Innovations in Practice: Grow2Grow – engaging hard‐to‐reach adolescents through combined mental health and vocational support outside the clinic setting

Abstract

Background Based on an organic farm and education centre, Grow2Grow offers young people with complex mental health needs both clinical mental health support and vocational opportunities. Methods Change in functioning (CGAS), vocational outcomes and client satisfaction were assessed for all young people completing Grow2Grow placements between June 2010 and July 2014. Results Twenty‐one young people completed Grow2Grow placements, achieving increased CGAS scores (p < .001) and reporting high levels of satisfaction with the project. Eighty‐one per cent achieved educational and/or employment outcomes. Conclusion This innovative approach to working with hard‐to‐reach young people is achieving high levels of engagement and positive vocational and mental health outcomes.

Review of services to inform clinical frameworks for adolescents and young adults with severe, persistent and complex mental illness

“…Many sources only described the target group as adolescents and/or young adults with serious mental illness or complex mental health needs. No sources reported the duration of mental illness, although target groups were sometimes described as having been difficult to engage with services (Assan et al, 2008; Conway & Clatworthy, 2015; Schley, Radovini, Halperin, & Fletcher, 2011; Schley, Yuen, Fletcher, & Radovini, 2012) or as having previous out-of-home placements (Assan et al, 2008; McGrew & Danner, 2009; Nadkarni, Blakelock, Jha, Tiffin, & Sullivan, 2012; Underwood, Barretti, Storms, & Safonte-Strumolo, 2004), which are likely indicative of both illness persistence and complexity of needs. Some sources described entry criteria for services as the consideration of three aspects: the presence of diagnosed psychiatric disorder, severe functional impairment and a demonstrated inability to have needs met by less intensive services (Ahrens, Frey, Knoedler, & Senn-Burke, 2007; Grimes et al, 2011; McGrew & Danner, 2009; Mental Health Justice Health Alcohol and Drug Services, 2013; NSW Health, n.d.…”

“…Services utilised assertive community treatment (Ahrens et al, 2007; Conway & Clatworthy, 2015; McGrew & Danner, 2009), assertive outreach (Adrian & Smith, 2015), the wraparound approach (Blizzard, Glos, Stephan, Medoff, & Slade, 2017; Grimes et al, 2011), multisystemic therapy (Henggeler et al, 2003; Henggeler et al, 1999; Rowland et al, 2005), intensive community treatment (Darwish, Salmon, Ahuja, & Steed, 2006; Duffy & Skeldon, 2013; Simpson, Cowie, Wilkinson, Lock, & Monteith, 2010), intensive mobile youth outreach (Assan et al, 2008; Chia et al, 2013; Schley et al, 2011; Schley et al, 2012), day programmes (Kennair, Mellor, & Brann, 2011; Vanderploeg, Franks, Plant, Cloud, & Tebes, 2009) and intensive home-based treatment (Preyde et al, 2011). Many sources reporting on community treatment stated that even when receiving intensive treatment in the community, inpatient admission was still sometimes necessary for this population; however, the length and/or frequency of such admissions could be reduced when intensive community services were provided (Ahrens et al, 2007; Chia et al, 2013; Darwish et al, 2006; Duffy & Skeldon, 2013; Grimes et al, 2011; Henggeler et al, 2003; McGrew & Danner, 2009; Rowland et al, 2005).…”

“…vocational and/or life skills training) with clinical services (e.g. psychotherapy and/or pharmacotherapy) (Ahrens et al, 2007; Assan et al, 2008; Conway & Clatworthy, 2015; Duffy & Skeldon, 2013; Kennair et al, 2011; McGrew & Danner, 2009; Preyde et al, 2011; Schley et al, 2011, 2012).…”

“…Educational and vocational support was provided in most services; some also provided assistance with finding accommodation (Hodges et al, 2013; McGrew & Danner, 2009; Schley et al, 2011, 2012). Most services assisted development of independent living skills (Ahrens et al, 2007; Conway & Clatworthy, 2015; Hintikka et al, 2003; Leichtman et al, 2001; McGrew & Danner, 2009; NSW Health, n.d. ; Styron et al, 2006; Underwood et al, 2004).…”

“…This prevents us from being able to generalise the real-world effectiveness of the described models. Furthermore, a number of studies reported on methodological limitations including small sample sizes (Conway & Clatworthy, 2015) and no control groups (Adrian & Smith, 2015; Conway & Clatworthy, 2015). These findings must, therefore, be interpreted with caution.…”