Snowdon Nicole, Allan Julaine, Shakeshaft Anthony, Courtney Ryan J
National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW 2031, Australia.
National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW 2031, Australia; School of Health and Society, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia.
J Subst Use Addict Treat. 2023 Mar;146:208959. doi: 10.1016/j.josat.2023.208959. Epub 2023 Jan 24.
With 150 centers Australia-wide, the headspace National Youth Mental Health Foundation is an exemplary integrated youth health service. Headspace centers provide medical care, mental health interventions, alcohol and other drug (AOD) services, and vocational support to Australian young people (YP) aged 12 to 25 years. Co-located headspace salaried youth workers, private health care practitioners (e.g. psychologists, psychiatrists, and medical practitioners) and in-kind community service providers (e.g. AOD clinicians) form coordinated multidisciplinary teams. This article aims to identify the factors influencing the access to AOD interventions for YP, in the Australian rural headspace setting; as perceived by YP, their family and friends, and headspace staff.
The study purposively recruited YP (n = 16), their family and friends (n = 9), and headspace staff (n = 23) and management (n = 7) in four headspace centers in rural New South Wales, Australia. Recruited individuals participated in semistructured focus groups about the access to YP AOD interventions in the headspace setting. The study team thematically analyzed the data through the lens of the socio-ecological model.
The study identified convergent themes across groups and found several barriers to the access of AOD interventions; 1) YP's personal factors, 2) YP's family and peer attitudes, 3) practitioner skills, 4) organizational processes and 5) societal attitudes were all identified as negatively impacting access to YP AOD interventions. Practitioners' client-centered stance, and the youth-centric headspace model were factors that were considered as enablers of engagement of YP with an AOD concern.
While this Australian example of an integrated youth health care model is well placed to provide YP AOD interventions, a mismatch existed between practitioner capability and YP needs. The sampled practitioners described limited AOD knowledge, and low confidence in providing AOD interventions. At the organizational level, multiple AOD intervention supply and utilization issues occurred. Taken together, these problems likely underlie previous findings of poor service utilization and low user satisfaction.
Clear enablers exist for AOD interventions to be better integrated into headspace services. Future work should determine how this integration can be achieved and what early intervention means in relation to AOD interventions.
headspace全国青少年心理健康基金会在澳大利亚各地设有150个中心，是一个堪称典范的综合性青少年健康服务机构。headspace中心为12至25岁的澳大利亚年轻人提供医疗保健、心理健康干预、酒精及其他药物（AOD）服务以及职业支持。与headspace同址办公的受薪青年工作者、私人医疗从业者（如心理学家、精神科医生和医生）以及实物社区服务提供者（如AOD临床医生）组成了协调的多学科团队。本文旨在确定在澳大利亚农村headspace环境中，影响年轻人获得AOD干预措施的因素；这些因素是年轻人、他们的家人和朋友以及headspace工作人员所感知到的。
该研究有目的地招募了澳大利亚新南威尔士州农村地区四个headspace中心的年轻人（n = 16）、他们的家人和朋友（n = 9）、headspace工作人员（n = 23）以及管理人员（n = 7）。被招募的个体参加了关于在headspace环境中年轻人获得AOD干预措施的半结构化焦点小组。研究团队通过社会生态模型的视角对数据进行了主题分析。
该研究确定了各群体间趋同的主题，并发现了获得AOD干预措施的几个障碍；1）年轻人的个人因素，2）年轻人的家庭和同伴态度，3）从业者技能，4）组织流程，5）社会态度，所有这些都被确定为对年轻人获得AOD干预措施产生负面影响。从业者以客户为中心的立场以及以青少年为中心的headspace模式被认为是促使年轻人参与AOD相关问题的因素。
虽然澳大利亚这个综合性青少年医疗保健模式的例子很适合提供年轻人AOD干预措施，但从业者能力与年轻人需求之间存在不匹配。抽样的从业者表示AOD知识有限，对提供AOD干预措施信心不足。在组织层面，出现了多个AOD干预措施供应和利用问题。综合来看，这些问题可能是先前服务利用率低和用户满意度低的调查结果的潜在原因。
存在明确的因素可促使AOD干预措施更好地融入headspace服务。未来的工作应确定如何实现这种整合，以及早期干预在AOD干预措施方面意味着什么。
