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Capturing the clinical complexity in young people presenting to primary mental health services: a data-driven approach.
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- Additional Information
- Source:
Publisher: Cambridge University Press Country of Publication: England NLM ID: 101561091 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-7979 (Electronic) Linking ISSN: 20457960 NLM ISO Abbreviation: Epidemiol Psychiatr Sci Subsets: MEDLINE
- Publication Information:
Original Publication: Cambridge : Cambridge University Press
- Subject Terms:
- Abstract:
Aims: The specific and multifaceted service needs of young people have driven the development of youth-specific integrated primary mental healthcare models, such as the internationally pioneering headspace services in Australia. Although these services were designed for early intervention, they often need to cater for young people with severe conditions and complex needs, creating challenges in service planning and resource allocation. There is, however, a lack of understanding and consensus on the definition of complexity in such clinical settings.
Methods: This retrospective study involved analysis of headspace 's clinical minimum data set from young people accessing services in Australia between 1 July 2018 and 30 June 2019. Based on consultations with experts, complexity factors were mapped from a range of demographic information, symptom severity, diagnoses, illness stage, primary presenting issues and service engagement patterns. Consensus clustering was used to identify complexity subgroups based on identified factors. Multinomial logistic regression was then used to evaluate whether these complexity subgroups were associated with other risk factors.
Results: A total of 81,622 episodes of care from 76,021 young people across 113 services were analysed. Around 20% of young people clustered into a 'high complexity' group, presenting with a variety of complexity factors, including severe disorders, a trauma history and psychosocial impairments. Two moderate complexity groups were identified representing 'distress complexity' and 'psychosocial complexity' (about 20% each). Compared with the 'distress complexity' group, young people in the 'psychosocial complexity' group presented with a higher proportion of education, employment and housing issues in addition to psychological distress, and had lower levels of service engagement. The distribution of complexity profiles also varied across different headspace services.
Conclusions: The proposed data-driven complexity model offers valuable insights for clinical planning and resource allocation. The identified groups highlight the importance of adopting a holistic and multidisciplinary approach to address the diverse factors contributing to clinical complexity. The large number of young people presenting with moderate-to-high complexity to headspace early intervention services emphasises the need for systemic change in youth mental healthcare to ensure the availability of appropriate and timely support for all young people.
- References:
Psychol Res Behav Manag. 2023 Dec 05;16:4897-4908. (PMID: 38077168)
Aust N Z J Public Health. 2001 Dec;25(6):494-7. (PMID: 11824981)
Aust N Z J Psychiatry. 2006 Aug;40(8):616-22. (PMID: 16866756)
Early Interv Psychiatry. 2019 Feb;13(1):159-166. (PMID: 30311423)
Aust N Z J Psychiatry. 2011 Nov;45(11):993-1001. (PMID: 21999241)
Br J Psychiatry Suppl. 2013 Jan;54:s30-5. (PMID: 23288499)
J Comorb. 2015 Jul 16;5:110-119. (PMID: 29090159)
J Gen Intern Med. 2007 Dec;22 Suppl 3:382-90. (PMID: 18026806)
Lancet. 2011 Jun 18;377(9783):2093-102. (PMID: 21652063)
BMJ. 2019 Mar 28;364:l1285. (PMID: 30923039)
Psychol Med. 2002 Aug;32(6):959-76. (PMID: 12214795)
Psychol Res Behav Manag. 2018 Apr 03;11:67-77. (PMID: 29662330)
Am J Psychiatry. 1993 Oct;150(10):1447-65. (PMID: 8379547)
Psychiatry Res. 2011 Oct 30;189(3):344-8. (PMID: 21708410)
BMC Med. 2012 Sep 27;10:111. (PMID: 23016556)
Evid Based Ment Health. 2018 Nov;21(4):182-184. (PMID: 30352884)
Perm J. 2018 Sep 06;22:18-010. (PMID: 30227907)
World Psychiatry. 2022 Feb;21(1):61-76. (PMID: 35015367)
BMJ Open. 2020 Oct 29;10(10):e039699. (PMID: 33122321)
J Adv Nurs. 2024 Jan;80(1):84-95. (PMID: 37574775)
Nurs Health Sci. 2017 Mar;19(1):13-21. (PMID: 28054430)
Psychosomatics. 2001 Mar-Apr;42(2):106-9. (PMID: 11239122)
Lancet. 2007 Apr 14;369(9569):1302-1313. (PMID: 17434406)
Med J Aust. 2007 Oct 1;187(S7):S35-9. (PMID: 17908023)
Early Interv Psychiatry. 2023 Apr;17(4):412-421. (PMID: 36683278)
World Psychiatry. 2019 Jun;18(2):140-141. (PMID: 31059618)
Med J Aust. 2014 Feb 3;200(2):108-11. (PMID: 24484115)
Mol Psychiatry. 2022 Jan;27(1):281-295. (PMID: 34079068)
Am J Psychiatry. 1992 Sep;149(9):1148-56. (PMID: 1386964)
Med J Aust. 2017 Nov 20;207(10):S5-S18. (PMID: 29129182)
Psychiatry Res. 2023 Sep;327:115265. (PMID: 37348404)
Aust N Z J Psychiatry. 2017 Aug;51(8):799-809. (PMID: 28718716)
- Contributed Indexing:
Keywords: adolescent; complexity; episode of care; mental health; mental health services
- Publication Date:
Date Created: 20240918 Date Completed: 20240918 Latest Revision: 20241006
- Publication Date:
20241006
- Accession Number:
PMC11450420
- Accession Number:
10.1017/S2045796024000386
- Accession Number:
39291560
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