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Hui CLM, Suen YN, Lam BYH, Wong SMY, Wong CSM, Lui SSY, Chan KT, Wong MTH, Chan SKW, Lee EHM, Chang WC, Wong GHY, Chen EYH. LevelMind@JC: Development and evaluation of a community early intervention program for young people in Hong Kong. Early Interv Psychiatry 2022; 16:920-925. [PMID: 34894378 DOI: 10.1111/eip.13261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 11/10/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022]
Abstract
AIM Hong Kong's existing mental health services are inadequate in addressing young people's needs. The LevelMind@JC project established an early intervention platform of community-based youth-specific mental health centres involving youth workers, cross-disciplinary professionals, and young people. The project intends to (1) pilot a community platform that incorporates a youth-friendly early screening tool with preventative intervention capabilities, (2) set up a state-of-the-art training system for youth mental health workers, (3) establish a community clinical support team and (4) develop a timely evaluation system to monitor the service and evaluate its outcome and cost-effectiveness against generic youth services. METHODS Six hundred LevelMind@JC service users will be assessed alongside 600 young people visiting generic youth centres and 100 young people in the community. Participants will be matched according to age, gender, years of education, socioeconomic status, and level of distress. Assessments, administered at baseline and at 3, 6 and 12 months, will cover demographic characteristics, psychological distress, quality of life, depressive and anxiety symptoms, functioning, physical health and lifestyle, personality and social measures, cognitive measures and health economics. Mixed-model ANOVAs will be used to indicate interactions between services and between time points. CONCLUSION Built upon a community-based support model, LevelMind@JC aims to promote positive mental health in young people through the collaboration of cross-disciplinary mental health professionals. If efficacy and cost-effectiveness are established, the project could be scaled up, implicating a wider reach of care. We anticipate its success to be critical in combatting mental health issues stemming from both personal and population-level stressors.
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Affiliation(s)
- Christy L-M Hui
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Yi-Nam Suen
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Bess Y-H Lam
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | | | - Corine S-M Wong
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Simon S-Y Lui
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Kai-Tai Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Michael T-H Wong
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Sherry K-W Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong.,State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Edwin H-M Lee
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Wing-Chung Chang
- Department of Psychiatry, The University of Hong Kong, Hong Kong.,State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Gloria H-Y Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Eric Y-H Chen
- Department of Psychiatry, The University of Hong Kong, Hong Kong.,State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
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Sanz-Barbero B, Briones-Vozmediano E, Otero-García L, Fernández-García C, Vives-Cases C. Spanish Intimate Partner Violence Survivors Help-Seeking Strategies Across the Life Span. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP8651-NP8669. [PMID: 33289463 DOI: 10.1177/0886260520976213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Intimate partner violence (IPV) and its associated factors may vary according to women's age. In this study, we analyze the effect of age on help-seeking behavior and the associated factors among women exposed to IPV in Spain. Using the Spanish Macrosurvey on Gender Violence of 2014, we analyzed the frequency of help-seeking behavior (police report, formal resources, and informal networks of support) in women who were exposed to lifetime physical/sexual or fear-based IPV (n = 1,567 women). We used Poisson regression models to obtain variables associated with support resources. The analysis was carried out in three age groups: young women (16-29 years old), adults (30-49 years old), and older women (50 years and over). Our results show that informal support networks are the most used resource by all women´s age groups. The probability of filing a police complaint increases among women exposured to physical IPV (PRadult : 1.58;
PRelder : 2.17 ). The probability of using formal resources decreased among older women with low family socioeconomic status (PR: 0.80) and in adult women exposed to sexual IPV (PR: 0.78), and increased among young women and adult Spanish women (PRyoung: 1.65; PRadult: 1.34). The use of informal support networks increased among adult women with physical and mental health effects (PR: 1.22). In older women use of informal support networks was associated with the type of IPV (PRphysical: 1.14; PRsexual: 0.88). The presence of minors who witnessed IPV increased help-seeking behavior among adult and older women.In conclusion, the knowledge of the differences in help-seeking strategies by women in different age groups could contribute to designing strategies to promote women's ability to seek formal help when exposed to IPV.
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Affiliation(s)
- Belén Sanz-Barbero
- Institute of Health Carlos III, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Erica Briones-Vozmediano
- University of Lleida, Lleida, Spain
- Research Group of Health Care Research (GRECS), Institution of Biomedical Research (IRB) of Lleida, Spain
| | - Laura Otero-García
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universidad Autonoma de Madrid, Madrid, Spain
| | | | - Carmen Vives-Cases
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Universitat d'Alacant, Alicante, Spain
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Uchino T, Kotsuji Y, Kitano T, Shiozawa T, Iida S, Aoki A, Iwai M, Shirahata M, Seki A, Mizuno M, Tanaka K, Nemoto T. An integrated youth mental health service in a densely populated metropolitan area in Japan: Clinical case management bridges the gap between mental health and illness services. Early Interv Psychiatry 2022; 16:568-575. [PMID: 34743415 DOI: 10.1111/eip.13229] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/03/2021] [Accepted: 10/19/2021] [Indexed: 11/27/2022]
Abstract
AIMS A global movement, including in Asia, is seeking to establish integrated youth mental health services that provide early intervention in the continuum from mental health to mental illness. Clinical case management (CCM), in which a case manager becomes not only a coordinator of services but also a provider of psychosocial support, can establish a 'one-stop network' that supports youth in densely populated areas with various social resources. In 2019, we opened a community-based centre called 'SODA' in front of a metropolitan railway station, which was designed to be highly accessible, stigma-free and youth-friendly to provide CCM. We aimed to clarify its services and effectiveness of CCM. METHODS Data from 105 youths were investigated in a case-controlled study, dividing them into two groups: those who had received CCM for 6 months, and those whose needs were met in fewer sessions. RESULTS Twenty-one subjects who received CCM for 6 months had difficulties in more domains than the others. The mean of the total service minutes for the subjects who received CCM for 6 months was 491.3 min: psychological support (accounted for 24.8% of the time), support for community living (31.2%), work support (13.8%), family support (10.5%) and support for cooperation with other organizations (19.8%). Global Assessment of Functioning (GAF) score improved significantly, from 46.6 at baseline to 59.3 at 6 months. CONCLUSION Even in metropolitan areas with numerous medical facilities, young people can face high barriers to access. CCM can be effective as an early intervention for subjects developing mental illness.
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Affiliation(s)
- Takashi Uchino
- SODA, Youth Mental Health Council, Adachi, Japan.,Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota, Japan.,Tokyo Adachi Hospital, Adachi, Japan
| | - Yumi Kotsuji
- SODA, Youth Mental Health Council, Adachi, Japan.,Tokyo Adachi Hospital, Adachi, Japan
| | - Tomoji Kitano
- SODA, Youth Mental Health Council, Adachi, Japan.,Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota, Japan.,Tokyo Adachi Hospital, Adachi, Japan
| | - Takuma Shiozawa
- SODA, Youth Mental Health Council, Adachi, Japan.,Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Satomi Iida
- SODA, Youth Mental Health Council, Adachi, Japan.,Tokyo Adachi Hospital, Adachi, Japan
| | - Akiko Aoki
- SODA, Youth Mental Health Council, Adachi, Japan.,Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota, Japan
| | - Momoko Iwai
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota, Japan
| | - Masanori Shirahata
- SODA, Youth Mental Health Council, Adachi, Japan.,Tokyo Adachi Hospital, Adachi, Japan
| | - Akihiko Seki
- SODA, Youth Mental Health Council, Adachi, Japan.,Tokyo Adachi Hospital, Adachi, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota, Japan.,Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Japan
| | - Kuniaki Tanaka
- SODA, Youth Mental Health Council, Adachi, Japan.,Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota, Japan.,Tokyo Adachi Hospital, Adachi, Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Ota, Japan
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McGorry PD, Mei C, Chanen A, Hodges C, Alvarez-Jimenez M, Killackey E. Designing and scaling up integrated youth mental health care. World Psychiatry 2022; 21:61-76. [PMID: 35015367 PMCID: PMC8751571 DOI: 10.1002/wps.20938] [Citation(s) in RCA: 119] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Mental ill-health represents the main threat to the health, survival and future potential of young people around the world. There are indications that this is a rising tide of vulnerability and need for care, a trend that has been augmented by the COVID-19 pandemic. It represents a global public health crisis, which not only demands a deep and sophisticated understanding of possible targets for prevention, but also urgent reform and investment in the provision of developmentally appropriate clinical care. Despite having the greatest level of need, and potential to benefit, adolescents and emerging adults have the worst access to timely and quality mental health care. How is this global crisis to be addressed? Since the start of the century, a range of co-designed youth mental health strategies and innovations have emerged. These range from digital platforms, through to new models of primary care to new services for potentially severe mental illness, which must be locally adapted according to the availability of resources, workforce, cultural factors and health financing patterns. The fulcrum of this progress is the advent of broad-spectrum, integrated primary youth mental health care services. They represent a blueprint and beach-head for an overdue global system reform. While resources will vary across settings, the mental health needs of young people are largely universal, and underpin a set of fundamental principles and design features. These include establishing an accessible, "soft entry" youth primary care platform with digital support, where young people are valued and essential partners in the design, operation, management and evaluation of the service. Global progress achieved to date in implementing integrated youth mental health care has highlighted that these services are being accessed by young people with genuine and substantial mental health needs, that they are benefiting from them, and that both these young people and their families are highly satisfied with the services they receive. However, we are still at base camp and these primary care platforms need to be scaled up across the globe, complemented by prevention, digital platforms and, crucially, more specialized care for complex and persistent conditions, aligned to this transitional age range (from approximately 12 to 25 years). The rising tide of mental ill-health in young people globally demands that this focus be elevated to a top priority in global health.
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Affiliation(s)
- Patrick D McGorry
- Orygen, National Centre of Excellence in Youth Mental Health; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Cristina Mei
- Orygen, National Centre of Excellence in Youth Mental Health; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Andrew Chanen
- Orygen, National Centre of Excellence in Youth Mental Health; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Craig Hodges
- Orygen, National Centre of Excellence in Youth Mental Health; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Mario Alvarez-Jimenez
- Orygen, National Centre of Excellence in Youth Mental Health; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Eóin Killackey
- Orygen, National Centre of Excellence in Youth Mental Health; Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
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Harish SS, Kundadak GK, Lee YP, Tang C, Verma SK. A decade of influence in the Singapore youth mental health landscape: the Community Health Assessment Team (CHAT). Singapore Med J 2021; 62:225-229. [PMID: 34409464 DOI: 10.11622/smedj.2021061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Sekar S Harish
- Department of Psychosis, Institute of Mental Health, Singapore
| | | | - Yi Ping Lee
- Department of Psychosis, Institute of Mental Health, Singapore
| | - Charmaine Tang
- Department of Psychosis, Institute of Mental Health, Singapore
| | - Swapna K Verma
- Department of Psychosis, Institute of Mental Health, Singapore
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Subramaniam M, Abdin E, Vaingankar JA, Sambasivam R, Zhang YJ, Shafie S, Basu S, Chan CT, Tan CS, Verma SK, Tang C, Chua HC, Heng D, Chong SA. Lifetime Prevalence and Correlates of Schizophrenia and Other Psychotic Disorders in Singapore. Front Psychiatry 2021; 12:650674. [PMID: 33776823 PMCID: PMC7991584 DOI: 10.3389/fpsyt.2021.650674] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 02/12/2021] [Indexed: 12/15/2022] Open
Abstract
Introduction: The current study aimed to establish the lifetime prevalence of schizophrenia and other psychotic disorders, its sociodemographic correlates and association with physical disorders using data from the Singapore Mental Health Study (SMHS 2016). Methods: A two-phase design comprising population-level screening of psychotic symptoms using the World Health Organization Composite International Diagnostic Interview version 3.0 psychosis screen followed by clinical reappraisal based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria were used to establish the prevalence. Results: A total of 6,126 respondents completed the first phase of the study, giving a response rate of 69.5%. 5.2% (n = 326) of respondents endorsed at least one symptom in the psychosis screen. After the phase two clinical reappraisal interviews and adjusting for false-negative rate, the corrected prevalence of schizophrenia and other psychotic disorders was 2.3% (95% CI: 2.3-2.3%). The odds of having DSM-IV schizophrenia and other psychotic disorders was significantly higher among those of Malay ethnicity (OR = 3.9, 95% CI 1.4-11.0), and those who were unemployed (OR = 4.3, 95% CI 1.2-15.9). 80.4% of those with a psychotic disorder had consulted a doctor or a mental health professional for their symptoms. Conclusions: Our results indicate that approximately 2.3% of Singapore's community-dwelling adult population had a lifetime diagnosis of schizophrenia and other psychotic disorders. While the treatment gap of the disorder was relatively small, the severe nature of the disorder emphasizes the need for continued outreach and early diagnosis and treatment.
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Affiliation(s)
- Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | | | - Yun Jue Zhang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Saleha Shafie
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Sutapa Basu
- Department of Early Intervention in Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Chun Ting Chan
- Department of Early Intervention in Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Swapna K Verma
- Department of Psychosis and East Panel, Institute of Mental Health, Singapore, Singapore
| | - Charmaine Tang
- Department of Early Intervention in Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Hong Choon Chua
- CEO Office, Institute of Mental Health, Singapore, Singapore
| | - Derrick Heng
- Public Health Group, Ministry of Health, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
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