Two in three young people not helped by mental health programs

Australia needs to rethink how it delivers mental health support to the nation’s young, a new report finds

One in four young people ­experience mental ill-health by age 25, often first manifesting in adolescence or young adulthood.

Two in three young Australians with emerging mental health problems who access support services such as Headspace ­either remained in poor mental health or deteriorated further after two years, new research shows.

The study of more than 1500 12 to 25-year-olds found early intervention services in the primary health care system were failing to deliver the care ­required, and a more “comprehensive and multidisciplinary approach” was needed.

The paper, published in the Medical Journal of Australia, looked at the social and occupational outcomes of young ­people after two years of early ­intervention support in youth mental health programs at Sydney University’s Brain and Mind Institute.

“Only 35 per cent had good functional outcomes over two years; that is, only one in three people maintained an initially good level of function or substantially improved from a lower level of function,” said report co-­author Frank Iorfino from the Brain and Mind Institute.

“In contrast, functional impairment persisted in nearly two-thirds of participants, or their level of function deteriorated and was volatile.

“Our findings suggest that the current primary care-based model meets the needs of only a minority of young people seeking care, and that most require more comprehensive and multidisciplinary approaches.”

The report found those not doing well were also likely to not be in education, employment or training, had substance-related issues, first experienced mental disorders in childhood, and may have a history of self-harm or ­suicidal tendencies.

One in four young people ­experience mental ill-health by age 25, often first manifesting in adolescence or young adulthood, the study said. Many studies have shown the longer a person waited before seeking support for their mental health, the poorer the outcome would be.

Dr Iorfino’s study highlighted the limitations of primary care-based low-intensity early intervention services.

They are “driven by broad guidelines based on population effects or clinical experience, which can be inaccurate and inconsistent,” it said.

“They often do not recognise the dynamic nature of the disorders and needs of the individual, and service provision is ­accordingly characterised by low rates of change in the type or ­intensity of the interventions employed.”

Treatment needed to be more personalised, the report said, which in turn required more ­active monitoring and measurement of symptoms and condition, an approach “largely unused in youth mental health care”.

Patrick McGorry, professor of youth mental health at the ­University of Melbourne, also wrote in the MJA, saying Dr ­Iorfino’s findings were “not ­unexpected”.

“Headspace was designed and works extremely well for the first stage of care, which involves mild to moderate mental health conditions, but also as a stigma-free gateway for more specialised care, (but) it is only part of the ­solution,” Professor McGorry said.

“While primary care-based models offering soft entry to care for all young people is effective for some, it is clearly insufficient for most young people with more substantial needs.”