSLHD and Ingham Institute, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Teresa Winata
- Academic Unit of Infant, Child and Adolescent Psychiatry Services (AUCS), SWSLHD and Ingham Institute, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Sydney Australia
| | - Rajeev Jairam
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Sydney Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Giles Barton
- Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Sydney Australia
| | - Michael Bowden
- Mental Health Branch, NSW Ministry of Health, Sydney, Australia
- Sydney Children’s Hospitals Network, Sydney, Australia
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, Australia
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Quinton ML, Tidmarsh G, Parry BJ, Cumming J. A Kirkpatrick Model Process Evaluation of Reactions and Learning from My Strengths Training for Life™. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11320. [PMID: 36141592 PMCID: PMC9517080 DOI: 10.3390/ijerph191811320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
Underpinned by the New World Kirkpatrick model, and in the context of a community-based sport psychology programme (My Strengths Training for Life™) for young people experiencing homelessness, this process evaluation investigated (1) young peoples' reactions (i.e., program and facilitator evaluation, enjoyment, attendance, and engagement) and learning (i.e., mental skills and transfer intention), (2) the relationship between reaction and learning variables, and (3) the mediators underpinning this relationship. A total of 301 young people living in a West Midlands housing service completed questionnaires on demographics and reaction and learning variables. Higher levels of programme engagement were positively associated with more favourable reactions to the programme. Enjoyment positively predicted learning outcomes, which was mediated by transfer intention. Recommendations are made for (1) a balance between rigor and flexibility for evaluation methods with disadvantaged youth, (2) including engagement as well as attendance as indicators of meaningful programme participation, (3) measuring programme experiences (e.g., enjoyment) to understand programme effectiveness, and (4) providing opportunities for skill transfer during and after programme participation. Our findings have implications for researchers, programme commissioners, and policymakers designing and evaluating programmes in community-based settings.
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Affiliation(s)
- Mary L. Quinton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Grace Tidmarsh
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Benjamin J. Parry
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Jennifer Cumming
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
- Institute for Mental Health, University of Birmingham, Birmingham B15 2TT, UK
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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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Minnis H, Gajwani R, Ougrin D. Editorial: Early intervention and prevention of severe mental illness: A child and adolescent psychiatry perspective. Front Psychiatry 2022; 13:963602. [PMID: 35873256 PMCID: PMC9301369 DOI: 10.3389/fpsyt.2022.963602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/15/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
- Helen Minnis
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Ruchika Gajwani
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Dennis Ougrin
- Youth Resilience Unit, Queen Mary University of London, London, United Kingdom
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Dudley MJ, Lin PI. Preventing suicide by young people requires integrative strategies. Med J Aust 2021; 214:125-126. [PMID: 33583061 DOI: 10.5694/mja2.50939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 12/24/2020] [Accepted: 01/05/2021] [Indexed: 01/29/2023]
Affiliation(s)
- Michael J Dudley
- Adolescent Service, Prince of Wales and Sydney Children's Hospitals, Sydney, NSW.,University of New South Wales, Sydney, NSW
| | - Ping-I Lin
- University of New South Wales, Sydney, NSW.,South Western Sydney Local Health District, Sydney, NSW
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Bouchard J, Wong JS. Pathways to Engagement: An Exploratory Qualitative Analysis of Factors That Facilitate Men's Engagement in IPV Intervention Programs. Violence Against Women 2021; 27:2642-2663. [PMID: 33432859 DOI: 10.1177/1077801220981144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research on intimate partner violence (IPV) interventions has long indicated mixed support for their effectiveness at reducing abusive behaviors. Limited prior research has focused on factors associated with participant engagement in the treatment process. Using a qualitative thematic analysis and a sample of 180 participants who completed an IPV intervention program, the purpose of this study was to identify key factors that facilitate men's responsiveness to IPV intervention programs. The findings highlight several commonalities in participants' perceptions of pathways that facilitated and/or hindered their engagement in the treatment process, and provide insights into how program/process elements can be structured to enhance engagement.
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Broersen M, Frieswijk N, Kroon H, Vermulst AA, Creemers DHM. Young Patients With Persistent and Complex Care Needs Require an Integrated Care Approach: Baseline Findings From the Multicenter Youth Flexible ACT Study. Front Psychiatry 2020; 11:609120. [PMID: 33324268 PMCID: PMC7724087 DOI: 10.3389/fpsyt.2020.609120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/29/2020] [Indexed: 12/27/2022] Open
Abstract
Background: The Multicenter Youth Flexible ACT Study is an ongoing observational prospective cohort study that examines the effects of Youth Flexible ACT (Assertive Community Treatment) on young people with complex care needs who are difficult to engage in traditional (office-based) mental health services. However, a clear and detailed description of this patient group is lacking. In the current paper, we present baseline characteristics and psychosocial outcomes of the Youth Flexible ACT target group and explore the existence of underlying specific patient subgroups. Methods: Sixteen Youth Flexible ACT teams from seven mental healthcare institutes in the Netherlands participated in the study. Research participants were monitored for 18 months and administered questionnaires measuring psychiatric- and social functioning every 6 months, yielding four measurements. Baseline data were obtained from 199 adolescents, their mental health workers, and parents/carers. Latent Class Analysis based on HoNOSCA scores (measuring psychosocial and daily functioning) was conducted to identify underlying subgroups. Results: The target group of Youth Flexible ACT mainly consisted of patients older than 15 years of age with a history of (specialized) mental healthcare. They face many complex problems, including trauma; developmental, mood, and anxiety disorders; and problems with school attendance, family life, and peer relationships. Other frequently reported difficulties were substance misuse, the involvement of the legal system or police, problems with intellectual functioning, and personal finance. Patients were classified into four distinct classes: the "internalizing," "externalizing," "non-specific," and the "overly impulsive" subgroup. Each subgroup had its unique pattern of difficulties and focus, respectively, high levels of depression and anxiety, disruptive behavior, unspecific difficulties, and substance misuse. Conclusions: As expected, patients in Youth Flexible ACT experienced many severe problems, rendering them vulnerable to fragmented and, thus, ineffective care. Our findings underscore the need for an integrated care approach with a multidisciplinary team of skilled professionals that can bridge these wide-ranging psychosocial problems, as each class of participants experienced a different set of difficulties. Youth Flexible ACT teams need to adjust their care services accordingly.
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Affiliation(s)
- Marieke Broersen
- GGZ Oost Brabant, Oss, Netherlands.,Tranzo - Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | | | - Hans Kroon
- Tranzo - Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.,Trimbos Institute, Utrecht, Netherlands
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Goeman D, Howard J, Ogrin R. Implementation and refinement of a community health nurse model of support for people experiencing homelessness in Australia: a collaborative approach. BMJ Open 2019; 9:e030982. [PMID: 31748297 PMCID: PMC6887079 DOI: 10.1136/bmjopen-2019-030982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To implement, refine and evaluate an assertive community health nurse (CHN) model of support for people experiencing or at risk of homelessness that aims to improve their access to health and social care services. METHODS Participants were recruited between 30 August 2013 and 31 October 2015, including clients residing in a Victorian southern Melbourne metropolitan suburb, who registered with the CHN and stakeholders from local service provider organisations engaging with the CHN. A collaborative approach using demographic data collected from client records to identify need and measure the time clients took to engage and access services, qualitative data gathered during Stakeholder Advisory Group meetings and feedback from face-to-face interviews with service organisation representatives informed refinement of the CHN model. RESULTS Thirty-nine clients (22 Female, mean age 50±11 years) participated. Clients engaged with services after an average of seven CHN visits. Eighteen clients independently accessed services after approximately 9 weeks, including medical and housing services. Client need and feedback from 20 stakeholders and three community nurses contributed to refining the model to ensure it met local needs and informed the necessary organisational framework, the CHN role and the attributes, knowledge and the skills required. CONCLUSION A collaborative CHN model of support for people at risk of or experiencing homelessness has been articulated. Evaluation of the role demonstrated increased client engagement with health and community services and social activities. Additionally, the CHN assisted other service providers in their delivery of care to this very complex client group.
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Affiliation(s)
- Dianne Goeman
- Bolton Clarke Research Institute, Bolton Clarke, Bentleigh, Victoria, Australia
- Department of Public Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Jane Howard
- Bolton Clarke Research Institute, Bolton Clarke, Bentleigh, Victoria, Australia
- Victoria Department of Health and Human Services, Melbourne, Victoria, Australia
| | - Rajna Ogrin
- Bolton Clarke Research Institute, Bolton Clarke, Bentleigh, Victoria, Australia
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Schley C, Pace N, Mann R, McKenzie C, McRoberts A, Parker A. The headspace Brief Interventions Clinic: Increasing timely access to effective treatments for young people with early signs of mental health problems. Early Interv Psychiatry 2019; 13:1073-1082. [PMID: 30160372 DOI: 10.1111/eip.12729] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 06/15/2018] [Accepted: 07/29/2018] [Indexed: 12/17/2022]
Abstract
AIM Timely access to treatment in the early stages of mental illness is pivotal to recovery and prevention of longer-term disablement. Yet, this can be challenging at times of growing service demands. The headspace Brief Interventions Clinic (BIC) is an innovative treatment model aiming to promote quick access to evidence-based interventions for young people presenting with early signs of mental disorders. METHODS The BIC treatment package comprises eight skill-building and behavioural intervention modules that young people can choose from. Treatment occurs over a maximum of six sessions with graduate students under supervision. Treatment outcomes are compared at baseline and final sessions, with client satisfaction measured at the final session. RESULTS Allocation to the BIC occurred within 2 to 3 weeks of initial referral. Most young people (73%) completed their treatment, attending on average four sessions. Significant reductions in overall psychological distress, depressive symptomatology and anxiety severity ratings were observed at completion of treatment, as well as significant improvements in social and occupational functioning. About 91% of young people stated that their outcome expectations had been entirely met and 95% were entirely satisfied with their treatment experience. A strong therapeutic relationship, specific strategies for managing emotions, coping and problem-solving and a choice of engaging in flexible and modularised content were identified as the most valued experiences by young people. CONCLUSION The BIC might be ideally suited for health care settings aiming to promote timely access to treatments for young people with early signs of mental disorders.
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Affiliation(s)
- Carsten Schley
- Orygen, The National Centre of Excellence in Youth Mental Health, headspace Sunshine Visy Cares Hub, Sunshine, Victoria, Australia
| | - Nicholas Pace
- Jesuit Social Services, Richmond, Victoria, Australia
| | - Rhianna Mann
- Orygen, The National Centre of Excellence in Youth Mental Health, headspace Glenroy, Glenroy, Victoria, Australia
| | - Catherine McKenzie
- Orygen, The National Centre of Excellence in Youth Mental Health headspace Werribee, Werribee, Victoria, Australia
| | - Alison McRoberts
- Orygen, The National Centre of Excellence in Youth Mental Health, headspace Glenroy, Glenroy, Victoria, Australia
| | - Alexandra Parker
- Victoria University, Institute for Health and Sport, Melbourne, Victoria, Australia
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Woody C, Baxter A, Wright E, Gossip K, Leitch E, Whiteford H, Scott JG. Review of services to inform clinical frameworks for adolescents and young adults with severe, persistent and complex mental illness. Clin Child Psychol Psychiatry 2019; 24:503-528. [PMID: 30818969 DOI: 10.1177/1359104519827631] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Severe, persistent and complex mental illness (SPCMI) affects a small proportion of young people but is associated with severe disability and a large burden on families and health services. This article identifies and describes service models for adolescents and young adults with SPCMI. METHODS A systematic search was conducted for services for young people aged 12-25 years with SPCMI. The review sought service models providing extended care and/or multidisciplinary services to meet the complex and long-term needs of this population. RESULTS A total of 43 sources were identified. Evidence of effectiveness was found for both community- and bed-based services. Specific components suggested as important in service delivery included care provided by multidisciplinary teams, consumer and family involvement in care planning, intensive case management and service integration through the continuum of care. CONCLUSION Clinical frameworks for this population must incorporate effective community care integrated with inpatient treatment of short duration. Frameworks require consumer and family-centred care with flexibility to support progression through developmental stages and tasks while addressing issues related to risk management, fluctuation in illness severity and stages of recovery. A continuum of care is necessary to meet the needs that arise from SPCMI in adolescents and young adults.
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Affiliation(s)
- Charlotte Woody
- 1 School of Public Health, Faculty of Medicine, The University of Queensland, Australia.,2 Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Australia
| | - Amanda Baxter
- 1 School of Public Health, Faculty of Medicine, The University of Queensland, Australia.,2 Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Australia
| | - Eryn Wright
- 1 School of Public Health, Faculty of Medicine, The University of Queensland, Australia.,2 Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Australia
| | - Kate Gossip
- 1 School of Public Health, Faculty of Medicine, The University of Queensland, Australia.,2 Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Australia
| | - Elizabeth Leitch
- 1 School of Public Health, Faculty of Medicine, The University of Queensland, Australia.,2 Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Australia
| | - Harvey Whiteford
- 1 School of Public Health, Faculty of Medicine, The University of Queensland, Australia.,2 Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Australia
| | - James G Scott
- 1 School of Public Health, Faculty of Medicine, The University of Queensland, Australia.,2 Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Australia.,3 Metro North Mental Health, Royal Brisbane and Women's Hospital, Australia
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Yeh M, Lambros K, Tsai K, Zerr A, Trang D, McCabe K, Ganger W. Multistakeholder Etiological Explanation Agreement and Adolescent/Parent Treatment Engagement. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2019; 48:42-53. [PMID: 30652924 DOI: 10.1080/15374416.2018.1520120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Client-therapist consensus has been hypothesized to be an important element of culturally competent care. However, little is known about the relationship between explanatory model agreement and treatment engagement, particularly for services involving adolescents, where both parent and youth perspectives may need to be considered. This longitudinal study collected youth, parent, and therapist survey data on etiological beliefs as well as therapist-rated treatment engagement related to a culturally diverse sample of 285 outpatient mental health service-using youth (aged 12-18, M = 14.06 at Time 1 interview; 40% female). Youth-therapist and parent-therapist agreement on beliefs about the etiology of the youth's mental health problems were examined in relationship to later treatment engagement. Although parent-therapist agreement was unrelated to parent engagement, youth-therapist coendorsement of etiological beliefs predicted overall youth treatment engagement. In addition, youth-therapist agreement significantly predicted specific aspects of youth engagement: client-therapist interaction, communication/openness, and client's perceived usefulness of treatment. Results speak to the importance of agreement between therapist and youth upon key issues related to the youth's problems in mental health treatment settings and support facilitation of consensus as a component of culturally competent care. Differences between findings for youth and parents suggest that therapeutic relationships may vary for different stakeholders, indicating a need to consider individual perspectives and contributions separately.
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Affiliation(s)
- May Yeh
- a Department of Psychology , San Diego State University, and Child and Adolescent Services Research Center, and Department of Psychiatry, University of California , San Diego
| | - Katina Lambros
- b Department of Counseling and School Psychology , San Diego State University, and Child and Adolescent Services Research Center
| | - Katherine Tsai
- c Department of Psychology , San Diego State University, San Diego and Department of Psychiatry, University of California , San Diego
| | - Argero Zerr
- d Department of Psychology, San Diego State University, and Department of Psychological Sciences, University of San Diego, and Child and Adolescent Services Research Center
| | - Duyen Trang
- e Department of Psychology , San Diego State University, and Child and Adolescent Services Research Center
| | - Kristen McCabe
- f Department of Psychological Sciences , University of San Diego, and Child and Adolescent Services Research Center
| | - William Ganger
- g Child and Adolescent Services Research Center , and San Diego State University
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Graffigna G. Is a Transdisciplinary Theory of Engagement in Organized Settings Possible? A Concept Analysis of the Literature on Employee Engagement, Consumer Engagement and Patient Engagement. Front Psychol 2017; 8:872. [PMID: 28729843 PMCID: PMC5499260 DOI: 10.3389/fpsyg.2017.00872] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 05/12/2017] [Indexed: 11/29/2022] Open
Abstract
Organizations are experiencing increased competition, disruptive innovation, and continuous changes in their social and economic context. Furthermore, the decrease of resources (economic and human) in such a demanding context make it imperative for organizations to find new models and strategies to make their service delivery more sustainable at the economic, environmental and psychological levels. In such a complex scenario the concept of engagement of the individuals involved in organized settings (either as service providers or as final receivers) is a promising lever for innovation. However, despite the number of studies on the matter, the debate on engagement is still very fragmented because the corpus of literature addressing the different areas of engagement is divided and diverse in its nature. In this paper, we discuss the results of a conceptual analysis of the literature conducted in order to investigate overlapping features and areas of divergence among three different areas of investigation and application of the engagement phenomenon in organized settings: the domains of employee engagement, consumer engagement, and patient engagement. These are deliberately selected as prototypical of the phenomenon of engagement along the "inside/outside" of organizational settings. The analysis consisted in a qualitative conceptual survey? Of the scholarly literature indexed with the key terms "employee engagement," "consumer engagement," and "patient engagement." We performed a key-word based survey? Of the literature in the Scopus database. A total of 163 articles were selected and analyzed. The analysis cast light on the following areas of conceptual overlap among employee, consumer and patient engagement: (1) engagement is different from empowerment and activation; (2) engagement is a multi-componential psychological experience; (3) engagement is a self-transformative experience; (4) engagement develops within a relational context; (5) engagement is a systemic phenomenon. These findings, although preliminary and in need of further investigation, suggest the feasibility of promoting a transdisciplinary reflection on the phenomenon of engagement in organized settings.
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Herrman H, Humphreys C, Halperin S, Monson K, Harvey C, Mihalopoulos C, Cotton S, Mitchell P, Glynn T, Magnus A, Murray L, Szwarc J, Davis E, Havighurst S, McGorry P, Tyano S, Kaplan I, Rice S, Moeller-Saxone K. A controlled trial of implementing a complex mental health intervention for carers of vulnerable young people living in out-of-home care: the ripple project. BMC Psychiatry 2016; 16:436. [PMID: 27927174 PMCID: PMC5142401 DOI: 10.1186/s12888-016-1145-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 11/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Out-of-home care (OoHC) refers to young people removed from their families by the state because of abuse, neglect or other adversities. Many of the young people experience poor mental health and social function before, during and after leaving care. Rigorously evaluated interventions are urgently required. This publication describes the protocol for the Ripple project and notes early findings from a controlled trial demonstrating the feasibility of the work. The Ripple project is implementing and evaluating a complex mental health intervention that aims to strengthen the therapeutic capacities of carers and case managers of young people (12-17 years) in OoHC. METHODS The study is conducted in partnership with mental health, substance abuse and social services in Melbourne, with young people as participants. It has three parts: 1. Needs assessment and implementation of a complex mental health intervention; 2. A 3-year controlled trial of the mental health, social and economic outcomes; and 3. Nested process evaluation of the intervention. RESULTS Early findings characterising the young people, their carers and case managers and implementing the intervention are available. The trial Wave 1 includes interviews with 176 young people, 52% of those eligible in the study population, 104 carers and 79 case managers. CONCLUSIONS Implementing and researching an affordable service system intervention appears feasible and likely to be applicable in other places and countries. Success of the intervention will potentially contribute to reducing mental ill-health among these young people, including suicide attempts, self-harm and substance abuse, as well as reducing homelessness, social isolation and contact with the criminal justice system. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12615000501549 . Retrospectively registered 19 May 2015.
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Affiliation(s)
- Helen Herrman
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052 Australia
- Orygen The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC 3052 Australia
| | - Cathy Humphreys
- Department of Social Work, University of Melbourne, Parkville, VIC 3010 Australia
| | - Stephen Halperin
- Orygen Youth Health, 35 Poplar Road, Parkville, VIC 3052 Australia
| | - Katherine Monson
- Orygen Youth Health, 35 Poplar Road, Parkville, VIC 3052 Australia
| | - Carol Harvey
- Psychosocial Research Centre Department of Psychiatry, University of Melbourne, 130 Bell Street, Coburg, VIC 3058 Australia
- North Western Mental Health, Melbourne, Australia
| | - Cathrine Mihalopoulos
- Centre for Population Health Research, Faculty of Health, Deakin University, 221 Burwood Hwy, Burwood, VIC 3125 Australia
| | - Susan Cotton
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052 Australia
- Orygen The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC 3052 Australia
| | - Penelope Mitchell
- Youth Support and Advocacy Service (YSAS), 131 Johnston Street, Abbotsford, VIC 3065 Australia
| | - Tony Glynn
- Integrated Mental Health Program, Royal Children’s Hospital, 117-129 Warringa Cres, Hoppers Crossing, VIC 3029 Australia
| | - Anne Magnus
- Centre for Population Health Research, Faculty of Health, Deakin University, 221 Burwood Hwy, Burwood, VIC 3125 Australia
| | - Lenice Murray
- Orygen Youth Health, 35 Poplar Road, Parkville, VIC 3052 Australia
| | - Josef Szwarc
- Foundation House - Victorian Foundation for the Survivors of Torture Inc, 4 Gardiner Street, Brunswick, VIC 3056 Australia
| | - Elise Davis
- The Jack Brockhoff Child Health and Wellbeing Program, Centre for Health Equity, The Melbourne School of Population and Global Health, The University of Melbourne, Level 5, 207 Bouverie St, Melbourne, VIC 3010 Australia
| | - Sophie Havighurst
- Department of Psychiatry, Mindful, Centre for Training and Research in Developmental Health, University of Melbourne, Building C, 50 Flemington Street, Flemington, 3031 Australia
| | - Patrick McGorry
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052 Australia
- Orygen The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC 3052 Australia
| | - Sam Tyano
- Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Ida Kaplan
- Foundation House - Victorian Foundation for the Survivors of Torture Inc, 4 Gardiner Street, Brunswick, VIC 3056 Australia
| | - Simon Rice
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052 Australia
- Orygen The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC 3052 Australia
| | - Kristen Moeller-Saxone
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052 Australia
- Orygen The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC 3052 Australia
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Predictors and Moderators of Clinical Outcomes in Adolescents with Severe Mental Disorders After an Assertive Community Treatment. Child Psychiatry Hum Dev 2015; 46:997-1005. [PMID: 25700848 DOI: 10.1007/s10578-015-0537-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Previous studies have shown that stressful life events (SLEs), gender, social functioning and pretreatment severity are some of the predictors and/or moderators of treatment outcome in psychiatric care. The current study explored the effect of these predictors and moderators on the treatment outcome related to assertive community treatment (ACT) proposed to young people with severe mental disorders. 98 patients were assessed for externalizing and emotional difficulties, at admission and then at discharge of an ACT. Analyses revealed significant improvements in terms of symptomatology. In particular, regression analyses showed that pretreatment severity is a significant predictor of the outcome on emotional symptoms and is moderated by SLE on the outcome on externalizing symptoms. Furthermore, higher social functioning proved to predict better outcome on externalizing symptoms. Our results further evidence that these factors can explain inter-individual differences in outcome related to ACT. The theoretical and clinical implications of these results are discussed.
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Kwan B, Rickwood DJ. A systematic review of mental health outcome measures for young people aged 12 to 25 years. BMC Psychiatry 2015; 15:279. [PMID: 26573269 PMCID: PMC4647516 DOI: 10.1186/s12888-015-0664-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 10/27/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Mental health outcome measures are used to monitor the quality and effectiveness of mental health services. There is also a growing expectation for implementation of routine measurement and measures being used by clinicians as a feedback monitoring system to improve client outcomes. The recent focus in Australia and elsewhere targeting mental health services to young people aged 12-25 years has meant that outcome measures relevant to this age range are now needed. This is a shift from the traditional divide of child and adolescent services versus adult services with a transitioning age at 18 years. This systematic review is the first to examine mental health outcome measures that are appropriate for the 12 to 25 year age range. METHODS MEDLINE and PsychINFO databases were systematically searched to identify studies using mental health outcome measures with young people aged 12 to 25 years. The search strategy complied with the relevant sections of the PRISMA statement. RESULTS A total of 184 published articles were identified, covering 29 different outcome measures. The measures were organised into domains that consisted of eight measures of cognition and emotion, nine functioning measures, six quality of life measures, and six multidimensional mental health measures. No measures were designed specifically for young people aged 12 to 25 years and only two had been used by clinicians as a feedback monitoring system. Five measures had been used across the whole 12 to 25 year age range, in a range of mental health settings and were deemed most appropriate for this age group. CONCLUSIONS With changes to mental health service systems that increasingly focus on early intervention in adolescence and young adulthood, there is a need for outcome measures designed specifically for those aged 12 to 25 years. In particular, multidimensional measures that are clinically meaningful need to be developed to ensure quality and effectiveness in youth mental health. Additionally, outcome measures can be clinically useful when designed to be used within routine feedback monitoring systems.
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Affiliation(s)
- Benjamin Kwan
- Faculty of Health, University of Canberra, Kirinari Street, Bruce, ACT, 2601, Australia.
| | - Debra J Rickwood
- Faculty of Health, University of Canberra, Kirinari Street, Bruce, ACT, 2601, Australia.
- Headspace National Youth Mental Health Foundation National Office, 485 La Trobe Street, Melbourne, VIC, 3000, Australia.
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