Woody Charlotte, Baxter Amanda, Wright Eryn, Gossip Kate, Leitch Elizabeth, Whiteford Harvey, Scott James G
1 School of Public Health, Faculty of Medicine, The University of Queensland, Australia.
2 Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Australia.
Clin Child Psychol Psychiatry. 2019 Jul;24(3):503-528. doi: 10.1177/1359104519827631. Epub 2019 Feb 28.
Severe, persistent and complex mental illness (SPCMI) affects a small proportion of young people but is associated with severe disability and a large burden on families and health services. This article identifies and describes service models for adolescents and young adults with SPCMI.
A systematic search was conducted for services for young people aged 12-25 years with SPCMI. The review sought service models providing extended care and/or multidisciplinary services to meet the complex and long-term needs of this population.
A total of 43 sources were identified. Evidence of effectiveness was found for both community- and bed-based services. Specific components suggested as important in service delivery included care provided by multidisciplinary teams, consumer and family involvement in care planning, intensive case management and service integration through the continuum of care.
Clinical frameworks for this population must incorporate effective community care integrated with inpatient treatment of short duration. Frameworks require consumer and family-centred care with flexibility to support progression through developmental stages and tasks while addressing issues related to risk management, fluctuation in illness severity and stages of recovery. A continuum of care is necessary to meet the needs that arise from SPCMI in adolescents and young adults.
严重、持续性和复杂性精神疾病（SPCMI）影响一小部分年轻人，但与严重残疾以及家庭和卫生服务的沉重负担相关。本文确定并描述了患有SPCMI的青少年和青年的服务模式。
对为12至25岁患有SPCMI的年轻人提供的服务进行了系统检索。该综述寻找提供长期护理和/或多学科服务以满足该人群复杂和长期需求的服务模式。
共识别出43个来源。发现社区服务和住院服务均有有效性证据。在服务提供中被认为重要的具体组成部分包括多学科团队提供的护理、消费者和家庭参与护理计划、强化个案管理以及通过连续护理实现服务整合。
针对该人群的临床框架必须纳入有效的社区护理并结合短期住院治疗。框架需要以消费者和家庭为中心的护理，具备灵活性以支持个体在发展阶段和任务中取得进展，同时解决与风险管理、疾病严重程度波动和康复阶段相关的问题。连续护理对于满足青少年和青年中SPCMI所产生的需求是必要的。
