Delivering a sleep intervention across a youth mental health service using non-expert practitioners: A service evaluation

IF 2.1 4区 医学 Q3 PSYCHIATRY
Rebecca Rollinson, Amber Cole, Brioney Gee, Ioana Tofan, Adam Graham, Jude Hatton, Jonathan Lyons, Sarah Reeve, Jonathan Wilson, Kevin Beardsworth, Tim Clarke
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Abstract

Aims

Poor sleep is highly prevalent in young people and increases risk of mental health difficulties, yet access to sleep interventions remains limited. This paper evaluates the use of a sleep intervention delivered by non-expert practitioners in a secondary care youth mental health service.

Method

Assistant psychologists were trained to deliver a six-session 1:1 cognitive-behavioural sleep intervention adapted for use with young people with mental health difficulties. A within-subject design assessed clinical outcomes relating to sleep (Insomnia Severity Index), psychological distress and personal goals (Goal Based Outcome Measures) at four time points.

Results

High referral, intervention take-up (82.82%) and completion (70%) rates were reported, together with high baseline levels of insomnia (Insomnia Severity Index mean 20.47, SD 3.68) and poor sleep efficiency (56.36%, SD 17.23). Fifty-six young people (average age 19.2 years, SD 3.25) were included in the outcome analysis. Statistically and clinically significant improvements were seen across all outcome measures, with 68% no longer meeting clinical threshold (ISI ≥15) for insomnia at endpoint.

Conclusions

This study demonstrates exceptionally high levels of clinical need and engagement with a sleep intervention adapted specifically for young people with mental health difficulties. Whilst limited by the uncontrolled design, large improvements in insomnia and psychological distress support its effectiveness and utility in clinical settings. More robust implementation and evaluation is warranted in broader youth mental health services to promote earlier access.

Abstract Image

利用非专业从业人员在青少年心理健康服务中开展睡眠干预:服务评估
目的睡眠质量差在青少年中非常普遍,并会增加心理健康问题的风险,但获得睡眠干预的机会仍然有限。本文评估了由非专业从业人员在二级护理青少年心理健康服务中提供睡眠干预的使用情况。方法对心理助理人员进行培训,以提供六节课的 1:1 认知行为睡眠干预,该干预经调整后适用于有心理健康问题的青少年。结果转介率、干预接受率(82.82%)和干预完成率(70%)都很高,同时失眠的基线水平也很高(失眠严重程度指数平均值为 20.47,标准差为 3.68),睡眠效率也很低(56.36%,标准差为 17.23)。56 名青少年(平均年龄 19.2 岁,中位数 3.25)被纳入结果分析。所有结果指标均有统计学和临床意义上的显著改善,68%的人在终点时不再达到失眠的临床阈值(ISI ≥15)。虽然受到非对照设计的限制,但失眠和心理困扰方面的显著改善支持了其在临床环境中的有效性和实用性。有必要在更广泛的青少年心理健康服务中进行更有力的实施和评估,以促进更早地使用该疗法。
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来源期刊
Early Intervention in Psychiatry
Early Intervention in Psychiatry 医学-精神病学
CiteScore
4.80
自引率
5.00%
发文量
112
审稿时长
6-12 weeks
期刊介绍: Early Intervention in Psychiatry publishes original research articles and reviews dealing with the early recognition, diagnosis and treatment across the full range of mental and substance use disorders, as well as the underlying epidemiological, biological, psychological and social mechanisms that influence the onset and early course of these disorders. The journal provides comprehensive coverage of early intervention for the full range of psychiatric disorders and mental health problems, including schizophrenia and other psychoses, mood and anxiety disorders, substance use disorders, eating disorders and personality disorders. Papers in any of the following fields are considered: diagnostic issues, psychopathology, clinical epidemiology, biological mechanisms, treatments and other forms of intervention, clinical trials, health services and economic research and mental health policy. Special features are also published, including hypotheses, controversies and snapshots of innovative service models.
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