Oostermeijer Sanne, Bassilios Bridget, Nicholas Angela, Williamson Michelle, Machlin Anna, Harris Meredith, Burgess Philip, Pirkis Jane
The University of Melbourne, Melbourne, VIC, 3010, Australia.
The University of Queensland, Brisbane, Australia.
Int J Ment Health Syst. 2021 Feb 23;15(1):16. doi: 10.1186/s13033-021-00440-8.
Primary mental health care services play an important role in prevention and early intervention efforts to reduce the prevalence and impact of mental health problems amongst young people. This paper aimed to (1) investigate whether mental health services commissioned by Australia's 31 Primary Health Networks provided accessible care and increasingly reached children and youth across Australia, and (2) identify the challenges of, and facilitating factors to, implementing services for youth with, or at risk of, severe mental illness (i.e., youth enhanced services) in 10 PHNs which acted as mental health reform leaders (i.e., Lead Sites).
We used mixed methods, sourcing data from: a national minimum data set that captured information on consumers and the services they received via all 31 PHNs from 1 July 2016 to 31 December 2017; consultations with Lead Site staff and their regional stakeholders; and observational data from two Lead Site meetings.
Many children and youth receiving services were male and up to 10% were Aboriginal and/or Torres Strait Islander young people. The majority of young people came from areas of greater disadvantage. For most children and youth receiving services their diagnosis was unknown, or they did not have a formal diagnosis. Both child and youth service uptake showed a modest increase over time. Six key themes emerged around the implementation of youth enhanced services: service access and gaps, workforce and expertise, funding and guidance, integrated and flexible service models, service promotion, and data collection, access and sharing.
Early findings suggest that PHN-commissioned services provide accessible care and increasingly reach children and youth. Learnings from stakeholders indicate that innovative and flexible service models in response to local youth mental health needs may be a key to success.
初级精神卫生保健服务在预防和早期干预工作中发挥着重要作用，以降低年轻人心理健康问题的患病率及其影响。本文旨在：（1）调查澳大利亚31个初级卫生保健网络委托开展的精神卫生服务是否提供了可及的护理，并越来越多地覆盖澳大利亚各地的儿童和青少年；（2）确定在作为精神卫生改革领导者的10个初级卫生保健网络（即牵头站点）中，为患有严重精神疾病或有严重精神疾病风险的青少年（即青少年强化服务）实施服务所面临的挑战和促进因素。
我们采用了混合方法，数据来源包括：一个全国最低数据集，该数据集收集了2016年7月1日至2017年12月31日期间通过所有31个初级卫生保健网络的消费者及其接受服务的信息；与牵头站点工作人员及其区域利益相关者的磋商；以及两次牵头站点会议的观察数据。
许多接受服务的儿童和青少年为男性，多达10%为原住民和/或托雷斯海峡岛民青年。大多数年轻人来自处境更为不利的地区。对于大多数接受服务的儿童和青少年来说，他们的诊断情况不明，或者没有正式诊断。儿童和青少年服务的接受率均随时间略有上升。围绕青少年强化服务的实施出现了六个关键主题：服务可及性与差距、劳动力与专业知识、资金与指导、综合灵活的服务模式、服务推广以及数据收集、获取与共享。
早期研究结果表明，初级卫生保健网络委托开展的服务提供了可及的护理，并越来越多地覆盖儿童和青少年。利益相关者的经验表明，针对当地青少年心理健康需求的创新灵活服务模式可能是成功的关键。
