ABSTRACT
AIM: Significant overlap and comorbidity has been demonstrated among young people with mental health problems. This paper examined demographic characteristics, heterogeneity of need descriptors and services provided among young people (12-25 years) engaging in brief interventions at Jigsaw in the Republic of Ireland. METHOD: Between 1 January 2013 and 31 December 2013, a total of 2571 young people sought help from 1 of 10 Jigsaw sites. Of these, 1247 engaged in goal-focused brief interventions, typically consisting of one to six face-to-face sessions. Descriptive statistics were used to summarize social and demographic factors. Latent class analysis was used to cluster young people into relevant typologies of presenting issues. Multinomial logistic regression was then performed to determine significant predictors of class membership. RESULTS: The most common age of young people was 16. More women (59.6%) than men engaged in brief interventions, 56% attended school, 74% lived with their family of origin or with one parent, and 54.2% came from families where parents were married. Using established fit criteria, four relevant typologies emerged: Developmental (26.8%), Comorbid (15.8%), Anxious (42.7%) and Externalising (14.6%). Predictors varied by class membership, but general family problems and lack of adult support emerged as the strongest predictors for all classes. CONCLUSION: This study demonstrated that the mental health needs of young people in Ireland are significant and diverse. Because Jigsaw favours a more descriptive approach to problem identification, the four typologies suggest a need to determine program capacity in engaging youth with heterogeneous presenting issues and to tailor brief interventions to each group's clinical profiles.
Subject(s)
Early Medical Intervention/statistics & numerical data , Health Services Needs and Demand/statistics & numerical data , Mental Disorders/diagnosis , Mental Disorders/therapy , Adolescent , Child , Comorbidity , Female , Humans , Ireland , Male , Mental Disorders/psychology , Program Evaluation , 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
There is increasing recognition of the need for evaluations that identify program processes or mediators and assess degree of program implementation rather than focusing solely on outcome evaluation. This paper describes the application of complementary qualitative and quantitative evaluation procedures to assess the degree of implementation of multi-component family support programs for improving educational outcomes for at risk youth, and to assess the relationship between program implementation and outcomes. The qualitative evaluation involved prolonged engagement to identify common program domains or mediators. Using a method called Innovation Configuration Analysis, levels of implementation of program domains were explicated as well as an overall Implementation Fidelity Index. Strong positive relationships were found between overall program implementation and program-level outcomes achieved by student participants.
