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The pronounced increase in the number of young people struggling with mental health and wellbeing continues to puzzle researchers, politicians and practitioners. Discussions around this seem to fluctuate between individualizing understandings of the problem matter and more structural, institutional and cultural ones, calling for research exploring the role of the latter. In this paper, we present analyses of how broader societal frameworks linked to acceleration, performance and psychologization affect the wellbeing of young people. Based on a longitudinal qualitative study in Denmark with 37 young men and women between the ages of 16 and 24 struggling with wellbeing, this paper unfolds structural, cultural and institutional influences on mental health issues experienced by young people. The analyses are produced using a social-analytical lens of ‘diagnosis of the times’ to explore how young people’s subjective everyday life experiences of wellbeing and wellbeing struggles must be understood as interlinked with broader societal frameworks and expectations. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND METHODS RESULTS IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY CONCLUSIONS Youth mental health rates of depression and anxiety continue to climb. Schools have a role to play to support youth mental health but often struggle to navigate community expectations.Focus groups (n = 17) were conducted with over 100 participants to understand community perceptions on the role of schools.Three themes emerged around what schools should be doing: (1) provide accurate education about mental health, (2) create mental health promoting environments that positively supports young people, and (3) act as a common space to bring community members and organizations together for their young people.School professionals and systems should be equipped to adequately address youth mental health. The current US institutional response to this crisis is underdeveloped and exacerbates equity issues and health outcome disparities. Schools need institutional support for addressing mental health in ways that incorporate building a shared understanding with families and providing efforts to prevent and detect rather than just treat mental health.Schools should work with their communities to promote shared understanding and accountability for all to engage in building rich protective environments that promote mental well‐being for kids in their care. [ABSTRACT FROM AUTHOR]

Background: A significant number of young individuals are readmitted one or more times shortly after their first episode of psychosis. Readmission may represent a marker of psychopathological vulnerability. Our primary aim was to evaluate the impact of clinical and socio-demographic variables on readmission at 12-month follow-up. Secondly, our goal was to determine whether the use of Long-Acting Injection (LAI) antipsychotics provides notable benefits compared to oral medications in preventing subsequent readmissions. Subjects and methods: 80 patients hospitalised for the first time with a diagnosis of psychotic disorder (ICD-10 criteria) were retrospectively assessed through clinical records. The mean age was 21.7 years. Patients were predominantly male (n = 62, 77.5%), and 55 subjects had at least 8 years of education. 50% of the sample was "NEET" (not in education, employment, or training). Results: 35 patients (43.8%) were discharged with a LAI antipsychotic, while 45 (56.2%) recieved oral antipsychotic therapy. Substance use (p = 0.04) and oral antipsychotics at discharge (p = 0.003) were significantly associated with readmission at 1 year. We did not find any significant predictors of being discharged with LAI therapy. Conclusion: Our findings underlined the importance of identifying patients at risk of readmission in order to prevent future rehospitalization and promote appropriate prevention strategies. LAIs should be considered as a first-choice treatment for patients hospitalised for FEP since they proved to be effective in preventing relapse. [ABSTRACT FROM AUTHOR]

In recent times there has been increasing acknowledgement of the importance of attending to the agenda of people with lived experience in psychotherapy research. In particular, young people's voices have been recognised as central to the design and development of psychotherapies that work for them. It is important to recognise the limits of professional agendas and make sure that young people's own priorities are represented in the indicators against which we measure change in research evaluations of psychotherapy. This requires an extension of evaluation research indicators from psychiatric symptomatology, to include aspects of wellbeing that matter to young people themselves. This article joins others in calling for a shift from the focus on symptom change in the evaluation of psychotherapy with youth, to acknowledge subjective indicators identified through research conducted with young people. New indicators might, for example, be centred on the degree to which young people experience increased capacity for acceptance of their emotions, a comfortable sense of identity, improved relational trust, and a stronger sense of their own agency. If psychotherapy is to be meaningful to young people, it is vital that we tailor it to young people's own needs and priorities and evaluate it against the aspects of change that matter to them. [ABSTRACT FROM AUTHOR]

Many training initiatives are underway to increase implementation of evidence-based practice (EBPs) in mental healthcare. However, little is known about what types of trainings and supports yield the highest reach and engagement. Supported by a tax-funded, countywide initiative to improve access to quality care for youths, the current mixed methods study evaluates mental health (MH) provider reach, or registering for the training initiative, and engagement, or participation in training activities, for several EBP training and implementation supports. MH providers were offered free 1) formal EBP workshops, 2) a biweekly learning community, 3) individual case consultation, and 4) confidential online clinical feedback system. To register, interested providers (N = 698) completed a web-based assessment measuring clinical practice information, organizational implementation climate, and EBP knowledge, attitudes, and practices. Thirteen providers, selected via purposeful sampling stratified by level of participation, completed semi-structured qualitative interviews. While the training initiative achieved high reach (66% of county agencies had a provider register), far fewer providers engaged substantially in training. Quantitative results indicated that providers whose professional discipline was not psychology, had higher baseline EBP knowledge, more extensive use of common evidence-based strategies, and less extensive use of other therapy strategies, engaged in more training. Rapid qualitative analysis of interviews expanded upon these findings and illuminated provider, organizational, system, practical, and training activity-specific barriers and facilitators to engagement. Findings suggest the importance of identifying strategies for improving provider engagement in training activities beyond workshops. Implications for future research and training initiatives are discussed. [ABSTRACT FROM AUTHOR]

New generations of youth are coming of age at a time when digital technology is omnipresent, and ever-evolving. It is not yet fully appreciated what effect this level of digital technology use will have on current and future generations. Although not entirely negative, dramatic shifts in human interaction and well-being have already presented themselves. Among these shifts are rising rates of youth struggling with mental health–especially since the COVID-19 pandemic. In this study, we explore youth perspectives on the relationship between their digital technology and their mental health, through the use of semi-structured interviews and thematic analysis. Our research question was: How do youth understand the relationship between digital technology use and their mental health? We interviewed eight adolescents and asked them to share their experiences of the relationship between their devices and their well-being. Thematic findings highlight a conflictual relationship between digital technology use and youth mental health, affecting their relationships with others, themselves, and the world around them. Because digital technology consumption on this scale is so new, our sample represents one of the first available cohorts of youth to actively participate in the exploration of this topic. Implications include the need for further qualitative research to prioritize youth voices in ways that will benefit broader societal understandings of technology and mental health. [ABSTRACT FROM AUTHOR]

Rural Australian youth exhibit high rates of mental ill-health, exacerbated by reduced access to mental health services. While the need for innovative solutions is well-established rural youth themselves are frequently excluded from the dialogue, creating a significant gap in evidence and the development of relevant service provision that reflects young people’s lived experiences. Drawing on the concepts of individualism and healthism and research highlighting the continuing importance of relationships and trust in the lives of young people in a digital society, we aim to better understand how rural youth understand mental health and navigate mental health services and information. Using a qualitative methodology, we held 2 small focus groups with a total of 8 young people in rural Tasmania to identify aspects of rural mental healthcare that require improvement and to contribute to developing new and innovative solutions. Findings indicate that rural Tasmanian youth face numerous structural, social, and cultural barriers to positive mental health. Rural self-reliance and generational differences in attitudes towards mental health can negatively affect youths’ help-seeking behaviours. Findings from this study suggest a need to combine technology-and community-based approaches creating a multi-generational approach to combat mental ill-health among rural youth. [ABSTRACT FROM AUTHOR]

Youth-specific digital mental health interventions (DMHI) represent an emerging field of study, and aim to increase access, improve socioemotional outcomes, and, where required, support triage to targeted interventions. However, prior reviews have reported inconsistent findings on the clinical effectiveness of such interventions in young adults (12–25 years). Further, shortfalls remain for the impact of guided interventions based on the mode of delivery and the type of human support personnel (e.g., professional or peer) guiding the intervention. In response, this systematic review, co-designed with Australia's leading mental health organization, aims to assess the effectiveness of guided digital programs in improving youth socioemotional outcomes. Included studies involve young people experiencing mental ill-health, receiving brief (i.e., 1–12 sessions), digitally delivered (at least partially) psychological interventions that were guided or partially guided, tested in a type of experimental study, with a socioemotional outcome. Specific socioemotional outcomes examined were depression, anxiety, stress, wellbeing, mindfulness, and quality of life. A systematic search of the contemporary published and grey literature identified 22,482 records with 32 relevant records published between 2018 and 2023. A narrative synthesis guided integration of findings. Results demonstrated strong evidence for the effectiveness of guided interventions on socioemotional outcomes (i.e., depression, anxiety, stress) yet these effects were short-lived. When factoring in the use of different control groups (i.e., active vs. inactive), inconsistent effects were observed for the socioemotional outcomes of depression, anxiety, and stress. The mode of delivery (i.e., asynchronous, synchronous, combined) and the type of human support personnel did not appear to impact socioemotional outcomes. Results indicate efficacious brief digital interventions for depression and anxiety include refresher/follow-up content, goal setting content, and relapse prevention content. In contrast, poor efficacy is associated with interventions that include homework tasks, self-monitoring, and log-keeping content. PROSPERO, ID CRD42023405812. [ABSTRACT FROM AUTHOR]

Although many young people demonstrate resilience and strength, research and clinical evidence highlight an upward trend in mental health concerns among those aged 12 to 25 years. Youth-specific digital mental health interventions (DMHIs) aim to address this trend by providing timely access to mental health support for young people (12–25 years). However, there is a considerable gap in understanding young people user experiences with digital interventions. This review, co-designed with Australia's leading mental health organization Beyond Blue, utilizes a systematic methodology to synthesize evidence on user experience in youth-oriented digital mental health interventions that are fully or partially guided. Five relevant online databases were searched for articles published from 2018 to 2023, yielding 22,482 articles for screening and 22 studies were included in the present analysis. User experience outcomes relating to satisfaction and engagement were assessed for each included intervention, with experience indicators relating to usefulness, usability, value, credibility, and desirability being examined. Elements associated with positive/negative outcomes were extracted. Elements shown to positively influence user experience included peer engagement, modern app-based delivery, asynchronous support, and personalized content. In contrast, users disliked static content, homework/log-keeping, the requirement for multiple devices, and social media integration. Asynchronous interventions showed high satisfaction but faced engagement issues, with combined asynchronous/synchronous interventions reporting better completion rates. DMHIs offer a promising platform for youth mental health support and has the potential to dramatically increase the reach of interventions through the adoption of technological and user experience best practices. While young people respond positively to many aspects of intervention modernization, such as interactive, app-based design, other concepts, such as social media integration, they need to be adopted by the field more cautiously to ensure trust and engagement. Trial Registration CRD42023405812 [ABSTRACT FROM AUTHOR]

Background: Youth mental health is a major health concern in almost every country. Mental health accounts for about 13% of the global burden of disease in the 10-to-19-year age group. Still there are significant gaps between the mental health needs of young people and the quality and accessibility of available services. Collaboration between health and social service actors is a recognized way of reducing gaps in quality and access. Yet there is little scientific evidence on how these collaborations are applied, or on the challenges of cross-boundary collaboration in the youth mental health space. This study aims to explore how collaboration is understood and practiced by professionals working in the Swedish youth mental health system. Methods: We conducted 42 interviews (November 2020 to March 2022) with health and social care professionals and managers in the youth mental health system in Sweden. Interviews explored participants' experience and understanding of the purpose, realization, and challenges of collaboration. Data were analysed under an emergent study design using reflexive thematic analysis. Results: The analysis produced three themes. The first shows that collaboration is considered as essential and important, and that it serves diverse purposes and holds multiple meanings in relation to professionals' roles and responsibilities. The second addresses the different layers of collaboration, in relation to activities, relationships, and target levels, and the third captures the challenges and criticisms in collaborating across the youth mental health landscape, but also in growing possibilities for future development. Conclusion: We conclude that collaboration serves multiple purposes and takes many shapes in the Swedish youth mental health system. Despite the many challenges, participants saw potential in further building collaboration. Interestingly our participants also raised concerns about too much collaboration. There was scepticism about collaboration directing attention away from young people to the professionals, thereby risking the trust and confidentiality of their young clients. Collaboration is not a panacea and will not compensate for an under-resourced youth mental health system. [ABSTRACT FROM AUTHOR]

Background:Child and youth mental health problems represent a substantial burden of illness in Canada, with appropriate services only inconsistently available. Charitable organizations, such as Kids Help Phone (KHP), are, therefore, crucial to filling system gaps by offering 24/7 phone, chat, texting, and peer-to-peer services. Methods:We describe the services provided by KHP, the volume of use for each service, and compare usage across Canada's provinces and territories for a 5-year period from January 2018 to December 2022. Trends seen during the COVID-19 pandemic are highlighted. Results:More than 1.5 million total number of conversations were held across texting, chat, and phone services over 5 years. Considerable growth is demonstrated between 2018 and 2022, and many of the highest peaks in volume occurred in March or April of 2020, the onset of the COVID-19 pandemic. The highest proportional volumes were consistently from the northern territories. Discussion:KHP cannot provide specialized or repeat services, nor can it alone meet the scale of unmet youth mental health needs across the country. Nonetheless, KHP plays a pivotal role in the Canadian mental health system. Efforts to understand the role that KHP and other e-mental health services like it play within the national mental health landscape should be intensified to aid in understanding unmet needs, identify system gaps, and make needed enhancements. [ABSTRACT FROM AUTHOR]

Rates of youth behavioral health concerns have been steadily rising. Administrative data can be used to study behavioral health service utilization among youth, but current methods that rely on identifying an associated behavioral health diagnosis or provider specialty are limited. We reviewed all procedure codes billed to Medicaid for youth in one U.S. county over a 10-year period. We identified 158 outpatient behavioral health procedure codes and classified them according to service type. This classification system can be used by health services researchers to better characterize youth behavioral health service utilization. [ABSTRACT FROM AUTHOR]

The devastating impact of youth mental health concerns is increasingly evident on a global scale. This crisis calls for innovative solutions that are sufficiently accessible, scalable, and cost-effective to support diverse communities around the world. One such solution involves engagement in the arts: incorporating and building upon existing local resources and cultural practices to bolster youth mental health. In this article, we describe the global youth mental health crisis and note major gaps in the knowledge and resources needed to address it. We then discuss the potential for arts- and culture-based strategies to help meet this challenge, review the mounting evidence regarding art's ability to support mental health, and call for action to undertake critical research and its translation into accessible community practices. Four steps are suggested: (1) elevate and prioritize youth voice, (2) develop core outcome measures, (3) identify and analyze successful models around the globe, and (4) generate clear funding pathways for research and translational efforts. Worldwide implementation of arts- and culture-based strategies to address youth mental health will provide critical resources to support the health, wellbeing and flourishing of countless youth across the globe. [ABSTRACT FROM AUTHOR]

Background: For youth receiving care in community mental health centers, comorbidities are the rule rather than the exception. Using measurement-based care (MBC), or the routine evaluation of symptoms to inform care decisions, as the foundation of treatment for youth with comorbid problems significantly improves the impact of psychotherapy by focusing care and building engagement and alliance. MBC increases the rate of symptom improvement, detects clients who would otherwise deteriorate, and alerts clinicians to non-responders. Despite its demonstrated utility, MBC is rarely implemented with fidelity; less than 15% of providers report using MBC per recommendations. Previous efforts to support MBC implementation have yielded suboptimal outcomes, in part, due to organizations' challenges with identifying and prioritizing barriers and selecting and developing strategies to overcome them. New methods are needed for identifying and prioritizing barriers, and matching strategies to barriers to optimize MBC implementation and treatment quality to improve youth mental health outcomes in community settings. Methods: Pragmatic implementation methods will be piloted in four diverse community mental health centers. Methods include (a) rapid evidence synthesis; (b) rapid ethnography; (c) design kits (e.g., kits with disposable cameras, journals, maps); (d) barrier prioritization, and (e) causal pathway diagramming. These activities will generate actionable barriers; subsequently, we will use facilitated group processes to prioritize barriers and develop causal pathway diagrams to match strategies to barriers to create implementation plans that optimize MBC fidelity (Aim 1). We will track strategy deployment for 6 months, then compare MBC fidelity for another 6 months post-implementation with data from 2 years of historical controls (Aim 2). Finally, we will co-design a toolkit for design kit methods with youth and the practice and scientific communities (Aim 3). Discussion: Optimizing MBC implementation in community mental health centers could transform youth mental health care by ensuring the most pressing symptoms are targeted early in treatment. The discussion section highlights expected challenges and limits to using the five methods, including recruitment and engagement given the high pressure on community mental health settings. Trial registration: Clinicaltrials.gov. NCT05644756. Registered on 18 November 2022. This trial was retrospectively registered. [ABSTRACT FROM AUTHOR]

Standardized assessment measures are important for accurate diagnosis of mental health problems and for treatment planning and evaluation. However, little is known about youth mental health providers' typical use of standardized measures across disciplines and outside the context of evidence-based practice initiatives. A multidisciplinary national survey examined the frequency with which 674 youth mental health providers administer standardized and unstandardized measures, and the extent to which organizational (i.e., implementation climate, rigid hierarchical organizational structure) and provider (i.e., attitudes toward standardized assessment measures, highest degree, practice setting) characteristics are associated with standardized measure use. Providers used unstandardized measures far more frequently than standardized measures. Providers' perceptions (a) that standardized measures are practical or feasible, (b) that their organization supports and values evidence-based practices, and (c) that their organization has a rigid hierarchical structure predicted greater use of standardized measures. Working in schools predicted less frequent SMU, while working in higher education and other professional settings predicted more frequent SMU. Standardized measures were not routinely used in this community-based sample. A rigid hierarchical organizational structure may be conducive to more frequent administration of standardized measures, but it is unclear whether such providers actually utilize these measures for clinical decision-making. Alternative strategies to promote standardized measure use may include promoting organizational cultures that value empirical data and encouraging use of standardized measures and training providers to use pragmatic standardized measures for clinical decision making. [ABSTRACT FROM AUTHOR]

Aim: Innovative youth mental health services around the globe vigorously work on increasing highly needed mental health care accessibility but their service users and care effectiveness have rarely been studied. The Dutch youth walk‐in centres of @ease opened in 2018, with currently 11 locations at which free anonymous peer‐to‐peer counselling is offered to young people aged 12–25. The aim of this protocol is to outline the to‐be‐conducted research at @ease. Methods: Three studies are outlined: (1) an outcome evaluation of @ease visits using hierarchical mixed model analyses and change calculations, (2) a cost‐of‐illness study using calculations for costs of truancy and care usage among these help‐seeking young people, with regression analyses for risk group identification, and (3) a follow‐up evaluation at three, six and 12 months to assess long‐term effects after ending @ease visits. Data provided by young people include demographics, parental mental illness, truancy, past treatment, psychological distress (CORE‐10) and health‐related quality of life (EQ‐5D‐5L). Social and occupational functioning (SOFAS), suicidal ideation and need for referral are rated by the counsellors. Questionnaires are filled out at the end of every visit and at follow‐up via e‐mail or text, provided permission is given. Discussion: Research regarding the visitors and effectiveness of the @ease services is fully original. It offers unique insights into the mental wellbeing and cost‐of‐illness of young people who may otherwise remain unseen while suffering from a high disease burden. The upcoming studies shed light on this unseen group, inform policy and practice and direct future research. [ABSTRACT FROM AUTHOR]

Aim: Non‐attendance at appointments in youth mental health services is a common problem which contributes to reduced service effectiveness and unmet needs. Reasons cited by young people for non‐attendance are poorly understood. Information derived from short‐message‐service (SMS) conversations about appointments between patients and clinicians can uncover new insights about the circumstances leading to 'did not attend' events. Methods: Text messages between young people and clinicians were examined in a retrospective audit of medical records in two youth mental health services in Perth, Australia. Frequently non‐attending young people aged 16–24 (n = 40) engaged in 302 SMS message chains about appointments. Mixed methods included quantitative data and qualitative thematic analysis of textual data. Results: Medical reasons (32/190, 16.8%) and forgetfulness (20/190, 10.5%) were the most frequent reasons for non‐attendance. Major issues included non‐avoidable events while others were potentially preventable and could be addressed by the service. Conclusions: The analysis of mobile communications in clinical practice can be used for service evaluation and to reveal barriers that impede attendance to ongoing care. [ABSTRACT FROM AUTHOR]

Irritability is often described as a common problem affecting youth referred for mental health services; however, little is known about the prevalence and nature of irritability as a focus of treatment. We examined assessment data from a diverse sample of youths (N = 206; ages 7–15; 52% male, 48% female; 33% White, 27% Black, 25% Latinx) referred for outpatient treatment of emotional and behavioral concerns. Caregivers and youths completed nomothetic (standardized checklist) and idiographic (free response) measures at intake. Irritability was identified as a top problem (TP) in 58% of cases, commonly reported by caregivers (38%), youths (42%), or both (23%)—rates that were significantly greater than those of other TP domains (depression, anxiety, ADHD, conduct, and defiance). Further analyses identified clinical correlates of irritability TPs, with results supporting the incremental utility of multiple informants and methods. Findings suggest that irritability is among the most common problems for which families seek youth treatment. [ABSTRACT FROM AUTHOR]

Australia's mental health system is failing young people. Calls for accountability, strategic long-term policy planning, and regional leadership have been identified as solutions to guide mental health reform. Developing system dynamics models using a participatory approach (participatory systems modelling (PSM)) is recognized as a useful method that can support decision-making for strategic reform. This paper reports evaluation findings of a youth mental health PSM process conducted in the Australian Capital Territory (ACT). Baseline and follow-up mixed-methods evaluation data were collected in 2022 across diverse stakeholder groups to investigate the feasibility, value, impact, and sustainability of PSM. Although youth mental health system reform was viewed as desirable and a necessity across all stakeholder groups, shared perceptions of disabling powerless was observed regarding their ability to influence current decision-making processes to improve the youth mental health system. This suggests greater accountability is required to support systemic reform in youth mental health. PSM offers promise in improving transparency and accountability of decision-making for youth mental health, as exemplified in the ACT. However, more support and time are required to facilitate transformational change. Future research should investigate empowerment strategies to complement the implementation of findings from dynamic models developed through PSM, as well as the effectiveness of regional youth mental health policy decision-making supported by systems modelling. [ABSTRACT FROM AUTHOR]

Aim: Young people in Hong Kong have been facing numerous population‐level events over the past year, including social unrest and the COVID‐19 pandemic. Representative data concerning the mental health of youths, however, is limited. The Hong Kong Youth Epidemiological Study of Mental Health (HK‐YES) is commissioned to provide the first representative prevalence estimates and correlates of mental disorders among young people in Hong Kong. It will also examine the help‐seeking behaviours, treatment rates, quality of life, and functional outcomes of the young people. More importantly, the direct and indirect economic costs of mental disorders in youths will be estimated. Methods: A total of 4500 community‐dwelling participants aged 15–24 years from Hong Kong will be surveyed. Participants will be selected using a multistage stratified sampling design to provide representative estimates of the youth population in Hong Kong. All interviews will be conducted using computer‐assisted personal interviewing methods for assessments covering areas of psychiatric diagnoses, symptomatology, functioning, quality of life, disability, service utilization, health economic costs of mental disorders, and sociodemographic and lifestyle characteristics. A population‐weighted prevalence will be estimated using survey weights. Methods such as multivariate logistic and linear regression analyses will be used to calculate the risks and odds of factors that might be associated with different mental disorders. Conclusion: As the first population‐based youth study in Hong Kong, HK‐YES collects extensive and representative data on different mental conditions and their associated factors among young people. The information gathered will be important for future planning on youth mental health services in Hong Kong and will offer the opportunity for a more meaningful comparison of data with other youth populations. [ABSTRACT FROM AUTHOR]

One Mind, in partnership with Meadows Mental Health Policy Institute, convened several virtual meetings of mental health researchers, clinicians, and other stakeholders in 2020 to identify first steps toward creating an initiative for early screening and linkage to care for youths (individuals in early adolescence through early adulthood, ages 10–24 years) with mental health difficulties, including serious mental illness, in the United States. This article synthesizes and builds on discussions from those meetings by outlining and recommending potential steps and considerations for the development and integration of a novel measurement-based screening process in youth-facing school and medical settings to increase early identification of mental health needs and linkage to evidence-based care. Meeting attendees agreed on an initiative incorporating a staged assessment process that includes a first-stage brief screener for several domains of psychopathology. Individuals who meet threshold criteria on the first-stage screener would then complete an interview, a second-stage in-depth screening, or both. Screening must be followed by recommendations and linkage to an appropriate level of evidence-based care based on acuity of symptoms endorsed during the staged assessment. Meeting attendees proposed steps and discussed additional considerations for creating the first nationwide initiative for screening and linkage to care, an initiative that could transform access of youths to mental health screening and care. [ABSTRACT FROM AUTHOR]

Objective: This study utilised digital technology to assess the clinical needs of young people presenting for care at headspace centres across Australia. Method: 1490 young people (12–25 years) who presented to one of 11 headspace services from four geographical locations (urban New South Wales, urban South Australia, regional New South Wales, and regional Queensland) completed a digital multidimensional assessment at initial presentation. Characteristics were compared between services and geographical locations. Results: We identified major variation in the demographics, and the type and severity of needs across different services. Individuals from regional services were more likely to be younger, of Aboriginal and Torres Strait Islander origin, and present with psychotic-like symptoms and suicidality, while those in urban areas were more likely to have previously sought help and have problematic alcohol use. Further differences in age, distress, depressive symptoms, psychotic-like experiences, trauma, family history, alcohol use, education/employment engagement, and days out of role were identified between different urban sites. Conclusions: The variability between services provides insight into the heterogeneity of youth mental health populations which has implications for appropriate early intervention and prevention service provisions. We propose that integrating digital technologies has the potential to provide insights for smarter service planning and evaluation. [ABSTRACT FROM AUTHOR]

This work centers the voices of Indigenous young people to explore how they are defining and enacting self-determination, and how these expressions of self-determination influence the wellness of these young people and their communities. Thematic analysis was used to analyze 15 interviews with Indigenous young people about how they understood wellness in the context of their community work. Interview transcripts were analyzed to understand how young people conceptualized and enacted selfdetermination and its relationship to wellness, and to identify underlying connections to Indigenous self-determination theory. Results indicate that Indigenous young people define and enact selfdetermination through traditional healing and embracing cultural wellness practices; through sharing lived experience and meeting people where they are at; and through community inclusion and intuitive practice. Implications for researchers, policymakers, and care providers who work with Indigenous young people are considered. [ABSTRACT FROM AUTHOR]

Background: The involvement of young people as peer researchers, especially with lived experience, is increasingly considered important in youth mental health research. Yet, there is variation in the understanding of the role, and limited evidence on its implementation across different research systems. This case study focusses on the barriers and enablers of implementing peer researcher roles within and across majority world countries contexts. Methods: Based on an international youth mental health project involving different levels of peer researchers and participants from eight countries, peer researchers and a co-ordinating career researcher reflect on lessons regarding enabling and challenging factors. These reflections are captured and integrated by a systematic insight analysis process. Results: Building on existing international networks, it was feasible to actively involve peer researchers with lived experience in a multi-country mental health study, who in turn recruited and engaged young participants. Identified challenges include the terminology and definition of the role, cultural differences in mental health concepts, and consistency across countries and sites. Discussion: Peer researchers' role could be strengthened and mainstreamed in the future through ongoing international networks, training, sufficient planning, and active influence throughout the research process. Trial registration: Not applicable. Plain English summary: The involvement of young people with lived experience as collaborators (peer researchers) in mental health research has become more prominent in recent years. Yet, there is variation in the understanding of this role and how to involve young people. There is also limited evidence on how this role can be applied across different research systems, especially in majority world countries. We share our experience from a youth mental health project involving peer researchers in eight countries. Peer researchers and the co-ordinating career researcher reflected on lessons regarding enabling and challenging factors. Their reflections highlighted that, overall, it is feasible to successfully involve young people with lived experience in international mental health research. Several challenges were also identified, including terminology, definition of roles, cultural differences in understanding mental health, and consistency across participating countries and sites. According to peer researchers' reflections, these challenges can be overcome through the establishment of ongoing international networks, training and support, sufficient planning and peer researchers getting involved at all the stages of the research. Lessons from this case study can be of interest to the international research community in strengthening the involvement of young people in mental health research. [ABSTRACT FROM AUTHOR]

With growing diversity within the U.S. population and notable barriers to accessing behavioral health care, marginalized youth are placed at risk for developing psychosocial and mental health problems. Promoting evidence-based interventions (EBIs) through school-based mental health services may improve accessibility and quality of care for marginalized youth facing mental health disparities. Culturally sensitive interventions (CSIs) may further improve engagement with and effectiveness of EBIs with marginalized youth. In this article, we provide guidelines for advancing CSIs when implementing and adapting EBIs with marginalized youth in schools. First, we emphasize inclusive strategies for advancing CSIs with marginalized youth in schools, focusing on antiracist adaptations to interventions and using a community-based participatory research approach when implementing EBIs. Following, we discuss techniques for tailoring CSIs to more effectively support marginalized youth and their families with school-based prevention and treatment. Specifically, we recommend using the Adapting Strategies for Promoting Implementation Reach and Equity framework as a guide to promote equitable implementation as well as key strategies for engaging marginalized youth and their families with school-based EBIs. Ultimately, we offer these guidelines to address disparities and inform more equitable practice in youth mental health care—and to motivate future studies advancing culturally responsive services with marginalized youth in schools. Public Policy Relevance Statement: Promoting evidence-based interventions (EBIs) through school-based mental health services may improve accessibility and quality of care for marginalized youth facing mental health disparities. Inclusive and culturally sensitive EBIs may be especially useful for addressing inequities in marginalized youths' mental health outcomes. We provide guidelines and practical recommendations for implementing and adapting inclusive and culturally sensitive EBIs with marginalized youth in schools. [ABSTRACT FROM AUTHOR]

Aim: To describe the implementation and outcomes of a combined individual placement and support (IPS) and vocational peer work program for young people with mental ill‐health. Methods: This uncontrolled pilot study co‐located IPS workers and vocational peer workers within two integrated youth mental health services (provided to clients aged 15–25 years old). Employment outcomes included job placements (working 15 hours or more per week in a paid competitive job in the open employment market) and sustained employment (employed for at least 26 weeks). Participants who required additional assistance also received peer work. Results: Of the 326 young people enrolled, 195 (59.8%) achieved competitive employment, including 157 (48.2%) in funder‐approved placements. Among those in approved placements, 87 (55.4%) achieved sustained employment. For the 116 participants additionally receiving vocational peer work, 54 (46.6%) worked in funder‐approved placements, of whom 27 (50.0%) achieved sustained employment. Among 210 participants who did not receive peer work, 103 (49.0%) worked in funder‐approved placements, of whom 60 (58.3%) achieved sustained employment. Conclusions: The program achieved positive vocational outcomes and good fidelity to the IPS model. Approximately half of young people had employment placements, with a relatively high proportion maintained over time. The similar proportion of placements for those who did and did not receive peer work was encouraging given the IPS team determined that the former group needed additional support. Recommendations include upskilling the workforce, a data linkage system to obtain placement evidence, and using implementation science methodologies to understand how IPS programs are successfully embedded. This demands a coordinated effort between governments and funders, policymakers, services, and professional bodies. [ABSTRACT FROM AUTHOR]

Aims: Physical activity interventions are recommended for community‐based youth mental health services to prevent physical health disparities. Implementation is challenging, and studies focusing on the methods to achieve change are needed. This study aims to identify the context, implementation strategies, and implementation outcomes that illustrate how physical activity interventions were implemented within an early intervention service in Australia. Methods: A theoretically informed case study was undertaken. Data from a community‐based youth mental health service that delivers an early psychosis programme were collected between July and November 2020. Three data sources were accessed (1) interviews with service managers, mental health clinicians and exercise physiologists; (2) document review of organizational policies and procedures; and (3) survey using the Program Sustainability Assessment Tool. The implementation outcomes investigated were acceptability, fidelity, penetration, and sustainability. Framework analysis was used, and a logic model developed guided by an established template, to interpret findings. Results: Forty‐three contextual factors and 43 implementation strategies were identified. The data suggests that creating a new clinical team and auditing and feedback are critical for implementation. High levels of acceptability and sustainability were described, while fidelity of implementation was difficult to establish, and penetration was low. Conclusions: The relationship between constructs suggests several mechanisms underpinned implementation. These include changing professional beliefs, establishing new organizational norms, augmenting existing work processes, and aligning physical activity with priorities of the mental healthcare system and existing work tasks. This case study provides direction for future health service planning of physical activity interventions in community‐based youth mental health service. [ABSTRACT FROM AUTHOR]

Aim: The need for youth‐friendly early intervention services to meet the mental health, substance use, primary care, and other social needs of adolescents and young adults is well‐documented. This article describes Youth Wellness Hubs Ontario, a province‐wide initiative in Ontario, Canada to build and implement a one‐stop‐shop model of integrated youth services. Methods: We describe the development of Youth Wellness Hubs Ontario, in the context of global youth mental health system transformation, as well as pan‐Canadian youth mental health system change. We also describe Youth Wellness Hubs Ontario's values and services. Results: The demonstration phase of Youth Wellness Hubs Ontario was initiated in 2017–2018. Youth Wellness Hubs Ontario is co‐created with youth for youth aged 12–25 years old across diverse community contexts. Youth Wellness Hubs Ontario centres engagement and equity, and offers developmentally‐appropriate services in an integrated, community‐based walk‐in format. As an initiative committed to continuous learning and quality improvement, Youth Wellness Hubs Ontario offers evidence‐based and evidence‐generating services, and measurement‐based care. Youth Wellness Hubs Ontario is supported by backbone resources with expertise in implementation science, health equity, Indigenous practices, youth and family engagement, evaluation, and knowledge translation. In 2020 Youth Wellness Hubs Ontario secured sustainable funding for the first 10 locations and scale‐up began in 2021, with 10 additional locations in development. Conclusions: Youth Wellness Hubs Ontario demonstrates the feasibility of integrated mental health and substance use early intervention services, offered in the context of a broad range of health and social services. [ABSTRACT FROM AUTHOR]

Aim: Although mental disorders often emerge early in life, only a minority of young people receive timely and appropriate mental health care. A worldwide youth mental health movement aims to prevent development and persistence of psychiatric disorders. As part of this movement, the first four @ease centres were opened in the Netherlands. @ease is a youth driven, professionally supported initiative, providing peer‐to‐peer counselling, anonymous and free of charge, for people aged 12–25. Methods: Data consist of a detailed description of the working method of @ease, combined with characteristics of all young people accessing the services between its inception (January 2018) and July 2020. Results: Young‐adult peers, including experts by experience, served as counsellors after training in listening, motivational interviewing and solution‐focused strategies. They were supervised by a diverse group of healthcare professionals. A total of 291 visitors, aged 21 on average, were satisfied to very satisfied with @ease's services. Psychosocial distress, social functioning and quality of life measures at first visit showed moderate to severe levels of impairment, and almost half of all visitors reported skipping classes. One third reported parental mental illness, 28% suicidal ideations, and 11% had made specific plans. Less than a third of visitors had received mental health care in the 3 months prior to their visit. Conclusion: This study showed the need for and feasibility of a youth driven, professionally supported organization offering peer‐to‐peer counselling in the Netherlands. Its flexible and individualized working method enables @ease to normalize problems when possible and intervene when necessary. [ABSTRACT FROM AUTHOR]

Objective: We describe a research program to advance youth mental health service research in Australia, addressing two core knowledge gaps: the lack of available routine outcome measures and lack of understanding of how to assess and monitor complexity and heterogeneity in illness presentation and trajectory. Conclusions: Our research identifies better routine outcome measures (ROM) that are: designed specifically for the developmental nuances of the 12–25-year age range; multidimensional; and meaningful to young people, their carers, and service providers. Alongside much-needed new measures of complexity and heterogeneity, these tools will inform service providers to better meet the needs of young people presenting with mental health problems. [ABSTRACT FROM AUTHOR]

Publicly funded initiatives are underway to improve implementation of evidence-based practices (EBP) in youth mental health services. However, we know little about the success of these initiatives or about EBP implementation independent of such initiatives. We examined EBP implementation in a treatment as usual (TAU) state and in six states with publicly funded EBP initiatives (EBPIs). In Study 1, we examined providers' use of practices derived from the evidence base (PDEB) and their predictors among 780 providers in a TAU state. In Study 2, we conducted a systematic review of implementation strategies, outcomes, and predictors of EBP use in six state funded EBPIs. Study 1 suggests TAU providers use PDEB alongside practices without consistent research support; provider racial/ethnic minority status, learning theory orientation, and manual use predict greater PDEB use. Study 2 indicates EBPIs employ multiple recommended implementation strategies with variable outcomes across studies and measurement approaches. Predictors of EBP use in EBPIs also varied, though training, setting, and youth age were consistent predictors across studies. While sample differences and inconsistent measurement across studies made direct comparisons somewhat tenuous, rates of PDEB use in the TAU sample appeared similar to those in publicly funded EBPIs. However, two states reported comparisons with TAU samples and found higher EBP implementation under EBPI. Different predictors impacted EBP use in TAU versus EBPIs. Our findings highlight the need for improved evaluation of EBPIs including clear reporting standards for outcomes and more consistent, standardized measurement of EBP use in order to better understand and improve EBPIs. [ABSTRACT FROM AUTHOR]

Aim: The COVID‐19 pandemic has presented significant challenges for young people and youth mental health services. To address a gap in knowledge about the impact of the pandemic and associated restrictions on youth mental health services, this paper examined the nature of young people's engagement with Jigsaw's brief intervention service during the pandemic. Method: Data gathered from young people engaging with Jigsaw's brief intervention service in the 12 months after the official declaration of the COVID‐19 pandemic (n = 6161), and 12 months prior (n = 8665) were examined. Results: There were less referrals to Jigsaw during the pandemic, especially during lockdown periods, but this rebounded when public health restrictions were eased. A higher proportion of females (p <.001) and 12–17 year olds (p <.001) were referred during the pandemic period. There was an increase in the proportion of young people who presented with anxiety (p <.001) and sleep changes (p <.001). Although 12–16 year olds reported significantly higher levels of distress during the pandemic (p <.05), the effect size was small. Young people reported high levels of satisfaction with the new phone/video modes of support offered by Jigsaw, and the overall attendance rate improved during the pandemic period. Conclusions: The impact of COVID‐19 on young people's mental health needs to be considered as a priority. This paper is helpful for services considering the long‐term mental health needs of young people, and the best way of meeting those needs. [ABSTRACT FROM AUTHOR]

Aim: Residential group care is an important service for vulnerable young people experiencing mental health, substance abuse and/or behavioural challenges. Yet little is written about specific models and their outcomes, especially from the perspectives of the young people who use these services. This project aimed to explore what matters to young people living in a 12‐month voluntary residential program for young people aged 16–25. Methods: This participatory action research study was co‐produced with Youth Residential Rehabilitation Service residents and staff as co‐researchers. A steering group comprising residents, staff and researchers oversaw all research stages. 18 young people and 17 staff members participated in either individual or group interviews to discuss what was important in Youth Residential Rehabilitation Services. Data analysis drew on grounded theory techniques; subsequent codes and themes were refined in the steering group. Results: We identified the 'change work' that young people were expected to do, and the milieu factors that created a supportive environment. As young people were figuring out their directions and learning new skills, they needed to be understood as the developing expert of their own lives. Real relationships with staff and other young people created a culture of belonging, safety and feeling known. These findings are metaphorically captured in the image of an egg. Conclusions: Our study highlights that real relationships between all Youth Residential Rehabilitation Service community members are central to creating the atmosphere of safety and belonging that enables healing and self‐development to occur. [ABSTRACT FROM AUTHOR]

Introduction: Adolescents and young adults represent a vulnerable population in the context of the Coronavirus disease 2019 (COVID-19) pandemic. The present retrospective study aims to investigate the pandemic's psychological impact on adolescents and young adults by analyzing data from an outpatient mental health service dedicated to youths in Umbria, central Italy. Materials and Methods: The clinical charts of subjects aged 14–24 who first accessed the service in the timeframe between March 1st, 2019, and February 28th, 2021, were reviewed. Subjects were divided into two subgroups according to the period of time when they accessed the service (pre-COVID-19 vs. during- COVID-19 outbreak). Bivariate analyses were performed using the Chi-square test and the Welch's t -test. A secondary analysis was performed considering only subjects suffering from psychiatric disorders. Furthermore, data concerning individuals who were already followed by the service before the pandemic were analyzed by the McNemar's test and the t -paired test to assess changes in treatment features. Results: The number of new accesses during the pandemic period remained stable. After the emergency onset, youths accessing the service showed a higher prevalence of anxiety disorders (p = 0.022). During the COVID-19 period, services were more frequently delivered by using a digital mental health approach (p = 0.001). Psychopharmacological treatment was more frequently prescribed among subjects that were referred to the service after the pandemic onset (p = 0.033). As for substance use, a highly significant reduction in opioid use was observed (p = 0.003). Family therapy was delivered less frequently in the during-COVID-19 subgroup, especially in the subpopulation of subjects suffering from psychiatric disorders (p = 0.013). When considering subjects referred to the service in the pre-COVID-19 period, the number of interventions provided to this population increased after the pandemic outbreak (p = 0.038). Conclusion: In the context of the COVID-19-related public health crisis, youths represent an at-risk population for which pathways to care should be reinforced, and targeted interventions, including psychosocial treatments, should be implemented. [ABSTRACT FROM AUTHOR]

Objectives: LevelMind@JC youth mental wellness hubs have been launched as a novel early intervention initiative to mitigate the inevitable youth mental health problems in Hong Kong in 2019. The present study investigated the perceptions and experiences of these hubs amonst three key stakeholders, namely hub youths, hub carers of youths and hub staff. Method: An online survey assessing the perceptions and experiences of hubs on 6 major domains (e.g., youth‐friendly and nonstigmatizing characteristics) was administered to three stakeholders in December 2020. Seventy‐one hub youths (12–35 years old), 18 hub carers (30–64 years old) and 25 hub staff (24–59 years old) completed the survey. Results: On a 5‐point Likert scale with higher ratings representing better outcomes, all three stakeholders reported above‐average ratings on their overall satisfaction of hub experiences (hub youths: mean = 4.4, SD = 0.6; hub carers: mean = 4, SD = 0.8; hub staff: mean = 3.8, SD = 0.6). In addition, hub youths and hub carers reported above‐average ratings on youth‐friendly and nonstigmatizing characteristics regarding hubs (mean >=4.2). Conclusions: The present findings suggest that the key stakeholders are generally satisfied with and show support to the youth‐friendly, empowering and nonstigmatizing LevelMind @JC hubs. These findings along with the suggestions for hub improvement made by the stakeholders highlight the importance of taking cultural values into consideration whilst planning for mental services. More importantly, clinical implications are also highlighted which give insight for the development and implementation of a scalable, effective, and replicable early community intervention for psychiatric practise pertaining to youth mental health. [ABSTRACT FROM AUTHOR]

Aim: There has been a global movement towards transformation of youth mental health services, but limited information on the core principles and characteristics of these new services is available. Jigsaw is one such service, established in Ireland in 2006, with the intent of creating change in Ireland's system of mental healthcare for 12–25 year olds. The aim of this paper is to describe the evolution of Jigsaw services, which are now firmly embedded in the Irish system of care for young people, and recognized internationally as an established service network. Methods: This paper describes provides an up‐to‐date description of the Jigsaw service model, key areas of evolution that have shaped this model, and identifies future directions in service development. Results: Key attributes of the Jigsaw service model including therapeutic service, scope of practice, youth mental health promotion, youth participation, and monitoring/evaluation are described in this paper. Information on key enablers (funding and governance/quality) and service providers is also included. Conclusions: Information on the core principles and characteristics of youth mental health services is important. This paper addresses a gap in the literature by describing the Jigsaw service model, which continues to evolve so that it is responsive to the needs of young people. [ABSTRACT FROM AUTHOR]

Parental factors play a major role in youth mental health and many youth in high-income countries have at least one overseas-born parent. It is, hence, important to understand how immigrant parenting is associated with youth mental health in high-income countries. Following PRISMA guidelines, this review sought to identify modifiable parental factors to inform parenting interventions to prevent mental health problems in youth aged 0–18 years whose parents migrated voluntarily for economic reasons from low and middle-income countries to high-income countries. Sixteen parental factors were identified from 56 studies that were associated with five outcomes – youth self-esteem (k = 17), general stress (k = 4), acculturative stress (k = 4), anxiety symptoms (k = 9), and depressive symptoms (k = 41). A sound evidence base was found for one or more of these outcomes associated with protective factors – caring and supportive parenting and parental monitoring; and risk factors – parent-youth acculturative and general conflict, parental withdrawal, interparental conflict, and parent mental health problems. This systematic review and meta-analysis identified immigrant parental factors that have robust associations with youth mental health outcomes. These findings can be used to inform parenting interventions and support immigrant parents in preventing youth mental health problems. • Immigrant parental factors are associated with youth self-esteem, general and acculturative stress, and anxiety and depressive symptoms. • Immigrant parental factors can be targeted in parenting interventions. • Parenting interventions for immigrants can improve youth mental health. [ABSTRACT FROM AUTHOR]

Background: There is a significant push to change the trajectory of youth mental ill-health and suicide globally. Ensuring that young people have access to services that meet their individual needs and are easily accessible is a priority. Genuine stakeholder engagement in mental health system design is critical to ensure that system strengthening is likely to be successful within these complex environments. There is limited literature describing engagement processes undertaken by research teams in mental health program implementation and planning. This protocol describes the methods that will be used to engage local communities using systems science methods to mobilize knowledge and action to strengthen youth mental health services. Methods: Using participatory action research principles, the research team will actively engage with local communities to ensure genuine user-led participatory systems modelling processes and enhance knowledge mobilisation within research sites. Ensuring that culturally diverse and Aboriginal and Torres Strait Islander community voices are included will support this process. A rigorous site selection process will be undertaken to ensure that the community is committed and has capacity to actively engage in the research activities. Stakeholder engagement commences from the site selection process with the aim to build trust between researchers and key stakeholders. The research team will establish a variety of engagement resources and make opportunities available to each site depending on their local context, needs and audiences they wish to target during the process. Discussion: This protocol describes the inclusive community engagement and knowledge mobilization process for the Right care, first time, where you live research Program. This Program will use an iterative and adaptive approach that considers the social, economic, and political context of each community and attempts to maximise research engagement. A theoretical framework for applying systems approaches to knowledge mobilization that is flexible will enable the implementation of a participatory action research approach. This protocol commits to a rigorous and genuine stakeholder engagement process that can be applied in mental health research implementation. [ABSTRACT FROM AUTHOR]

Aim: A range of residential supports is available for young people experiencing mental health challenges. One Australian example is the Youth Residential Rehabilitation Service, which provides up to 12 months of intensive psychosocial support in a residential setting to young people aged 16–25 experiencing serious mental health challenges. This paper aimed to add to the scant literature on these services, describing the experiences of young people and staff members across the duration of a stay. Methods: This study drew on collaborative autoethnography to engage and centre the direct lived experience of young people who had lived, and staff who had worked, in a Youth Residential Rehabilitation Service. Results: We identified three phases that young people typically journey through during their stay at the service. The Arriving phase was marked by appropriate referrals, a warm welcome, a period of settling in and the development of trusting relationships. The Discovering phase saw young people identifying and enacting their strengths, hopes and values. Community connections were a focus of the Continuing phase as lives after service exit were envisioned and created. Conclusions: Drawing on collaborative autoethnography methods represents one approach to amplify the voice of young people in service design and evaluation. This paper richly described some of the possibilities and complexities of the Youth Residential Rehabilitation Service experience, which can be used to inform the service's pacing and structure of support. [ABSTRACT FROM AUTHOR]

Aim: Two integrated headspace Early Intervention Teams (hEITs) were established in 2017 to bridge gaps between headspace, the national primary care youth mental health programme in Australia, and the state funded secondary and tertiary mental health services. This study aims to describe functioning and outcomes of patients referred to hEIT over a 6‐month period. Methods: A retrospective file audit was conducted for all patients accepted into the service over a 6‐month period in 2018. Measures of distress, functioning and client satisfaction were collected and analysed. Exemplar vignettes were created to construct hypothetical examples and illustrate research findings. Results: At admission, the three most common presentations were depression/anxiety, trauma and stress related, and psychotic disorders. During their time in the service, young people displayed a statistically significant improvement in functioning, reduction in self‐harm in those 18 years and under, and a trend to reduction in distress scores. hEIT delivered a broad range of services covering social, occupational, educational, medical and mental health care, and the service was experienced positively by the patient cohort. Conclusions: hEIT appears to meet the needs of young people requiring greater care than primary care services can deliver. The integrated, wrap‐around care coordination facilitates treatments across social, educational and health domains. Further exploration of young people who disengage from care, improved outcome data reporting and economic evaluation are indicated. [ABSTRACT FROM AUTHOR]

Keywords: Caregiver-child relationship; Peer relationships; Developmental psychopathology; Youth mental health EN Caregiver-child relationship Peer relationships Developmental psychopathology Youth mental health 5 7 3 03/13/23 20230101 NES 230101 Adaptive relationships play a major role in healthy child development. Just as parental mental illness and adverse childhood experiences, child characteristics such as temperament and psychopathology shape the caregiver-child relationship and can pose challenges on parenting. Caregiver-child relationship, Developmental psychopathology, Youth mental health, Peer relationships. [Extracted from the article]

Background: Given the diversity that exists within youth mental health there is an ongoing concern that standardised evidence-based responses are not effectively addressing the levels of psychological distress experienced by some youth. It is becoming more evident in the use of crisis mental health services that alternative clinical pathways that consider the impact of developmental trajectories, subjective, social, and cultural beliefs on psychological distress are imperative. Aim: This mixed studies review sought to find effective Personalised Interventions (PIs) within Europe and the UK that could highlight an alternative pathway for youth accessing a mental health service. Methods: Empirically supported psychological interventions tailored to a youth or youth subgroup, modified modular psychological interventions, psychological interventions to target youth environments, and qualitative research that can inform or equate to a PI were searched in two large databases and then cross synthesised. Results: 21 studies met inclusion criteria. Nine quantitative studies had attendance rates of 82-89% and significant treatment outcomes. All 12 qualitative studies showed evidence of engagement and treatment outcome themes. Conclusion: PIs in this review evidence engagement and treatment effectiveness but may be underutilised for hard to reach and culturally diverse youth in Europe and the UK. [ABSTRACT FROM AUTHOR]

All too often policymakers have called upon teachers to attend to youth mental health in the classroom and school counselors have largely been left out of the discussion. The American School Counseling Association (ASCA) Model (2019) advocates for the practicing role of school counselors in providing direct service to youth. The Coalition model presented in this paper is a way for communities to support school counselors, and vice versa, in providing mental health services to youth in schools. [ABSTRACT FROM AUTHOR]

Aim: Late teens and early adulthood is the peak age of onset for mental disorders. Currently, there is a gap between primary mental health care and more intensive mental health services for young people in New South Wales (NSW), Australia. Two headspace Early Intervention Teams (hEITs) were developed to bridge this gap in Sydney Local Health District (SLHD), in Sydney, Australia. This study aims to explore clinician experiences of hEIT after the first 2 years of implementation. Methods: Semistructured interviews were conducted with key clinicians working within hEIT or closely associated with hEIT. Nine interviews were conducted, transcribed and analysed using qualitative thematic analysis. Results: Four themes were identified: (1) building a bridge between services, (2) filling a clinical gap, (3) service collaborations and their challenges and (4) difficulties of small team size. Conclusions: There is evidence that clinicians value the service provided by hEIT. There are difficulties such as referral confusion, staff turnover and suggestions to increase staffing to improve the stability, skill diversity and viability of the service. Findings have implications for other collaborative youth mental health models. [ABSTRACT FROM AUTHOR]

For example, the National Comorbidity Survey Replication - Adolescent Sample[2] showed that in 13-18-year olds, around 40% of youth with one mental health or substance use disorder also had another (comorbid) disorder. To date, little attention has been given to how complex interventions intersect with youth mental health initiatives, despite growing concern regarding rates of mental health problems in young people (exacerbated during the COVID-19 pandemic), and substantial investment into models of youth mental health care. Keywords: complex interventions; clinical high risk; youth mental health EN complex interventions clinical high risk youth mental health 755 757 3 09/27/22 20221001 NES 221001 There is growing acknowledgement that complex mental health problems are not readily resolved by one-dimensional solutions, such as medication alone. [Extracted from the article]

Aims: Increasing concerns about the specific needs and rates of mental illness among young adults have spurred the development of youth mental health services. Yet few outcome studies exist. This study aims to evaluate a young adult service in an independent mental health sector in Ireland. Methods: This is a service evaluation using a retrospective, descriptive and naturalistic study design. Routine demographic, diagnostic and service usage data were collected at entry into the service. Outcomes were recorded at discharge from the service using the Clinical Global Impression (CGI) improvement scores. Factors associated with better or worse outcomes were analyzed. Results: Five hundred and sixty‐seven young adults were assessed and managed during a 3‐year period by the Young Adult Service. Their characteristics fell midway between adolescent and adult mental health service populations. They had high levels of Axis I & II co‐morbidities reflecting the complex and fluid nature of emerging conditions in this age group. The majority (62.8%) had clinically improved by the end of follow‐up. Outcomes were significantly better in those who were hospitalized, prescribed psychotropic medication, received 1:1 psychology sessions and attended a group‐based psychology program or group program for specific disorders. One hundred and sixty‐six patients (29.3%) dropped out of follow‐up. Drop out was associated with longer time spent in the service, being treated solely in the community, without medication, not having a developmental disorder and not transferring from CAMHS. Conclusions: This study demonstrates that it is possible to establish an effective youth mental health service with favourable outcomes within a broader mental health system. It provides a benchmark for similar services, bridging the gap between adolescent and adult mental health services. [ABSTRACT FROM AUTHOR]

Aim: The involvement of young people in the development, implementation and evaluation of youth mental health services, policy and research programs is essential to ensure they are appropriate and responsive to the needs of young people. Despite the increasingly central role that youth engagement and participation plays internationally, such activities are rarely described in detail. This article aims to provide a thorough description of the development and implementation of an organization‐wide, 3‐year Youth Engagement and Participation Strategy for Orygen, a national youth mental health organization in Australia. Methods: A descriptive account of the development and implementation of the Strategy, with detailed examples of programs and initiatives. Results: The Strategy was developed based on available evidence, focus groups with key stakeholders and best practice principles. The implementation of the Strategy resulted in a number of programs being delivered that involved a range of young people from across Australia. Despite being successful overall, a number of challenges were experienced. Ongoing considerations include ensuring diversity of partnerships, 'raising the bar' of youth participation and creating meaningful pathways. Conclusions: Youth participation and engagement within a youth mental health context is best seen as an evolving ambition that must remain flexible to the needs of all stakeholders. Despite some challenges and ongoing fine‐tuning, it is possible to successfully implement youth participation and engagement across all areas of youth mental health, including service design and delivery, research and translation, and policy. [ABSTRACT FROM AUTHOR]

Aim: MyLifeTracker is a session‐by‐session mental health outcome measure for young people aged 12 to 25 years. The aim of this study was to determine clinically significant change indexes for this measure that would identify developmentally appropriate thresholds. The study also aimed to determine expected change trajectories to enable clinicians to compare a client's progress against average rates of change. Methods: Participants comprised young people aged 12 to 25 years from both a clinical and a community sample from Australia. The clinical sample was 63 840 young people that attended a headspace centre. The non‐clinical group was an Australian representative community sample of 4034 young people. Results: Clinically significant change indexes were developed for MyLifeTracker specific for age and gender groups by comparing clinical and non‐clinical samples. Males and young people aged 12 to 14 years needed to reach higher scores to achieve clinically significant change compared to females and other age groups, respectively. MyLifeTracker expected change trajectories followed a cubic pattern for those with lower baseline scores of 0 to 50, whereas those with baseline scores of 51 and above had varying patterns. For those with lower baseline scores, expected change trajectories showed that stronger change was evident early in treatment, which then tapered off before accelerating again later in treatment. Conclusions: The development of MyLifeTracker benchmarks allows the measure to be used for Feedback Informed Treatment by supporting treatment planning and decision‐making. This information can help clinicians to identify clients who are not on track or deteriorating and identify when clients are improving. [ABSTRACT FROM AUTHOR]

Background: India has a large youth population whose mental health needs must be addressed. This includes promotion of positive mental health, with early detection and effective intervention for mental health disorders. Understanding the perspectives of community stakeholders working with youth is pivotal to this effort. Current study aimed to bring together a group of community stakeholders (eg, parents, teachers, policy makers) to understand their perspectives on youth mental health problems, challenges in provision of care, and to provide recommendations to address these concerns at national level. Materials and methods: The study was conducted across two sites in India: Chennai and New Delhi. Three group meetings were conducted involving 52 participants, including governmental, non‐governmental and community representatives working with youth. The proceedings were manually recorded, transcribed, and analyzed using thematic analysis method. Results: Many youth mental health problems were similar across the two sites. The commonest drivers of mental health problems were reported to be academic pressure, substance use and problematic internet/social media use. Stigma and lack of awareness were identified as the most important challenges acting as barriers to seeking mental health help by youth. Prioritizing youth mental health as a national programmes along with strong political will were the major recommendations suggested by the stakeholders. Conclusion: Initial findings suggest that prioritizing youth mental health programmes in India would be advantageous. Inclusive and collaborative approach, involving community stakeholders working with youth in providing services that promote mental health and early access to care will help in developing healthy young citizens. [ABSTRACT FROM AUTHOR]