ABSTRACT
Despite the evidence showing that young people aged 12-25 years have the highest incidence and prevalence of mental illness across the lifespan, and bear a disproportionate share of the burden of disease associated with mental disorder, their access to mental health services is the poorest of all age groups. A major factor contributing to this poor access is the current design of our mental healthcare system, which is manifestly inadequate for the unique developmental and cultural needs of our young people. If we are to reduce the impact of mental disorder on this most vulnerable population group, transformational change and service redesign is necessary. Here, we present three recent and rapidly evolving service structures from Australia, Ireland and the UK that have each worked within their respective healthcare contexts to reorient existing services to provide youth-specific, evidence-based mental healthcare that is both accessible and acceptable to young people.
Subject(s)
Adolescent Health Services/organization & administration , Child Health Services/organization & administration , Health Policy , Health Services Accessibility/organization & administration , Mental Disorders , Mental Health Services/organization & administration , Adolescent , Adult , Australia , Child , Evidence-Based Medicine , History, 21st Century , Humans , Ireland , Mental Disorders/diagnosis , Mental Disorders/therapy , Referral and Consultation , United Kingdom , Young AdultABSTRACT
BACKGROUND: Young people in the Republic of Ireland do not have access to appropriate mental health services and supports, necessitating transformational change in delivery systems. AIMS: Describe ongoing development and change efforts facilitated by Headstrong--The National Centre for Youth Mental Health. METHODS: Discusses findings from a national needs assessment, core strategies within the change initiative, progress in system-building, and preliminary descriptive and outcome data. RESULTS: Five demonstration sites comprised of four counties and a city neighbourhood are operational and preliminary data are promising with respect to implementation and outcomes. CONCLUSION: Effective change initiatives require vision and leadership, competence- and capacity-building, participative planning and engagement, adequate and thoughtfully deployed resources, and a comprehensive change management approach.
Subject(s)
Adolescent Health Services/trends , Mental Health Services/trends , Adolescent , Child , Female , Humans , Ireland , Male , Needs Assessment , Program Evaluation , Young AdultABSTRACT
BACKGROUND: Irish young people exhibit high levels of psychological distress, but community-based services and supports are often unavailable or inaccessible. AIM: To describe efforts to engage communities in systematic and data-based processes of planning, programme design, implementation, and evaluation. METHOD: Details system-building initiatives in five communities (four counties and a distressed urban site) that will serve as a springboard for full national deployment. RESULTS: Extensive community engagement and planning has occurred in all sites, systems change efforts grounded in detailed business plans have begun, and process and outcome evaluation is underway. CONCLUSION: Needs and resource assessment processes confirmed the magnitude of need, but also suggested the creative re-allocation of local resources. Young people provided invaluable guidance for system design. Creating and sustaining a culture of innovation at each site was challenging, requiring leadership and continuous dialogue.
Subject(s)
Community Mental Health Services/organization & administration , Adolescent , Child , Health Plan Implementation/methods , Health Plan Implementation/organization & administration , Health Planning/methods , Health Planning/organization & administration , Humans , Ireland/epidemiology , Mental Disorders/epidemiology , Mental Disorders/therapy , Models, Organizational , Needs Assessment/organization & administration , Program Development/methods , Program Evaluation/methods , Psychology, Adolescent , Suicide PreventionABSTRACT
Since the publication of "Sustainable Communities--building for the future", Government attention has focused largely on high-density affordable housing in the four "growth areas": Thames Gateway; Ashford; Milton Keynes--South Midlands, and London--Stansted--Cambridge. In this article, Thomas Yeung and Tony Bates suggest that a greater and more sustainable impact would be achieved if architects, planners, and developers considered the potential for community-based water and waste management and on-site energy generation and distribution right from the start of the project. In particular, they consider that the communal nature of hospitals, universities, and public/community housing provides a great opportunity for on-site renewable CHP and/or distributed heating, which could combine global environmental benefits with improved local amenities. They describe a simple model for prioritising energy management in the built environment, and draw on lessons learnt at ETRCL in Dagenham and BedZED in Surrey to offer a few recommendations for Government and developers. Tony Bates is the business development manager for Scott Wilson in the South East and is responsible for the promotion of sustainable communities through relationships with architects, developers, land owners and local authorities. Thomas Yeung leads the Energy Infrastructure Technologies group in Scott Wilson. This team offers an integrated approach to clean community-based energy generation, energy management, waste and water management, sustainable transport, and sustainable buildings/communities.
