Poster presentation for Second International Conference on Child and Adolescent

Mental Health

Early Intervention by Primary Care in Youth Mental Health

C Hodges P McGorry: Education Research and Development Unit. Mental Health Services for Kids and Youth (MH-SICY). North West Health, Melbourne

Aim
To develop a model with primary care providers pertaining to detection, early intervention and management of young people with a mental illness.

Rationale
Epidemiological studies in adolescent psychiatry suggest a significant increase in the number of young people being affected by high prevalence disorders such as depression, anxiety and substance abuse. Recent studies have indicated that up to 40% of young people have experienced an episode of depression at some time during adolescence. With the rising tide of young people being affected by these disorders, we have also witnessed an increase in the untreated prevalence, leaving many young people at risk of developing persistent disorders with potentially serious and even life threatening consequences. While the causes remain obscure, hampering efforts at primary prevention, an effective service response is urgently required.

Purpose
Much of the effort to increase the coverage of high prevalence disorders by the health care system has focussed on the development of a range of models of shared care. However such models have not yet been well developed for young people (given this is the age of onset), who are typically reluctant to make use of standard primary care services , unless special conditions are present, and further, whose problems may go undetected without special expertise in the clinician. If the aim of meshing increased treated prevalence with early intervention is to be achieved, then a youth-specific focus for shared care or partnership models will need to be engineered.

Model
Essentially the model proposed by MR-SKY aims to ensure that specialist mental health services are utilised by those requiring specialist intervention and management. This will include most of those with low prevalence disorders and a smaller number of those with high prevalence disorders. The remaining group will be treated in primary care in a Iwo level model. Firstly, the model proposes an “enhanced” group of primary care providers, who have some interest and basic skills in working with young people. This group have already been identified and would be supported by the Youth Consultation and Development Team. This team will provide primary, secondary and tertiary consultation to this group, thereby enhancing their skills in youth mental health, and enabling them to be a destination as well ps a source of referrals. In addition there will be a larger general group of primary care providers whose role will primarily be detection of cases, with many able to take on an active management role for relatively simple cases, again with some secondary consultation support.