An Online Platform to Provide Work and Study Support for Young People With Mental Health Challenges: Observational and Survey Study.

BACKGROUND: Young people, aged 15-25 years, are at a critical stage of life when they need to navigate vocational pathways and achieve work and study outcomes. Those with mental health problems are particularly at risk of disengagement with work and study and need effective support. The headspace Work and Study (hWS) service is an innovative online platform implemented in Australia to support young people aged 15-25 years with mental health problems to achieve work and study goals. OBJECTIVE: This study aims to determine whether the hWS service has been implemented as planned, provides appropriate support for young people, and achieves its main goals. METHODS: Data were collected via 2 methodologies: (1) the hWS Minimum Data Set, which includes data on all clients in the service (n=1139), services delivered, and service impact; and (2) a survey of hWS clients who volunteered to participate in an evaluation of the hWS service (n=137). RESULTS: The service was accessed by its defined target group, young people aged 15-25 years with mental health and work and study difficulties. Young people found the online platform to be acceptable, and the assistance provided and clinical integration useful; many young people achieved positive work and study outcomes, particularly those who engaged more times with the service. More assistance was sought for work than study goals, suggesting that the transition to work may be particularly challenging for young people. One-third (298/881, 33.8%) of the sample for the service impact analyses achieved at least 1 primary work or study outcome, and this increased to 44.5% (225/506) for those who engaged with 5 or more sessions, demonstrating that greater engagement with the service produced better outcomes. CONCLUSIONS: Critical work and study support can be effectively delivered via an online modality to young people with common mental health problems. Digital services are scaleable to reach many young people and are of particular value for those with difficulty accessing in-person services.

Flattening the curve of mental ill-health: the importance of primary prevention in managing the mental health impacts of COVID-19.

The COVID-19 pandemic is one the biggest challenges the global community has faced this century. The threat of the virus coupled with the impacts of the social and economic shut-down measures required to slow its spread, appear to be impacting on people's mental health and wellbeing. Over the weeks, months and years ahead it is likely that many countries will experience a 'wave' of COVID-19 related mental disorders as a result of an increase in risk factors linked to the pandemic such as social isolation; unemployment; housing and income stress; intimate partner violence; work-related trauma; and grief and loss. The 'two-pronged' approach used to deal with COVID-19, provides an excellent blueprint for managing its mental health impacts as well. Nations must focus on preventing the occurrence of new-onset cases of mental disorders as well as strengthening their mental healthcare response to support people who become mentally unwell. A focus on primary prevention is particularly important to 'flatten the curve' and avoid a surge in incidence of mental disorders stemming from the COVID-19 pandemic. Evidence-based interventions designed to prevent common disorders are already available and should be scaled-up. These interventions include parenting programs, social and emotional learning programs, self-care strategies, and workplace mental wellbeing programs, among others.

Promoting equity in the mental wellbeing of children and young people: a scoping review.

There is increasing emphasis on wellbeing as a target for mental health promotion, especially during the formative period of childhood. Despite growing research on the importance of mental wellbeing, there is little information on how to effectively promote it or how to promote it equitably. This article presents a scoping review of interventions which seek to promote mental wellbeing and reduce inequities in children and young people living in high income countries. We used Fair Foundations: The VicHealth framework for health equity (VicHealth (2013) Melbourne, Australia: The Victorian Health Promotion Foundation) to identify points of entry at three layers of influence: (i) socioeconomic, cultural and political contexts, (ii) daily living conditions, and (iii) individual and family health-related factors. We identified more than 1000 interventions which aimed to prevent or treat childhood mental illness, but there were far fewer that aimed to promote children's or young people's mental wellbeing. The interventions we studied were either universal or specifically targeted children from disadvantaged families: none explicitly used an equity framework to guide their design or evaluation or addressed social gradients in wellbeing. Most interventions remained focused on proximate factors, although we also identified a handful of interventions that sought to address children's access to services and their educational and neighbourhood environments. However, we found encouraging evidence that interventions in family and educational settings were successful in building children's strengths and supporting positive parenting, universally and within disadvantaged groups. Such positive programme evaluations signal the potential for using a proportionate universalism approach that emphasizes equity in the promotion of mental wellbeing.

Emerging psychosis in young people - Part 1 - key issues for detection and assessment.

BACKGROUND: A delay in the recognition of first episode psychosis is common and is often associated with psychological distress, social decline, and as recent evidence suggests, lasting brain changes. It is increasingly evident that early intervention potentially alters the course of these serious mental illnesses. General practitioners are ideally placed to identify early changes that may herald an emergent psychotic illness and to bridge the existing gap between patients, their families and specialist mental health services. OBJECTIVE: This article summarises the rationale and importance of early detection of emerging psychotic illness in young people, and provides practical tips regarding its assessment and detection. DISCUSSION: Early warning signs of emerging psychotic illnesses include behavioural, emotional and cognitive disturbances. Risk factors include a combination of a family history of a psychotic illness coupled with a decline in functioning, or a history of a brief self limiting psychotic episode (even if triggered by drugs such as cannabis or amphetamines). It is important that those working in primary care recognise these features in order to facilitate a speedy referral to specialist youth friendly mental health services, or if such services are not available, to initiate treatment and provide appropriate ongoing management.