Skip to main content
Top
Published in: Social Psychiatry and Psychiatric Epidemiology 3/2016

01-03-2016 | Invited Reviews

From early intervention in psychosis to youth mental health reform: a review of the evolution and transformation of mental health services for young people

Authors: Ashok Malla, Srividya Iyer, Patrick McGorry, Mary Cannon, Helen Coughlan, Swaran Singh, Peter Jones, Ridha Joober

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 3/2016

Login to get access

Abstract

Purpose

The objective of this review is to report on recent developments in youth mental health incorporating all levels of severity of mental disorders encouraged by progress in the field of early intervention in psychotic disorders, research in deficiencies in the current system and social advocacy.

Methods

The authors have briefly reviewed the relevant current state of knowledge, challenges and the service and research response across four countries (Australia, Ireland, the UK and Canada) currently active in the youth mental health field.

Results

Here we present information on response to principal challenges associated with improving youth mental services in each country. Australia has developed a model comprised of a distinct front-line youth mental health service (Headspace) to be implemented across the country and initially stimulated by success in early intervention in psychosis; in Ireland, Headstrong has been driven primarily through advocacy and philanthropy resulting in front-line services (Jigsaw) which are being implemented across different jurisdictions; in the UK, a limited regional response has addressed mostly problems with transition from child–adolescent to adult mental health services; and in Canada, a national multi-site research initiative involving transformation of youth mental health services has been launched with public and philanthropic funding, with the expectation that results of this study will inform implementation of a transformed model of service across the country including indigenous peoples.

Conclusions

There is evidence that several countries are now engaged in transformation of youth mental health services and in evaluation of these initiatives.
Literature
1.
go back to reference McGorry P, Bates T, Birchwood M (2013) Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. Br J Psychiatry 202(s54):s30–s35CrossRef McGorry P, Bates T, Birchwood M (2013) Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. Br J Psychiatry 202(s54):s30–s35CrossRef
2.
go back to reference Iyer S, Boksa P, Lal S, Shah J, Marandola G, Jordan G, Doyle M, Joober R, Malla A (2015) Transforming youth mental health: a Canadian perspective. Ir J Psychol Med 32(01):51–60CrossRef Iyer S, Boksa P, Lal S, Shah J, Marandola G, Jordan G, Doyle M, Joober R, Malla A (2015) Transforming youth mental health: a Canadian perspective. Ir J Psychol Med 32(01):51–60CrossRef
3.
4.
go back to reference Malla AK, Norman R, Joober R (2005) First-episode psychosis, early intervention, and outcome: what have we learned? Can J Psychiatry Rev 50(14):881–891 Malla AK, Norman R, Joober R (2005) First-episode psychosis, early intervention, and outcome: what have we learned? Can J Psychiatry Rev 50(14):881–891
5.
go back to reference Bertelsen M, Jeppesen P, Petersen L, Thorup A, Øhlenschlæger J, le Quach P, Christensen TØ, Krarup G, Jørgensen P, Nordentoft M (2008) Five-year follow-up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness: the OPUS trial. Arch Gen Psychiatry 65(7):762–771CrossRefPubMed Bertelsen M, Jeppesen P, Petersen L, Thorup A, Øhlenschlæger J, le Quach P, Christensen TØ, Krarup G, Jørgensen P, Nordentoft M (2008) Five-year follow-up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness: the OPUS trial. Arch Gen Psychiatry 65(7):762–771CrossRefPubMed
6.
go back to reference Harvey P, Lepage M, Malla A (2007) Benefits of enriched intervention compared with standard care for patients with recent-onset psychosis: a metaanalytic approach. Can J Psychiatry 52(7):464PubMed Harvey P, Lepage M, Malla A (2007) Benefits of enriched intervention compared with standard care for patients with recent-onset psychosis: a metaanalytic approach. Can J Psychiatry 52(7):464PubMed
7.
go back to reference Craig TK, Garety P, Power P, Rahaman N, Colbert S, Fornells-Ambrojo M, Dunn G (2004) The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis. BMJ 329(7474):1067CrossRefPubMedPubMedCentral Craig TK, Garety P, Power P, Rahaman N, Colbert S, Fornells-Ambrojo M, Dunn G (2004) The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis. BMJ 329(7474):1067CrossRefPubMedPubMedCentral
8.
go back to reference McGorry PD, Hickie IB, Yung AR, Pantelis C, Jackson HJ (2006) Clinical staging of psychiatric disorders: a heuristic framework for choosing earlier, safer and more effective interventions. Aust N Z J Psychiatry 40(8):616–622CrossRefPubMed McGorry PD, Hickie IB, Yung AR, Pantelis C, Jackson HJ (2006) Clinical staging of psychiatric disorders: a heuristic framework for choosing earlier, safer and more effective interventions. Aust N Z J Psychiatry 40(8):616–622CrossRefPubMed
9.
go back to reference Yung AR, McGorry PD (1996) The prodromal phase of first-episode psychosis: past and current conceptualizations. Schizophr Bull 22(2):353–370CrossRefPubMed Yung AR, McGorry PD (1996) The prodromal phase of first-episode psychosis: past and current conceptualizations. Schizophr Bull 22(2):353–370CrossRefPubMed
10.
go back to reference McGorry PD (2007) The specialist youth mental health model: strengthening the weakest link in the public mental health system. Med J Aust 187(7):S53–S56PubMed McGorry PD (2007) The specialist youth mental health model: strengthening the weakest link in the public mental health system. Med J Aust 187(7):S53–S56PubMed
11.
go back to reference Malla A, Jordan G, Joober R, Schmitz N, Norman R, Brown T, Goldberg K, Loohuis H, Vracotas N, Rochford J (2014) A controlled evaluation of a targeted early case detection intervention for reducing delay in treatment of first episode psychosis. Soc Psychiatry Psychiatr Epidemiol 49(11):1711–1718CrossRefPubMed Malla A, Jordan G, Joober R, Schmitz N, Norman R, Brown T, Goldberg K, Loohuis H, Vracotas N, Rochford J (2014) A controlled evaluation of a targeted early case detection intervention for reducing delay in treatment of first episode psychosis. Soc Psychiatry Psychiatr Epidemiol 49(11):1711–1718CrossRefPubMed
12.
go back to reference Anderson KK, Fuhrer R, Schmitz N, Malla AK (2013) Determinants of negative pathways to care and their impact on service disengagement in first-episode psychosis. Soc Psychiatry Psychiatr Epidemiol 48(1):125–136CrossRefPubMed Anderson KK, Fuhrer R, Schmitz N, Malla AK (2013) Determinants of negative pathways to care and their impact on service disengagement in first-episode psychosis. Soc Psychiatry Psychiatr Epidemiol 48(1):125–136CrossRefPubMed
13.
go back to reference Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62(6):593–602CrossRefPubMed Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62(6):593–602CrossRefPubMed
14.
go back to reference Rössler W, Salize HJ, van Os J, Riecher-Rössler A (2005) Size of burden of schizophrenia and psychotic disorders. Eur Neuropsychopharmacol 15(4):399–409CrossRefPubMed Rössler W, Salize HJ, van Os J, Riecher-Rössler A (2005) Size of burden of schizophrenia and psychotic disorders. Eur Neuropsychopharmacol 15(4):399–409CrossRefPubMed
15.
go back to reference Wang PS, Berglund P, Olfson M, Pincus HA, Wells KB, Kessler RC (2005) Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62(6):603–613CrossRefPubMed Wang PS, Berglund P, Olfson M, Pincus HA, Wells KB, Kessler RC (2005) Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62(6):603–613CrossRefPubMed
16.
go back to reference Slade T, Johnston A, Oakley Browne MA, Andrews G, Whiteford H (2009) 2007 National survey of mental health and wellbeing: methods and key findings. Aust N Z J Psychiatry 43(7):594–605CrossRefPubMed Slade T, Johnston A, Oakley Browne MA, Andrews G, Whiteford H (2009) 2007 National survey of mental health and wellbeing: methods and key findings. Aust N Z J Psychiatry 43(7):594–605CrossRefPubMed
17.
go back to reference Cheung AH, Dewa CS (2007) Mental health service use among adolescents and young adults with major depressive disorder and suicidality. Can J Psychiatry 52(4):228PubMed Cheung AH, Dewa CS (2007) Mental health service use among adolescents and young adults with major depressive disorder and suicidality. Can J Psychiatry 52(4):228PubMed
18.
go back to reference Singh SP, Paul M, Ford T, Kramer T, Weaver T (2008) Transitions of care from child and adolescent mental health services to adult mental health services (TRACK study): a study of protocols in Greater London. BMC Health Serv Res 8(1):135CrossRefPubMedPubMedCentral Singh SP, Paul M, Ford T, Kramer T, Weaver T (2008) Transitions of care from child and adolescent mental health services to adult mental health services (TRACK study): a study of protocols in Greater London. BMC Health Serv Res 8(1):135CrossRefPubMedPubMedCentral
19.
go back to reference Hovish K, Weaver T, Islam Z, Paul M, Singh SP (2012) Transition experiences of mental health service users, parents, and professionals in the United Kingdom: a qualitative study. Psychiatry Rehabil J 35(3):251CrossRef Hovish K, Weaver T, Islam Z, Paul M, Singh SP (2012) Transition experiences of mental health service users, parents, and professionals in the United Kingdom: a qualitative study. Psychiatry Rehabil J 35(3):251CrossRef
20.
go back to reference Paul M, Ford T, Kramer T, Islam Z, Harley K, Singh SP (2013) Transfers and transitions between child and adult mental health services. Br J Psychiatry 202(s54):s36–s40CrossRef Paul M, Ford T, Kramer T, Islam Z, Harley K, Singh SP (2013) Transfers and transitions between child and adult mental health services. Br J Psychiatry 202(s54):s36–s40CrossRef
21.
go back to reference Lamb C, Hall D, Kelvin R, Van Beinum M (2008) Working at the CAMHS/Adult Interface: good practice guidance for the provision of psychiatric services to adolescents/young adults. Royal College of Psychiatrists Lamb C, Hall D, Kelvin R, Van Beinum M (2008) Working at the CAMHS/Adult Interface: good practice guidance for the provision of psychiatric services to adolescents/young adults. Royal College of Psychiatrists
22.
go back to reference Blum RW, Garell D, Hodgman CH, Jorissen TW, Okinow NA, Orr DP, Slap GB (1993) Transition from child-centered to adult health-care systems for adolescents with chronic conditions: a position paper of the Society for Adolescent Medicine. J Adolesc Health 14(7):570–576CrossRefPubMed Blum RW, Garell D, Hodgman CH, Jorissen TW, Okinow NA, Orr DP, Slap GB (1993) Transition from child-centered to adult health-care systems for adolescents with chronic conditions: a position paper of the Society for Adolescent Medicine. J Adolesc Health 14(7):570–576CrossRefPubMed
23.
go back to reference McDonagh JE, Viner RM (2006) Lost in transition? Between paediatric and adult services: it’s time to improve the transition of adolescents from paediatric to adult services. Br Med J 332(7539):435CrossRef McDonagh JE, Viner RM (2006) Lost in transition? Between paediatric and adult services: it’s time to improve the transition of adolescents from paediatric to adult services. Br Med J 332(7539):435CrossRef
24.
go back to reference McDonagh JE, Kelly DA (2003) Transitioning care of the pediatric recipient to adult caregivers. Pediatr Clin N Am 50(6):1561–1583CrossRef McDonagh JE, Kelly DA (2003) Transitioning care of the pediatric recipient to adult caregivers. Pediatr Clin N Am 50(6):1561–1583CrossRef
25.
go back to reference McGorry PD, Tanti C, Stokes R, Hickie IB, Carnell K, Littlefield LK, Moran J (2007) Headspace: Australia’s National Youth Mental Health Foundation—where young minds come first. Med J Aust 187(7 Suppl):S68–S70PubMed McGorry PD, Tanti C, Stokes R, Hickie IB, Carnell K, Littlefield LK, Moran J (2007) Headspace: Australia’s National Youth Mental Health Foundation—where young minds come first. Med J Aust 187(7 Suppl):S68–S70PubMed
26.
go back to reference Rickwood DJ, Telford NR, Parker AG, Tanti CJ, McGorry PD (2014) Headspace—Australia’s innovation in youth mental health: who are the clients and why are they presenting. Med J Aust 200(2):1–4CrossRef Rickwood DJ, Telford NR, Parker AG, Tanti CJ, McGorry PD (2014) Headspace—Australia’s innovation in youth mental health: who are the clients and why are they presenting. Med J Aust 200(2):1–4CrossRef
27.
go back to reference Hughes F, Stavely H, Simpson R, Goldstone S, Pennell K, McGorry P (2014) At the heart of an early psychosis centre: the core components of the 2014 Early Psychosis Prevention and Intervention Centre model for Australian communities. Australas Psychiatry 22:228–234CrossRefPubMed Hughes F, Stavely H, Simpson R, Goldstone S, Pennell K, McGorry P (2014) At the heart of an early psychosis centre: the core components of the 2014 Early Psychosis Prevention and Intervention Centre model for Australian communities. Australas Psychiatry 22:228–234CrossRefPubMed
28.
go back to reference Department of Health (2009) New horizons: a shared vision for mental health. Department of Health London, pp 1–94 Department of Health (2009) New horizons: a shared vision for mental health. Department of Health London, pp 1–94
29.
go back to reference H Government (2011) No health without mental health: a cross-government mental health outcomes strategy for people of all ages. Department of Health London, pp 1–93 H Government (2011) No health without mental health: a cross-government mental health outcomes strategy for people of all ages. Department of Health London, pp 1–93
30.
go back to reference Meier R, Murphy M, Singh SP, Lamb C (2011) Developing services to improve the quality of life of young people with neurodevelopmental disorders, emotional/neurotic disorders and emerging personality disorder. R Coll Psychiatr Occas Pap 77:1–24 Meier R, Murphy M, Singh SP, Lamb C (2011) Developing services to improve the quality of life of young people with neurodevelopmental disorders, emotional/neurotic disorders and emerging personality disorder. R Coll Psychiatr Occas Pap 77:1–24
31.
go back to reference Parker C, Clements L, Harbour A, Honigmann J (2011) Transitions in Mental Health Care. Young Minds. United Kingdom National CAMHS Support Service, pp 1–81 Parker C, Clements L, Harbour A, Honigmann J (2011) Transitions in Mental Health Care. Young Minds. United Kingdom National CAMHS Support Service, pp 1–81
32.
go back to reference Brodie I, Goldman R, Clapton J (2011) Mental health service transitions for young people. In: Social care institute for excellence, Research Briefing, pp 1–20 Brodie I, Goldman R, Clapton J (2011) Mental health service transitions for young people. In: Social care institute for excellence, Research Briefing, pp 1–20
33.
go back to reference Vyas NS, Birchwood M, Singh SP (2015) Youth services: meeting the mental health needs of adolescents. Ir J Psychol Med 32(01):13–19CrossRef Vyas NS, Birchwood M, Singh SP (2015) Youth services: meeting the mental health needs of adolescents. Ir J Psychol Med 32(01):13–19CrossRef
34.
go back to reference Coughlan H, Tiedt L, Clarke M, Kelleher I, Tabish J, Molloy C, Harley M, Cannon M (2014) Prevalence of DSM-IV mental disorders, deliberate self-harm and suicidal ideation in early adolescence: an Irish population-based study. J Adolesc 37(1):1–9CrossRefPubMed Coughlan H, Tiedt L, Clarke M, Kelleher I, Tabish J, Molloy C, Harley M, Cannon M (2014) Prevalence of DSM-IV mental disorders, deliberate self-harm and suicidal ideation in early adolescence: an Irish population-based study. J Adolesc 37(1):1–9CrossRefPubMed
35.
go back to reference Cannon M, Coughlan H, Clarke M, Harley M, Kelleher I (2013) The Mental Health of Young People in Ireland: a report of the Psychiatric Epidemiology Research across the Lifespan (PERL) Group. Royal College of Surgeons in Ireland, Dublin Cannon M, Coughlan H, Clarke M, Harley M, Kelleher I (2013) The Mental Health of Young People in Ireland: a report of the Psychiatric Epidemiology Research across the Lifespan (PERL) Group. Royal College of Surgeons in Ireland, Dublin
36.
go back to reference Harley M, Connor D, Clarke M, Kelleher I, Coughlan H, Lynch F, Fitzpatrick C, Cannon M (2015) Prevalence of Mental Disorder among young adults in Ireland: a population based study. Ir J Psychol Med 32(01):79–91CrossRef Harley M, Connor D, Clarke M, Kelleher I, Coughlan H, Lynch F, Fitzpatrick C, Cannon M (2015) Prevalence of Mental Disorder among young adults in Ireland: a population based study. Ir J Psychol Med 32(01):79–91CrossRef
37.
go back to reference Dooley BA, Fitzgerald A (2012) My world survey: National study of youth mental health in Ireland. Headstrong and UCD School of Psychology Dooley BA, Fitzgerald A (2012) My world survey: National study of youth mental health in Ireland. Headstrong and UCD School of Psychology
38.
go back to reference O’Keeffe L, O’Reilly A, O’Brien G, Buckley R, Illback R (2015) Description and outcome evaluation of Jigsaw: an emergent Irish mental health early intervention programme for young people. Ir J Psychol Med 32(01):71–77CrossRef O’Keeffe L, O’Reilly A, O’Brien G, Buckley R, Illback R (2015) Description and outcome evaluation of Jigsaw: an emergent Irish mental health early intervention programme for young people. Ir J Psychol Med 32(01):71–77CrossRef
39.
go back to reference Kutcher S, Davidson S, Manion I (2009) Child and youth mental health: integrated health care using contemporary competency-based teams. Paediatr Child Health 14(5):315PubMedPubMedCentral Kutcher S, Davidson S, Manion I (2009) Child and youth mental health: integrated health care using contemporary competency-based teams. Paediatr Child Health 14(5):315PubMedPubMedCentral
40.
go back to reference Baumbusch JL, Kirkham SR, Khan KB, McDonald H, Semeniuk P, Tan E, Anderson JM (2008) Pursuing common agendas: a collaborative model for knowledge translation between research and practice in clinical settings. Res Nurs Health 31(2):130–140CrossRefPubMed Baumbusch JL, Kirkham SR, Khan KB, McDonald H, Semeniuk P, Tan E, Anderson JM (2008) Pursuing common agendas: a collaborative model for knowledge translation between research and practice in clinical settings. Res Nurs Health 31(2):130–140CrossRefPubMed
41.
go back to reference Lomas J (1991) Words without action? The production, dissemination, and impact of consensus recommendations. Annu Rev Public Health 12(1):41–65CrossRefPubMed Lomas J (1991) Words without action? The production, dissemination, and impact of consensus recommendations. Annu Rev Public Health 12(1):41–65CrossRefPubMed
42.
go back to reference McGrath PJ, Lingley-Pottie P, Emberly DJ, Thurston C, McLean C (2009) Integrated knowledge translation in mental health: family help as an example. J Can Acad Child Adolesc Psychiatry 18(1):30PubMedPubMedCentral McGrath PJ, Lingley-Pottie P, Emberly DJ, Thurston C, McLean C (2009) Integrated knowledge translation in mental health: family help as an example. J Can Acad Child Adolesc Psychiatry 18(1):30PubMedPubMedCentral
Metadata
Title
From early intervention in psychosis to youth mental health reform: a review of the evolution and transformation of mental health services for young people
Authors
Ashok Malla
Srividya Iyer
Patrick McGorry
Mary Cannon
Helen Coughlan
Swaran Singh
Peter Jones
Ridha Joober
Publication date
01-03-2016
Publisher
Springer Berlin Heidelberg
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 3/2016
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-015-1165-4

Other articles of this Issue 3/2016

Social Psychiatry and Psychiatric Epidemiology 3/2016 Go to the issue