Mental health planning for children and youth: is it developmentally appropriate?

Too far from care? A descriptive analysis of young Australian mental health aeromedical retrievals

OBJECTIVES

Young Australians living in rural and remote locations have poorer mental health outcomes and higher rates of self-harm and suicide than their major city counterparts. Significant service gaps and barriers exist in accessing general and youth-specific mental health services. With a lack of access, comes delays in treatment and associated poorer outcomes. This paper describes the characteristics of young people requiring an aeromedical retrieval (AR) for acute inpatient psychiatric care.

STUDY DESIGN AND METHODS

A retrospective secondary analysis was conducted of Royal Flying Doctor Service ARs for a six-year period from 2016 to 2021. Data were summarised by demographic, geographic, and diagnostic factors.

RESULTS

The total sample size was 1534 (60% male, 40% female; and 31% aged 12-17 years, 69% aged 18-24 years), with 668 (43.5%) affected by schizophrenia and related disorders. Port Augusta, 300 km north of Adelaide, had the highest proportion of aeromedical retrievals (4.4%). The Women's and Children's Hospital in Adelaide received the highest proportion of retrievals (25.6%). Statistically significant gender and age differences were identified as were specific high-usage geographical locations across several Australian states.

CONCLUSIONS

AR is essential for young people in accessing specialist acute health services. Developmentally appropriate, responsive, youth mental health services are mostly located in large, already well-resourced major cities. Our study provides valuable information to assist governments, communities, and services to enhance the resources available for young people who live rurally.

An Evaluation of the Acceptability, Appropriateness, and Utility of a Bibliotherapy for Children of Parents With a Mental Illness

BACKGROUND

Children of parents with a mental illness are at higher risk for various psychiatric problems and adaptive difficulties compared to those of parents without mental health problems. Certain preventive psychoeducational interventions target these children to promote their well-being and resilience and prevent the emergence of adaptive difficulties. However, few such interventions have been developed and evaluated specifically for elementary school-aged children of parents with a mental illness.

OBJECTIVES

This study aims to evaluate an interpersonal psychotherapy-based book targeting children living with a parent with a mental illness.

METHODS

The study examines children, parents and psychosocial workers' perception of the acceptability, appropriateness and utility of the book. In total, 22 participants answered online open-ended questions after reading the book.

RESULTS

The book was highly appreciated and positively perceived by the families and psychosocial workers. Results suggest that children, parents and psychosocial workers viewed it as an appropriate and useful tool for supporting children with a parent with a mental illness. The present study reveals that the bibliotherapy appears well adapted to the developmental level of school-age children.

DISCUSSION

This study presents a book that shows promise for supporting the resilience of elementary school-aged children having a parent with a mental illness. Results highlight the importance of tailoring the content and modalities of interventions to the developmental level, needs and preferences of elementary school-aged children. The relevance of a collaborative method is also discussed, thus providing knowledge regarding this type of approach for the development of interventions targeting children.

What are the barriers, facilitators and interventions targeting help-seeking behaviours for common mental health problems in adolescents? A systematic review

BACKGROUND

Increasing rates of mental health problems among adolescents are of concern. Teens who are most in need of mental health attention are reluctant to seek help. A better understanding of the help-seeking in this population is needed to overcome this gap.

METHODS

Five databases were searched to identify the principal barriers, facilitators and interventions targeting help-seeking for common mental health problems in adolescents aged 10-19 years. The search was performed in June 2018 and updated in April 2019. Two independent screening processes were made using the eligibility criteria. Quality assessment of each study was performed, and findings summarised using a narrative synthesis.

RESULTS

Ninety studies meet the inclusion criteria for this review for barrier and facilitators (n = 54) and interventions (n = 36). Stigma and negative beliefs towards mental health services and professionals were the most cited barriers. Facilitators included previous positive experience with health services and mental health literacy. Most interventions were based on psychoeducation, which focused on general mental health knowledge, suicide and self-harm, stigma and depression. Other types of interventions included the use of multimedia and online tools, peer training and outreach initiatives. Overall, the quality of studies was low to medium and there was no general agreement regarding help-seeking definition and measurements.

CONCLUSION

Most of the interventions took place in an educational setting however, it is important to consider adolescents outside the educational system. Encouraging help-seeking should come with the increased availability of mental health support for all adolescents in need, but this is still a major challenge for Child and Adolescent Mental Health Services. There is also a need to develop shared definitions, theoretical frameworks and higher methodological standards in research regarding help-seeking behaviours in adolescents. This will allow more consistency and generalisability of findings, improving the development of help-seeking interventions and ensuring timely access to mental health treatments.

Youth perceptions of positive mental health

Introduction

Positive mental health underpins individual well-being and occupational participation. Internationally, youth mental health services are expanding to include interventions that promote positive mental health and prevent mental illness, to reduce the growing burden of disease caused by mental illness across the lifespan. Policy initiatives have increased the funding of early intervention initiatives, and evidence is required to inform changes in practice.

Method

This study aimed to explore youths’ perceptions of positive mental health. An interpretive descriptive qualitative study design was utilized, which involved purposive sampling to recruit three adolescent community mental health service users. Data were collected using the digital storytelling method within a series of three individual interviews. The Canadian Model of Occupational Performance and Engagement was used as a lens to guide thematic analysis.

Findings

Five main themes emerged, including: Components of spirituality; Occupational factors; Aspirations; Social influences; and Challenges and barriers. Positive mental health was developed through experiences with adversity, primarily mental illness, and being able to increase adequate coping strategies and resilience. Spirituality was expressed through experiences with identity formation and positive mental health was linked with a strong sense of self, being able to accept oneself and embracing one’s identity. Equally important were aspirations and hope, engagement in leisure occupations, role models and positive relationships with family and friends.

Conclusion

Using the Canadian Model of Occupational Performance and Engagement, personal, occupational and environment factors were demonstrated as being important in how youth perceive positive mental health, with spirituality being particularly influential. Further exploration of positive mental health for adolescents is required to inform policy and practice for community youth mental health services, and more broadly for preventative public health campaigns. Research, such as through the use of digital storytelling method, should actively engage young people in developing definitions, to ensure that they are meaningful to youth and that services understand their unique developmental needs.