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headspace - Australia's innovation in youth mental health: who are the clients and why are they presenting?

Ian B Hickie, Elizabeth M Scott and Nicholas Glozier
Med J Aust 2014; 200 (8): 452-454. || doi: 10.5694/mja14.00145
Published online: 5 May 2014

To the Editor: We commend Rickwood and colleagues1 for presenting aggregated data from headspace centres. However, to judge whether headspace is meeting its key policy objectives, more detailed information is required. No performance benchmarks were proposed for the national program or for the constituent centres. Specifically, the variance in key characteristics (age, sex, Aboriginal and Torres Strait Islander populations, rurality, socioeconomic status and current disability) of young people attending the individual centres was not described. As headspace centres were initially placed in areas of need (ie, non-urban, low socioeconomic status, fewer private medical or psychological services, or high Aboriginal and Torres Strait Islander populations), one might expect to see evidence of enhanced access for those with disability or financial hardship. For example, at the University of Sydney-managed headspace sites, 25% of young people were receiving financial assistance and “the same fraction (were) completely disconnected from employment or education” (emphasis added).2 Internationally, youth-targeted mental health services are being encouraged to focus on such disadvantaged individuals.3 In Australia, 12% of youth are in this category, and the proportion varies significantly by geographical region (7%–35%).4 These proportions are not the same as those reported by Rickwood et al1 (29% in the headspace cohort and 27% in the Australian population), where the measure used appears to be that of not participating fully in employment or education. Given that the economic and social justifications for early intervention are focused on enhancing such participation rates,5 clarification of the metrics being reported by headspace is essential.

  • Ian B Hickie
  • Elizabeth M Scott
  • Nicholas Glozier

  • University of Sydney, Sydney, NSW.

Correspondence: ian.hickie@sydney.edu.au

Competing interests:

Ian Hickie is a National Health and Medical Research Council Senior Principal Research Fellow and a National Mental Health Commissioner. He was a Director of headspace until 2012. He has led community-based and pharmaceutical industry-supported education programs related to anxiety, depression and psychosis. Current investigator-initiated studies in depression and circadian systems at the Brain & Mind Research Institute are supported by Servier. He has received honoraria or travel support for participation in educational seminars related to depression, youth mental health or circadian rhythms research and clinical practice. Nicholas Glozier has served on an advisory board for Lundbeck and has received honoraria for presenting depression, sleep and functional-related presentations for Servier and Lundbeck.

  • 1. Rickwood DJ, Telford NR, Parker AG, et al. headspace — Australia's innovation in youth mental health: who are the clients and why are they presenting? Med J Aust 2014; 200: 108-111. <MJA full text>
  • 2. Scott EM, Hermens DF, Glozier N, et al. Targeted primary care-based mental health services for young Australians. Med J Aust 2012; 196: 136-140. <MJA full text>
  • 3. Scott J, Fowler D, McGorry P, et al. Adolescents and young adults who are not in employment, education, or training. BMJ 2013; 347: f5270.
  • 4. OECD. Education policy outlook: Australia. June 2013. http://www.oecd.org/edu/EDUCATION%20POLICY%20OUTLOOK%20AUSTRALIA_EN.pdf (accessed Apr 2014).
  • 5. Hickie IB. Youth mental health: we know where we are and we can now say where we need to go next. Early Interv Psychiatry 2011; 5 Suppl 1: 63-69.

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