Stemming the tide of mental health problems in young people: Challenges and potential solutions

Eapen, Valsamma; Stylianakis, Anthea A.; Scott, Elizabeth; Milroy, Helen; Bowden, Michael; Haslam, Ric; Stathis, Stephen

doi:10.1177/00048674221136037

Cited by 10 publications

(8 citation statements)

References 24 publications

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“… 65 Increasing availability of interventions and improving pathways of care may be particularly important for culturally diverse and socioeconomically disadvantaged families who are less likely and less able to access services. 66 , 67 …”

Section: Discussionmentioning

confidence: 99%

Difficult Toddler Temperament – Prevalence and Associated Factors at 18-Month Follow-Up of a Birth Cohort

Bhadelia,

Barr,

John

et al. 2024

NDT

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Purpose Difficult temperament coupled with other risk factors may lead to mental health problems in childhood and have long-lasting effects in adolescence and adulthood. This study aimed to investigate the prevalence of parental perception of difficult temperament in toddlers and identify significant factors associated with individual and family-level sociodemographic risk factors. Patients and Methods The prevalence of parental perception of difficult temperament was derived from items in the 18-month follow-up questionnaire within the Watch Me Grow (WMG) longitudinal birth cohort study in a multicultural and socioeconomically disadvantaged community in Sydney, Australia. Data was available for 500 children and their parents. Descriptive analysis was used to calculate the participant characteristics and the prevalence of parental perception of difficult temperament, whereas multivariable logistic regression analysis was used to assess significant risk factors associated with a difficult temperament. Results Parental perception of difficult temperament in the cohort was 7.3% (n = 492). Findings of the multivariable logistic regression showed that screen time >2 hours a day (AOR 2.43, 95% CI: 1.2, 4.9), child not being read to (AOR 3.92, 95% CI: 1.8, 8.5), and family history of mental health problems (AOR 2.69, 95% CI: 1.1, 6.5) significantly increased the odds of having a difficult temperament. Conclusion Toddlers with difficult temperament were less likely to have received stimulatory experiences, and their families were more likely to be under greater stress. The findings emphasize the importance of parental support and anticipatory guidance in promoting nurturing care to facilitate child health and development, particularly in disadvantaged communities.

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Section: Discussionmentioning

confidence: 99%

Difficult Toddler Temperament – Prevalence and Associated Factors at 18-Month Follow-Up of a Birth Cohort

Bhadelia,

Barr,

John

et al. 2024

NDT

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“… 8 The access to multidimensional data for Primary Health Networks has the potential to guide specialised resource allocation and the facilitation of care coordination. 16 headspace has demonstrated the capacity to absorb variation in needs which is both a benefit and vulnerability of this model. Yet, with smarter tools, funders of other locality-based services can reset their own service parameters knowing the role headspace takes within the context of a local healthcare eco-system and the needs of its population.…”

Section: Discussionmentioning

confidence: 99%

Characterising variability in youth mental health service populations: A detailed and scalable approach using digital technology

Capon

Hickie

McKenna

et al. 2023

Australas Psychiatry

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Objective This study utilised digital technology to assess the clinical needs of young people presenting for care at headspace centres across Australia. Method 1490 young people (12–25 years) who presented to one of 11 headspace services from four geographical locations (urban New South Wales, urban South Australia, regional New South Wales, and regional Queensland) completed a digital multidimensional assessment at initial presentation. Characteristics were compared between services and geographical locations. Results We identified major variation in the demographics, and the type and severity of needs across different services. Individuals from regional services were more likely to be younger, of Aboriginal and Torres Strait Islander origin, and present with psychotic-like symptoms and suicidality, while those in urban areas were more likely to have previously sought help and have problematic alcohol use. Further differences in age, distress, depressive symptoms, psychotic-like experiences, trauma, family history, alcohol use, education/employment engagement, and days out of role were identified between different urban sites. Conclusions The variability between services provides insight into the heterogeneity of youth mental health populations which has implications for appropriate early intervention and prevention service provisions. We propose that integrating digital technologies has the potential to provide insights for smarter service planning and evaluation.

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“…This reiterates the need to redirect resources to target improvements to not only the ED system but the entire child and adolescent mental health care system. In this regard, an Integrated Continuum of Connect and Care (I-CCC) model has been proposed that would integrate all relevant services using a tiered care pathway proportionate to the needs of the CYP and their families/carers [45]. Directions for future research include ascertaining subjective experiences via qualitative interviews of children and adolescents and their families about the ED presentations, as well their subsequent service use including provision of appropriate care pathways.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Extended Length of Stay for Paediatric Mental Health Presentations to Emergency Departments in South Western Sydney, Australia

Khan¹,

John²,

Middleton³

et al. 2023

Preprint

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Background: Evidence suggests that children and young people (CYP) who present to the emergency department (ED) for mental health (MH) difficulties may have extended lengths of stay (LOS); however, there is a paucity of research in Australia regarding the factors associated with extended LOS. This study aimed to determine the factors associated with extended LOS for paediatric MH-related presentations to the EDs in South Western Sydney (SWS), a multicultural community in Australia. Methods: We analysed electronic medical records (eMR) of 7,409 MH-related ED encounters of CYP aged 0 up to 18 years from all six public hospitals in SWS from January 2016 to April 2022. Extended LOS was defined as encounters of more than 4 hours. We assessed factors associated with extended LOS using a multilevel logistic regression model, accounting for hospital-level clustering. Results: Approximately 57.6% of all ED presentations for paediatric MH involved extended LOS. ED presentations by adolescents (adjusted odds ratio (AOR) 2.23, 95% CI 1.20-4.17 for 12-14 years and AOR 2.69, 95% CI 1.44-5.00 for 15-17 years), and patients with a preferred language other than English (AOR 1.47, 95% CI 1.15-1.89) had increased odds of extended LOS compared to their counterparts. Deliberate self-harm related presentations, the most commonly presented MH condition, had higher odds of extended LOS than other MH-related presentations (AOR 1.77, 95% CI 1.59-1.98). Patients with MH presentations that required urgent evaluation (triage levels 1-2) had higher odds of extended LOS (AOR 1.38, 95% CI 1.15-1.65) compared to triage level 3, whereas those with triage levels 4-5 had lower odds (AOR 0.66, 95% CI 0.58-0.74). Further, patients with MH-related presentations that came by ambulance (compared to other mode of presentations) and presentations that happened at night and late at night (compared to early morning and daytime presentations). The odds of extended LOS were considerably lower during the COVID-19 period compared to the pre-COVID-19 period (AOR 0.74, 95% CI 0.67-0.82). Additionally, extended paediatric LOS for MH issues in the ED showed notable hospital-level heterogeneity. Conclusion: A large proportion of extended LOS in ED and sociodemographic disparities reflect inequality in access to paediatric MH care. Our findings highlight the need for equitable distribution of resources directed towards at-risk CYP to improve MH outcomes and reduce health system burden.

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Stemming the tide of mental health problems in young people: Challenges and potential solutions

Cited by 10 publications

References 24 publications

Difficult Toddler Temperament – Prevalence and Associated Factors at 18-Month Follow-Up of a Birth Cohort

Difficult Toddler Temperament – Prevalence and Associated Factors at 18-Month Follow-Up of a Birth Cohort

Characterising variability in youth mental health service populations: A detailed and scalable approach using digital technology

Factors Associated with Extended Length of Stay for Paediatric Mental Health Presentations to Emergency Departments in South Western Sydney, Australia

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