Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia.
Int J Environ Res Public Health. 2022 Aug 23;19(17):10494. doi: 10.3390/ijerph191710494.
This paper aims to report on effective approaches for, and early impacts of, implementing and delivering services for youth with, or at risk of, severe mental illness commissioned by 10 Primary Health Network (PHN) Lead Sites (reform leaders) in Australia.
The following qualitative data sources were analyzed using a thematic approach: focus group consultations with 68 Lead Site staff and 70 external stakeholders from Lead Site regions; and observational data from one Lead Site meeting with a focus on services for youth with, or at risk of, severe mental illness and one national symposium that was attended by Lead Site staff and service providers.
The Lead Site staff described common effective strategies for implementing and delivering youth enhanced services as follows: building on existing youth services, establishing effective linkages with other local youth enhanced services, and providing complementary clinical and non-clinical services. Early impacts of youth enhanced services that were described by Lead Site staff and external stakeholders included: improved service quality and access, positive effects on consumers and/or carers (e.g., reduced symptomology), and sector-wide impacts such as improved service integration. Staff members from two Lead Sites also mentioned negative impacts (e.g., uncertainty of continued funding). Suggestions for future improvements by Lead Site staff and external stakeholders included: involving young people in service design and planning, improving service access, addressing clinical workforce shortages, improving data collection and usage, and establishing greater service integration.
These findings highlight the necessity for collaborative and localized responses as well as service models that combine clinical and non-clinical care to address the needs of young people with, or at risk of, severe mental illness. Early impacts that were reported by stakeholders indicated that PHN-commissioned youth-enhanced services had positive impacts for consumers, carers, and the wider service sector.
本文旨在报告澳大利亚 10 个初级卫生网络（PHN）主导站点（改革领导者）实施和提供青少年严重精神疾病服务的有效方法及其早期影响。
采用主题分析方法对以下定性数据来源进行了分析：与 68 名主导站点工作人员和 70 名来自主导站点地区的外部利益相关者进行的焦点小组咨询；以及对一个以青少年严重精神疾病服务为重点的主导站点会议和一个全国研讨会的观察数据，该研讨会由主导站点工作人员和服务提供商参加。
主导站点工作人员描述了实施和提供青少年增强服务的常见有效策略如下：利用现有的青少年服务，与其他当地青少年增强服务建立有效的联系，并提供互补的临床和非临床服务。主导站点工作人员和外部利益相关者描述的青少年增强服务的早期影响包括：提高服务质量和可及性，对消费者和/或照顾者产生积极影响（例如，症状减轻），以及全行业的影响，例如服务整合的改善。来自两个主导站点的工作人员还提到了负面影响（例如，持续资金的不确定性）。主导站点工作人员和外部利益相关者提出的未来改进建议包括：让年轻人参与服务设计和规划，改善服务可及性，解决临床劳动力短缺问题，改善数据收集和使用，并建立更大的服务整合。
这些发现强调了协作和本地化应对措施以及结合临床和非临床护理的服务模式的必要性，以满足患有或有严重精神疾病风险的年轻人的需求。利益相关者报告的早期影响表明，PHN 委托的青少年增强服务对消费者、照顾者和更广泛的服务部门产生了积极影响。
