Recognition of depression and psychosis by young Australians and their beliefs about treatment

Abstract

Objectives: To assess young people's ability to recognise clinically defined depression and psychosis, the types of help they thought appropriate for these problems, their knowledge of appropriate treatments, and their perceptions regarding prognosis. Design: A cross‐sectional telephone survey using structured interviews. Vignettes of a person with either depression or psychosis were presented, followed by questions related to recognition of the disorder, best forms of treatment and the prognosis. Participants: A randomly selected sample of 1207 young people aged 12–25 years. Setting: Melbourne, Victoria, and surrounding regional and rural areas. Outcome measures: Responses to a mental health literacy questionnaire. Results: Almost half the respondents were able to identify depression correctly, whereas only a quarter identified psychosis correctly. Counsellors and family or friends were the most commonly cited forms of best help, with family or friends preferred by the younger age group for depression. General practitioners were considered more helpful for depression, and psychiatrists and psychologists more helpful for psychosis. Most respondents considered counselling and psychotherapy to be helpful. However, more than half the respondents expressed negative or equivocal views regarding the helpfulness of recommended pharmacological treatments. Conclusions: The limitations we identified in youth mental health literacy may contribute to the low rates of treatment and the long duration of untreated illness reported in other studies. There is a need for initiatives to enhance mental health literacy among young people, and those close to them, if benefits of early treatment are to be realised.

Trends in GP prescribing of psychotropic medications among young patients aged 16–24 years: a case study analysis

“…This finding is consistent with previous research suggesting that GPs are reluctant to ‘over-medicalise’ young people [5]. Low rates of prescribing to this age group may also be influenced by the negative views held by young people about pharmaceutical treatments [6] and a preference for non-pharmaceutical intervention [7]. It may also relate to fears of inducing suicidality and aggression in young people prescribed SSRIs and SNRIs with recent evidence showing a doubling of these behaviours in young people using these forms of medication [27].…”

“…UK, Canadian, and Australian studies show that GPs face many challenges in managing mental illness for this patient group, such as grappling with the unique behavioural and biological changes associated with adolescence; navigating the difficulties associated with triadic consults (i.e., where a third party such as a parent or friend might be present during the GP consult with a young person); negotiating different expectations by young people and families around socially accepted behaviours regarding alcohol and substance use, use of digital media, and relationships between teenagers and parents; working out ways to forge effective and trusting therapeutic relationships with young people; [2] and treating severe and persistent mental illness [3, 4]. Studies show that GPs are apprehensive about over-medicalising young patients [5] and are less likely to prescribe psychotropics if their young patient’s hold negative views about psychotropics [6], express a preference for non-pharmacological treatments [7], or are new patients at their clinic [8]. Health warnings also reduce the likelihood of prescriptions; for example, the imposition of US and European regulator suicidality warnings on Selective Serotonin Reuptake Inhibitors (SSRIs) use in young people resulted in a decline in SSRI prescriptions among US and Dutch clinicians [9].…”

250 labels used to stigmatise people with mental illness

“…An appreciation of both factual ignorance and the degree of emotionally-charged prejudice by school students against people with mental illness is necessary when planning interventions intended to improve help-seeking [25,59,60]. The strongest evidence-based intervention known to reduce stigmatising attitudes (but not yet shown to change discriminatory behaviour) is direct social contact with a person who has mental illness [21,26,42,61,62].…”

What’s wrong with John? a randomised controlled trial of Mental Health First Aid (MHFA) training with nursing students

“…In comparison, baseline levels of recognition have been found to be lower among other groups completing MHFA training such as a broader university community (74% of students and 77% of staff) [6] and an Australian rural community (68% of intervention group participants and 74% of control group participants) [31]. A sample of young Australians aged 18–25 years who were not participating in a MHFA course found 58.6% were able to correctly identify depression using the vignette [52]. …”