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From early intervention in psychosis to youth mental health reform: a review of the evolution and transformation of mental health services for young people

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Abstract

Purpose

The objective of this review is to report on recent developments in youth mental health incorporating all levels of severity of mental disorders encouraged by progress in the field of early intervention in psychotic disorders, research in deficiencies in the current system and social advocacy.

Methods

The authors have briefly reviewed the relevant current state of knowledge, challenges and the service and research response across four countries (Australia, Ireland, the UK and Canada) currently active in the youth mental health field.

Results

Here we present information on response to principal challenges associated with improving youth mental services in each country. Australia has developed a model comprised of a distinct front-line youth mental health service (Headspace) to be implemented across the country and initially stimulated by success in early intervention in psychosis; in Ireland, Headstrong has been driven primarily through advocacy and philanthropy resulting in front-line services (Jigsaw) which are being implemented across different jurisdictions; in the UK, a limited regional response has addressed mostly problems with transition from child–adolescent to adult mental health services; and in Canada, a national multi-site research initiative involving transformation of youth mental health services has been launched with public and philanthropic funding, with the expectation that results of this study will inform implementation of a transformed model of service across the country including indigenous peoples.

Conclusions

There is evidence that several countries are now engaged in transformation of youth mental health services and in evaluation of these initiatives.

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References

  1. McGorry P, Bates T, Birchwood M (2013) Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. Br J Psychiatry 202(s54):s30–s35

    Article  Google Scholar 

  2. Iyer S, Boksa P, Lal S, Shah J, Marandola G, Jordan G, Doyle M, Joober R, Malla A (2015) Transforming youth mental health: a Canadian perspective. Ir J Psychol Med 32(01):51–60

    Article  Google Scholar 

  3. McGorry PD, Killackey E, Yung A (2008) Early intervention in psychosis: concepts, evidence and future directions. World Psychiatry 7(3):148–156

    Article  PubMed  PubMed Central  Google Scholar 

  4. Malla AK, Norman R, Joober R (2005) First-episode psychosis, early intervention, and outcome: what have we learned? Can J Psychiatry Rev 50(14):881–891

    Google Scholar 

  5. Bertelsen M, Jeppesen P, Petersen L, Thorup A, Øhlenschlæger J, le Quach P, Christensen TØ, Krarup G, Jørgensen P, Nordentoft M (2008) Five-year follow-up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness: the OPUS trial. Arch Gen Psychiatry 65(7):762–771

    Article  PubMed  Google Scholar 

  6. Harvey P, Lepage M, Malla A (2007) Benefits of enriched intervention compared with standard care for patients with recent-onset psychosis: a metaanalytic approach. Can J Psychiatry 52(7):464

    PubMed  Google Scholar 

  7. Craig TK, Garety P, Power P, Rahaman N, Colbert S, Fornells-Ambrojo M, Dunn G (2004) The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis. BMJ 329(7474):1067

    Article  PubMed  PubMed Central  Google Scholar 

  8. McGorry PD, Hickie IB, Yung AR, Pantelis C, Jackson HJ (2006) Clinical staging of psychiatric disorders: a heuristic framework for choosing earlier, safer and more effective interventions. Aust N Z J Psychiatry 40(8):616–622

    Article  PubMed  Google Scholar 

  9. Yung AR, McGorry PD (1996) The prodromal phase of first-episode psychosis: past and current conceptualizations. Schizophr Bull 22(2):353–370

    Article  CAS  PubMed  Google Scholar 

  10. McGorry PD (2007) The specialist youth mental health model: strengthening the weakest link in the public mental health system. Med J Aust 187(7):S53–S56

    PubMed  Google Scholar 

  11. Malla A, Jordan G, Joober R, Schmitz N, Norman R, Brown T, Goldberg K, Loohuis H, Vracotas N, Rochford J (2014) A controlled evaluation of a targeted early case detection intervention for reducing delay in treatment of first episode psychosis. Soc Psychiatry Psychiatr Epidemiol 49(11):1711–1718

    Article  PubMed  Google Scholar 

  12. Anderson KK, Fuhrer R, Schmitz N, Malla AK (2013) Determinants of negative pathways to care and their impact on service disengagement in first-episode psychosis. Soc Psychiatry Psychiatr Epidemiol 48(1):125–136

    Article  PubMed  Google Scholar 

  13. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62(6):593–602

    Article  PubMed  Google Scholar 

  14. Rössler W, Salize HJ, van Os J, Riecher-Rössler A (2005) Size of burden of schizophrenia and psychotic disorders. Eur Neuropsychopharmacol 15(4):399–409

    Article  PubMed  Google Scholar 

  15. Wang PS, Berglund P, Olfson M, Pincus HA, Wells KB, Kessler RC (2005) Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62(6):603–613

    Article  PubMed  Google Scholar 

  16. Slade T, Johnston A, Oakley Browne MA, Andrews G, Whiteford H (2009) 2007 National survey of mental health and wellbeing: methods and key findings. Aust N Z J Psychiatry 43(7):594–605

    Article  PubMed  Google Scholar 

  17. Cheung AH, Dewa CS (2007) Mental health service use among adolescents and young adults with major depressive disorder and suicidality. Can J Psychiatry 52(4):228

    PubMed  Google Scholar 

  18. Singh SP, Paul M, Ford T, Kramer T, Weaver T (2008) Transitions of care from child and adolescent mental health services to adult mental health services (TRACK study): a study of protocols in Greater London. BMC Health Serv Res 8(1):135

    Article  PubMed  PubMed Central  Google Scholar 

  19. Hovish K, Weaver T, Islam Z, Paul M, Singh SP (2012) Transition experiences of mental health service users, parents, and professionals in the United Kingdom: a qualitative study. Psychiatry Rehabil J 35(3):251

    Article  Google Scholar 

  20. Paul M, Ford T, Kramer T, Islam Z, Harley K, Singh SP (2013) Transfers and transitions between child and adult mental health services. Br J Psychiatry 202(s54):s36–s40

    Article  Google Scholar 

  21. Lamb C, Hall D, Kelvin R, Van Beinum M (2008) Working at the CAMHS/Adult Interface: good practice guidance for the provision of psychiatric services to adolescents/young adults. Royal College of Psychiatrists

  22. Blum RW, Garell D, Hodgman CH, Jorissen TW, Okinow NA, Orr DP, Slap GB (1993) Transition from child-centered to adult health-care systems for adolescents with chronic conditions: a position paper of the Society for Adolescent Medicine. J Adolesc Health 14(7):570–576

    Article  CAS  PubMed  Google Scholar 

  23. McDonagh JE, Viner RM (2006) Lost in transition? Between paediatric and adult services: it’s time to improve the transition of adolescents from paediatric to adult services. Br Med J 332(7539):435

    Article  Google Scholar 

  24. McDonagh JE, Kelly DA (2003) Transitioning care of the pediatric recipient to adult caregivers. Pediatr Clin N Am 50(6):1561–1583

    Article  Google Scholar 

  25. McGorry PD, Tanti C, Stokes R, Hickie IB, Carnell K, Littlefield LK, Moran J (2007) Headspace: Australia’s National Youth Mental Health Foundation—where young minds come first. Med J Aust 187(7 Suppl):S68–S70

    PubMed  Google Scholar 

  26. Rickwood DJ, Telford NR, Parker AG, Tanti CJ, McGorry PD (2014) Headspace—Australia’s innovation in youth mental health: who are the clients and why are they presenting. Med J Aust 200(2):1–4

    Article  Google Scholar 

  27. Hughes F, Stavely H, Simpson R, Goldstone S, Pennell K, McGorry P (2014) 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 22:228–234

    Article  PubMed  Google Scholar 

  28. Department of Health (2009) New horizons: a shared vision for mental health. Department of Health London, pp 1–94

  29. H Government (2011) No health without mental health: a cross-government mental health outcomes strategy for people of all ages. Department of Health London, pp 1–93

  30. Meier R, Murphy M, Singh SP, Lamb C (2011) Developing services to improve the quality of life of young people with neurodevelopmental disorders, emotional/neurotic disorders and emerging personality disorder. R Coll Psychiatr Occas Pap 77:1–24

    Google Scholar 

  31. Parker C, Clements L, Harbour A, Honigmann J (2011) Transitions in Mental Health Care. Young Minds. United Kingdom National CAMHS Support Service, pp 1–81

  32. Brodie I, Goldman R, Clapton J (2011) Mental health service transitions for young people. In: Social care institute for excellence, Research Briefing, pp 1–20

  33. Vyas NS, Birchwood M, Singh SP (2015) Youth services: meeting the mental health needs of adolescents. Ir J Psychol Med 32(01):13–19

    Article  Google Scholar 

  34. Coughlan H, Tiedt L, Clarke M, Kelleher I, Tabish J, Molloy C, Harley M, Cannon M (2014) Prevalence of DSM-IV mental disorders, deliberate self-harm and suicidal ideation in early adolescence: an Irish population-based study. J Adolesc 37(1):1–9

    Article  PubMed  Google Scholar 

  35. Cannon M, Coughlan H, Clarke M, Harley M, Kelleher I (2013) The Mental Health of Young People in Ireland: a report of the Psychiatric Epidemiology Research across the Lifespan (PERL) Group. Royal College of Surgeons in Ireland, Dublin

  36. Harley M, Connor D, Clarke M, Kelleher I, Coughlan H, Lynch F, Fitzpatrick C, Cannon M (2015) Prevalence of Mental Disorder among young adults in Ireland: a population based study. Ir J Psychol Med 32(01):79–91

    Article  Google Scholar 

  37. Dooley BA, Fitzgerald A (2012) My world survey: National study of youth mental health in Ireland. Headstrong and UCD School of Psychology

  38. O’Keeffe L, O’Reilly A, O’Brien G, Buckley R, Illback R (2015) Description and outcome evaluation of Jigsaw: an emergent Irish mental health early intervention programme for young people. Ir J Psychol Med 32(01):71–77

    Article  Google Scholar 

  39. Kutcher S, Davidson S, Manion I (2009) Child and youth mental health: integrated health care using contemporary competency-based teams. Paediatr Child Health 14(5):315

    PubMed  PubMed Central  Google Scholar 

  40. Baumbusch JL, Kirkham SR, Khan KB, McDonald H, Semeniuk P, Tan E, Anderson JM (2008) Pursuing common agendas: a collaborative model for knowledge translation between research and practice in clinical settings. Res Nurs Health 31(2):130–140

    Article  PubMed  Google Scholar 

  41. Lomas J (1991) Words without action? The production, dissemination, and impact of consensus recommendations. Annu Rev Public Health 12(1):41–65

    Article  CAS  PubMed  Google Scholar 

  42. McGrath PJ, Lingley-Pottie P, Emberly DJ, Thurston C, McLean C (2009) Integrated knowledge translation in mental health: family help as an example. J Can Acad Child Adolesc Psychiatry 18(1):30

    PubMed  PubMed Central  Google Scholar 

  43. CIHR Knowledge Translation & Commercialization E-Newsletter/E-Bulletin de l’application des connaissances et commercialisation des IRSC. http://www.cihr-irsc.gc.ca/e/48432.html

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Author information

Authors and Affiliations

  1. Department of Psychiatry, McGill University, Montreal, QC, Canada

    Ashok Malla, Srividya Iyer & Ridha Joober

  2. ACCESS Open Minds Canada, Douglas Mental Health University Institute, Montreal, Canada

    Ashok Malla, Srividya Iyer & Ridha Joober

  3. ORYGEN, University of Melbourne, Parkville, Australia

    Patrick McGorry

  4. Department of Psychiatry, Royal College of Surgeons of Ireland, Dublin, Ireland

    Mary Cannon & Helen Coughlan

  5. Division of Mental Health, Warwick University, Coventry, England, UK

    Swaran Singh

  6. Department of Psychiatry, Cambridge University, Cambridge, England, UK

    Peter Jones

  7. Douglas Hospital Research Centre, ACCESS Open Minds Pavilion, 6625 LaSalle Boulevard, Montreal, QC, H4H 1R3, Canada

    Ashok Malla

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  1. Ashok Malla
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  2. Srividya Iyer
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  3. Patrick McGorry
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  4. Mary Cannon
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  5. Helen Coughlan
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  6. Swaran Singh
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  7. Peter Jones
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  8. Ridha Joober
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Correspondence to Ashok Malla.

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Malla, A., Iyer, S., McGorry, P. et al. From early intervention in psychosis to youth mental health reform: a review of the evolution and transformation of mental health services for young people. Soc Psychiatry Psychiatr Epidemiol 51, 319–326 (2016). https://doi.org/10.1007/s00127-015-1165-4

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  • DOI: https://doi.org/10.1007/s00127-015-1165-4

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