Volume 217 - Issue 4
Social and occupational outcomes for young people who attend early intervention mental health services: a longitudinal study
Authors: Frank Iorfino, Elizabeth M Scott and Ian B Hickie
Med J Aust 2022; 217 (4): 218-218. || doi: 10.5694/mja2.51653
Published online: 15 August 2022
Published online: 15 August 2022
In reply
In reply: While Wallis and colleagues’ commentary1 highlights limitations common to studies conducted in real world settings, these considerations do not diminish the significance of the main findings. The study focused on young people’s longer term social and occupational functioning as the main outcome and demonstrated that the current treatment model appears to deliver very limited benefits.2 Clearly, we need to reflect on why this may be so and what changes to the service model may be required to achieve better functional outcomes.
Youth mental health problems do not fit well within the 20th century‐bound or physical health concepts of primary and secondary care services. As we have demonstrated repeatedly,3,4 large proportions of young people presenting to headspace services with an admixture of anxiety, mood and more complex disorders are already experiencing significant functional impairment. This is made more complex by difficulties accessing services that match their clinical or functional needs. Delayed access to appropriate care5 and a lack of support for multidisciplinary teams that are focused on delivering engagement with education, training and employment are likely contributors to the poor functional outcomes observed in our study.2
Consequently, we have presented a youth model of care that provides highly personalised and measurement‐based care.6 This involves a more coordinated and connected system that shifts the focus away from providing brief psychological care for those with greater needs to using smarter approaches (ie, digital technologies) that facilitate access to more complex interventions, delivered by multidisciplinary teams.7 We are committed to the systematic evaluation of these new approaches and combining this with ongoing systems modelling for smarter and transparent health services planning.8,9
Competing interests
No relevant disclosures.
References
- Wallis KA, Zwar NA, Glasziou PP. Social and occupational outcomes for young people who attend early intervention mental health services: a longitudinal study [letter]. Med J Aust 2021; 217: 218.
- Iorfino F, Carpenter JS, Cross SP, et al. Social and occupational outcomes for young people who attend early intervention mental health services: a longitudinal study. Med J Aust 2021; 216: 87‐93. https://www.mja.com.au/journal/2022/216/2/social‐and‐occupational‐outcomes‐young‐people‐who‐attend‐early‐intervention
- 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. https://www.mja.com.au/journal/2012/196/2/targeted‐primary‐care‐based‐mental‐health‐services‐young‐australians
- Iorfino F, Scott EM, Carpenter JS, et al. Clinical stage transitions in persons aged 12 to 25years presenting to early intervention mental health services with anxiety, mood, and psychotic disorders. JAMA Psychiatry 2019; 76: 1167‐1175.
- headspace. Increasing demand in youth mental health: a rising tide of need. Melbourne: headspace National Youth Mental Health Foundation, 2019.
- Hickie IB, Scott EM, Cross SP, Iorfino F, Davenport TA, Guastella AJ, Naismith SL, Carpenter JS, Rohleder C, Crouse JJ, Hermens DF. Right care, first time: a highly personalised and measurement‐based care model to manage youth mental health. Med J Aust 2019; 211 (Suppl): S3‐S46. https://www.mja.com.au/journal/2019/211/9/right‐care‐first‐time‐highly‐personalised‐and‐measurement‐based‐care‐model
- Hickie IB. Implementing 21st century “end‐to‐end” and technology‐enhanced care for young people. World Psychiatry 2022; 21: 79‐81.
- University of Sydney. Funding success for clinical trials research totalling over $10m [news release]. 25 June 2021. www.sydney.edu.au/news‐opinion/news/2021/06/25/funding‐success‐for‐clinical‐trials‐research‐totalling‐over‐10m.html (viewed Apr 2022).
- Occhipinti JA, Skinner A, Doraiswamy PM, et al. Mental health: build predictive models to steer policy. Nature 2021; 597: 633‐636.
Linked content
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MJA Research: Social and occupational outcomes for young people who attend early intervention mental health services: a longitudinal study
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MJA Letter: Social and occupational outcomes for young people who attend early intervention mental health services: a longitudinal study
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MJA Letter: In reply