Youth Mental Health: Early Intervention

• Early interventions are important for young people's mental health due to increased risks and disabilities.
• 25% of 17-25 year olds require mental health support.
• Young adults are the least likely to access mental health services.
• Mental illness can lead to substance use, poor education, violence, abuse, and poor sexual health.
• It also increases the likelihood of unemployment, social exclusion, and poorer psychological treatment outcomes.

Risk Factors

• Being female increases the risk of mental illness, with females aged 16-24 being three times more likely to experience it.
• Poverty, especially growing up in a poor household, triples the risk of developing mental illness.
• Trauma and adverse childhood experiences elevate the risk of experiencing mental illness.

Barriers to Accessing Support

• Lack of available services and CAMHS/AMHS transition issues hinder access.
• Waiting lists and low engagement levels are also significant barriers.
• Public stigma prevents many from accessing mental health services.

Costs of Poor Mental Health

• Individual costs include treatment expenses, reduced learning/work abilities, suffering, side effects, suicide risk, stigma, and social exclusion.
• Family costs involve informal caregiving, time off work, reduced productivity, and psychological hardship.
• Societal costs include reduced productivity and loss of lives.

Transition of Care

• Transition is the transfer of care to a new service, often poorly managed between ages 16-18.
• Only 4% of young people experience optimum transition, commonly falling through the cracks.
• Those with severe mental illness, like psychosis or bipolar disorder, are more likely to transition.
• Waiting lists can extend up to 6 months, and two-thirds are not referred to adult services despite needing it.

MILESTONE Project

• The MILESTONE project aims to enhance care for young people transitioning between child and adult services, involving 1000 young people over 24 months.
• Inflexible organizational workflows, inadequate staff training, and negative attitudes from staff and patients are barriers to transition.
• Young people leaving CAMHS may not want another service or find no suitable service, leading to crises.
• Individuals were more likely to transition if rated severely ill by CAMHS, had attempted suicide, or had higher scores on measures of overall health, functioning, and independent behaviors.

Engagement

• Young adults are the least likely to start care at IAPT after referral.
• Inflexibility and prior negative experiences in CAMHS can deter engagement.
• Services often lack youth-friendly resources.

Stigma

• Stigma arises from family, friends, and the public, with young people reporting more stigma for severe mental illnesses.
• Public information campaigns, like "Time to change," have had limited impact.

Early Support Hubs

• Early support hubs are mental health and wellbeing centers offering open access and flexible early support for young people.
• They are community-based, offering drop-in services and other interventions.
• These services are targeted for people aged 11-25.
• Services include drop-in options, no referral requirements, outreach programs, psychoeducation, and referrals to other services.
• Headspace (Australia) shows anxiety and depression improvements, with 1/3 improving in psychological distress and psychosocial functioning, and 2/3 improving in psychological distress, functioning, and quality of life.

Policy Context

• Charities like Youth Access advocate for early support hubs.
• The DHSC allocated £8 million to fund 24 hubs, which started new service offerings with 12-month funding, requiring engagement with an evaluation.

Proposed Work Plan

• The work plan includes: evidence synthesis, qualitative studies, and quantitative analysis.
• Evidence synthesis consists os systematic review of early interventions for young people, a qualitative meta-synthesis of young people’s experiences, and an umbrella review of early intervention approaches.
• Qualitative studies will focus on service managers, clinicians and young service users.
• A consultation on outcome measures plus an evaluation of effectiveness is planned for the quantitative analysis

Systematic Review

• The research question to be addressed through a systematic review involves: what services/approaches to delivering early intervention are effective in improving access/reducing waiting times to support, improving mental health symptoms, and improving social outcomes/functioning/quality of life.
• Qualitative data from interviews with young people, staff, and managers will be analyzed.
• Consultation on outcomes will involve a young person webinar to identify important outcomes and a stakeholder webinar to operationalize these findings.
• Important outcomes include wellbeing, ability to function at work/uni/school, progress towards goals, mental health difficulties/symptoms, and quality of relationships.