Novel youth mental health services in Australia: What differences are being reported about the clinical needs of those who attend and the outcomes achieved?

Abstract

Globally, youth mental health services are evolving, with Australia's headspace services presented as a leading exemplar. headspace services were designed as enhanced primary care-based entities and were expected to collaborate with local acute, and specialist clinical and psychosocial services. The lack of large-scale health services trials necessitates understanding their impact through systematic monitoring and evaluation. This paper compares data from differing sources that describe the demographic and clinical features, and functional outcomes, of young people presenting to various headspace services. headspace National reports that care is provided largely to youth with transient distress, minimal clinical disorders, suicidality or comorbidities and limited functional impairment. Almost 50% of clients are reported to have no significant psychological symptoms or risk factors, and less than 30% to have a clinical disorder. Consequently, 36% receive only a single session of care and the median number of clinical sessions provided is three. By contrast, empirically derived estimates, utilising data from an academic centre and its affiliated centres, other independent agencies and more refined analyses of headspace national data variously portray 50-60% of youth as presenting with at least moderate clinical complexity (including at least 20% with high complexity), and with another 27% requiring active clinical intervention. Together, these data suggest approximately 75% of attendees require substantive clinical care. Clinical outcomes data from all sources indicate limited impacts on functional outcomes, with less than a third achieving significant improvement. These data support the original intent of headspace services to focus on equitable access to multidimensional and clinical assessment, evidence-based early interventions for early stages of major anxiety, mood or psychotic disorders. As demand for youth services continues to rise, there is an urgent need to reconfigure our national youth service networks to address the unmet clinical and psychosocial needs of youth presenting in the early stages of major mental disorders.