Bellairs-Walsh India, Nichterlein Maria, Assan Ben, Stargatt Robyn
School of Psychology and Public Health, La Trobe University, Plenty Road & Kingsbury Drive, Bundoora, VIC, 3086, Australia.
Orygen, 35 Poplar Road, Parkville, VIC, 3052, Australia.
Community Ment Health J. 2025 May;61(4):693-703. doi: 10.1007/s10597-024-01387-z. Epub 2025 Jan 6.
Engagement with traditional mental health services can be particularly challenging for young people experiencing severe and complex mental health problems. Assertive community treatment-based services providing mobile outreach, such as Intensive Mobile Youth Outreach Services (IMYOS), operate across Australia to support these young people's mental health needs in the transition to adulthood. Past research on IMYOS has focused on quantitative outcome measures, and young people's experiences of this type of model are poorly understood. This study explored youth service users' experiences of an IMYOS program, focusing on the model and intervention aspects perceived as barriers and facilitators to their overall recovery and service engagement. Semi-structured, in-depth interviewing was undertaken with nine young people aged 16-19 years (M = 17.61 years) who were current or recent service users of an IMYOS program in Melbourne, Australia. Data were analysed using thematic analysis. Having a therapeutic space, clinicians' specialised expertise, use of an outreach and community-oriented approach, and care continuity and availability across settings were program aspects identified by young people as facilitating their recovery and service engagement. Program aspects perceived as barriers to recovery and engagement were clinical unsuitability and ineffectiveness of the program and interventions, and conflicts between personal autonomy and assertive care. Young people's perceptions of clinical suitability and therapeutic relevance influenced their evaluations of the overall effectiveness of the IMYOS service, which subsequently impacted their engagement. The findings provide opportunities for IMYOS clinicians to enhance young people's recovery and engagement outcomes and have implications for the improvement of this innovative service for at-risk young people.
对于有严重和复杂心理健康问题的年轻人来说,与传统心理健康服务机构接触可能特别具有挑战性。基于积极社区治疗的服务,如强化移动青年外展服务(IMYOS),在澳大利亚各地开展,以满足这些年轻人在向成年过渡过程中的心理健康需求。过去对IMYOS的研究主要集中在定量结果测量上,而对这种模式下年轻人的体验了解甚少。本研究探讨了青年服务使用者对IMYOS项目的体验,重点关注被视为其全面康复和服务参与的障碍和促进因素的模式及干预方面。对9名年龄在16 - 19岁(平均年龄 = 17.61岁)的年轻人进行了半结构化的深入访谈,他们是澳大利亚墨尔本一个IMYOS项目的当前或近期服务使用者。采用主题分析法对数据进行了分析。年轻人认为,拥有一个治疗空间、临床医生的专业知识、采用外展和以社区为导向的方法以及不同环境下护理的连续性和可及性是有助于他们康复和参与服务的项目方面。被视为康复和参与障碍的项目方面包括项目及干预措施在临床上不适用和无效,以及个人自主权与积极护理之间的冲突。年轻人对临床适用性和治疗相关性的看法影响了他们对IMYOS服务整体有效性的评估,进而影响了他们的参与度。研究结果为IMYOS临床医生提供了机会,以提高年轻人的康复和参与度,并对改善这项针对高危年轻人的创新服务具有启示意义。