Skip to main content Accessibility help
×
Home
Hostname: page-component-559fc8cf4f-7x8lp Total loading time: 0.319 Render date: 2021-03-05T21:25:57.591Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": false, "newCiteModal": false, "newCitedByModal": true }

Youth services: meeting the mental health needs of adolescents

Published online by Cambridge University Press:  19 December 2014

N. S. Vyas
Affiliation:
Child Psychiatry Branch, National Institutes of Mental Health, National Institutes of Health, Bethesda, MD, USA Department of Psychology, Kingston University London, Kingston Upon Thames, Surrey, UK
M. Birchwood
Affiliation:
Division of Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
S. P. Singh
Affiliation:
Division of Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
Corresponding
E-mail address:

Abstract

Objectives

Youth mental health services are poised for a paradigm shift. Recent epidemiological evidence confirms the seriousness of adolescence as a risk period for mental ill-health - 50% of all adult mental disorders begin before the age of 16% and 75% before the age of 25. Here, we identify issues with transition of care between CAMHS-AMHS service, and effectiveness of early intervention services.

Methods

We provide a selective review providing evidence of adolescence as a risk period, discuss CAMHS-AMHS service transition problems, and discuss avenues for change to implement the early intervention model across youth mental health.

Results

Traditional service structures,with paediatric -adult split at 16–18 years increasingly appear not fit for purpose. A radical redesign of youth mental health services is not only necessary, it is also feasible and achievable, as illustrated by a pilot Birmingham youth service – Youthspace.

Conclusions

Pilot youth mental projects currently underway can help radically redesign the existing child and adolescent services. This will in turn lead to an improvement in the young people's experience of engagement with the services so that they too have a positive future.

Type
Review Articles
Copyright
© College of Psychiatrists of Ireland 2014 

Access options

Get access to the full version of this content by using one of the access options below.

References

Arnett, JJ (2004). Emerging Adulthood: The Winding Road from the Late Teens Through the Twenties. Oxford University Press: New York.Google Scholar
Birmaher, B, Ryan, ND, Wiliamson, DE, Brent, DA, Kaufman, J, Dahl, RE, Perel, J, Nelson, B (1996). Childhood and adolescent depression: a review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry 35, 14271439.CrossRefGoogle ScholarPubMed
Budd, T, Sharp, C, Weir, G, Wilson, D, Owen, N (2005). Young People and Crime: Findings from the 2004 Offending, Crime and Justice Survey. Home Office: London.Google Scholar
Chanen, AM, Jackson, HJ, McCutcheon, LK, Jovev, M, Dudgeon, P, Yuen, HP, Germano, D, Nistico, H, McDougall, E, Weinstein, C, Clarkson, V, McGorry, PD (2009). Early intervention for adolescents with borderline personality disorder: quasi-experimental comparison with treatment as usual. The Australian and New Zealand Journal of Psychiatry 43, 397408.CrossRefGoogle ScholarPubMed
Chanen, AM, Jovev, M, Djaja, D, McDougall, E, Yuen, HP, Rawlings, D, Jackson, HJ (2008). Screening for borderline personality disorder in outpatient youth. Journal of Personality Disorders 22, 353364.CrossRefGoogle ScholarPubMed
Chanen, AM, McCutcheon, LK, Germano, D, Nistico, H, Jackson, HJ, McGorry, PD (2009). The HYPE clinic: an early intervention service for borderline personality disorder. Journal of Psychiatric Practice 15, 163172.CrossRefGoogle ScholarPubMed
Compton, SN, March, JS, Brent, D, Albano, AM 5th, Weersing, R, Curry, J. (2004). Cognitive-behavioral psychotherapy for anxiety and depressive disorders in children and adolescents: an evidence-based medicine review. American Academy of Child and Adolescent Psychiatry 43, 930959.CrossRefGoogle Scholar
Colman, I, Wadsworth, ME, Croudace, TJ, Jones, PB (2007). Forty-year psychiatric outcomes following assessment for internalizing disorder in adolescence. American Journal of Psychiatry 164, 126133.CrossRefGoogle ScholarPubMed
Copeland, W, Shanahan, L, Costello, EJ, Angold, A (2011). Cumulative prevalence of psychiatric disorders by young adulthood: a prospective cohort analysis from the great smoky mountains study. Journal of American Academy of Child and Adolescent Psychiatry 50, 252261.CrossRefGoogle ScholarPubMed
Craig, TKJ, Garety, P, Power, P, Rahaman, N, Susannah, C, Fornells-Ambrojo, M, Dunn, G (2004). The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis. British Medical Journal 329, 1067.CrossRefGoogle ScholarPubMed
De Clercq, B, De Fruyt, F (2007). Childhood antecedents of personality disorder. Current Opinion in Psychiatry 20, 5761.CrossRefGoogle ScholarPubMed
Department of Health (2009). Recognising Complexity: Commissioning Guidance for Personality Disorder Services. Department of Health: London.Google Scholar
Fonagy, P, Target, M, Gergely, G (2000). Attachment and borderline personality disorder: a theory and some evidence. The Psychiatric Clinics of North America 23, 103122.CrossRefGoogle ScholarPubMed
Ford, T, Goodman, R, Meltzer, H (2003). The British child and adolescent mental health survey 1999: the prevalence of DSM-IV disorders. Journal of the American Academy of Child and Adolescent Psychiatry 42, 12031211.CrossRefGoogle ScholarPubMed
Ford, T, Hamilton, H, Dosani, S, Burke, L, Goodman, R (2007). The children’s services interview: validity and reliability. Social Psychiatry and Psychiatric Epidemiology 42, 3649.CrossRefGoogle ScholarPubMed
Garety, PA, Craig, TKJ, Dunn, G, Fornells-Ambrojo, M, Colbert, S, Rahaman, N, Read, J, Power, P (2006). Specialised care for early psychosis: symptoms, social functioning and patient satisfaction: randomised controlled trial. British Journal of Psychiatry 188, 3745.CrossRefGoogle ScholarPubMed
Green, H, McGinnity, A, Meltzer, H, Ford, T, Goodman, R (2005). Mental Health of Children and Young People in Great Britain 2004. Palgrave Macmillan: New York, NY.CrossRefGoogle Scholar
Greenbaum, PE, Prange, ME, Friedman, RM, Silver, SE (1991). Substance abuse prevalence and comorbidity with other psychiatric disorders among adolescents with severe emotional disturbances. Journal of the American Academy of Child and Adolescent Psychiatry 30, 575583.CrossRefGoogle ScholarPubMed
Harrington, R, Clark, A (1998). Prevention and early intervention for depression in adolescence and early adult life. European Archives of Psychiatry and Clinical Neuroscience 248, 3245.CrossRefGoogle ScholarPubMed
Hensley, PL, Nadiga, D, Uhlenhuth, EH (2004). Long-term effectiveness of cognitive therapy in major depressive disorder. Depression and Anxiety 20, 17.CrossRefGoogle ScholarPubMed
Kelleher, KJ, McInerny, TK, Gardner, WP, Childs, GE, Wasserman, RC (2000). Increasing identification of psychosocial problems: 1979–1996. Pediatrics 105, 13131321.CrossRefGoogle ScholarPubMed
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry 62, 593602.CrossRefGoogle ScholarPubMed
Kessler, RC, Walters, EE (1998). The epidemiology of DSM-III-R major depression and minor depression among adolescents and young adults in the national comorbidity survey. Depression and Anxiety 7, 314.3.0.CO;2-F>CrossRefGoogle Scholar
Lamb, C, Hall, D, Kelvin, R, Van Beinum, A (2008). Working at the CAMHS/adult interface: good practice guidance for the provision of psychiatric services to adolescents/young adults. Interfaculty working group of the Child and Adolescent Faculty and the General and Community Faculty of the Royal College of Psychiatrists, May. London, UK.Google Scholar
Larsen, TK, Melle, I, Auestad, B, Friis, S, Haahr, U, Johannessen, JO, Opjordsmoen, S, Rund, BR, Simonsen, E, Vaglum, P, McGlashan, T (2006). Early detection of first-episode psychosis: the effect on 1-year outcome. Schizophrenia Bulletin 32, 758764.CrossRefGoogle ScholarPubMed
Lester, H, Birchwood, M, Bryan, S, England, E, Rogers, H, Sirvastava, N (2009). Development and implementation of early intervention services for young people with psychosis: case study. British Journal of Psychiatry 194, 446450.CrossRefGoogle ScholarPubMed
Leventhal, T, Brooks-Gunn, J (2000). The neighborhoods they live in: the effects of neighborhood residence on child and adolescent outcomes. Psychological Bulletin 126, 309337.CrossRefGoogle ScholarPubMed
Lewinsohn, PM, Allen, NB, Seeley, JR, Gotlib, IH (1999). First onset versus recurrence of depression: differential processes of psychosocial risk. Journal of Abnormal Psychology 108, 483489.CrossRefGoogle ScholarPubMed
Lewinsohn, PM, Hops, H, Roberts, RE, Seeley, JR, Andrews, JA (1993). Adolescent psychopathology: I. prevalence and incidence of depression and other DSM-III-R disorders in high school students. Journal of Abnormal Psychology 102, 133144.CrossRefGoogle ScholarPubMed
Lin, A, RLEP, Reniers, Wood, SJ (2013). Clinical staging in severe mental disorder: evidence from neurocognition and neuroimaging. British Journal of Psychiatry 202, s11s17.CrossRefGoogle Scholar
McCabe, K, Yeh, M, Hough, RL, Landsverk, J, Hurlburt, MS, Culver, SW, Reynolds, B (1999). Racial/ethnic representation across five public sectors of care for youth. Journal of Emotional and Behavioral Disorders 7, 7282.CrossRefGoogle Scholar
McCrone, P, Knapp, M, Proudfoot, J, Ryden, C, Cavanagh, K, Shapiro, DA, Ilson, S, Gray, JA, Goldberg, D, Mann, A, Marks, I, Everitt, B, Tylee, A (2004). Cost-effectiveness of computerised cognitive behavioural therapy for anxiety and depression in primary care: randomised controlled trial. British Journal of Psychiatry 185, 5562.CrossRefGoogle ScholarPubMed
McGlashan, T (2005). Early detection and intervention in psychosis: an ethical paradigm shift. British Journal of Psychiatry 187, s113s115.CrossRefGoogle Scholar
McGorry, P, Bates, T, Birchwood, M (2013). Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. British Journal of Psychiatry 202, 3035.CrossRefGoogle Scholar
McGorry, PD, Yung, AR, Phillips, LJ, Yuen, HP, Francey, S, Cosgrave, EM, German, D, Bravin, J, McDonald, T, Blair, A, Adlard, S, Jackson, H (2002). Randomized controlled trial of interventions designed to reduce the risk of progression to first-episode psychosis in a clinical sample with subthreshold symptoms. Archives of General Psychiatry 59, 921928.CrossRefGoogle Scholar
Melle, I, Larsen, TK, Haahr, U, Friis, S, Johannessen, JO, Opjordsmoen, S, Simonsen, E, Rund, BD, Vaglum, P, McGlashan, T (2004). Reducing the duration of untreated first-episode psychosis: effects on clinical presentation. Archives of General Psychiatry 61, 143150.CrossRefGoogle ScholarPubMed
Melle, I, Larsen, TK, Haahr, U, Friis, S, Johannesen, JO, Opjordsmoen, S, Simonsen, E, Rund, BR, Vaglum, P, McGlashan, T (2008). Reducing the duration of untreated first-episode psychosis: effects on clinical presentation. Archives of General Psychiatry 65, 634640.CrossRefGoogle Scholar
Morrison, AP, French, P, Walford, L, Lewis, SW, Kilcommons, A, Green, J, Parker, S, Bentall, RP (2004). Cognitive therapy for the prevention of psychosis in people at ultra-high risk: randomised controlled trial. British Journal of Psychiatry 185, 291297.CrossRefGoogle ScholarPubMed
National Collaborating Centre for Mental Health (2009). Antisocial Personality Disorder: Understanding NICE guidance. NICE: London.Google Scholar
Office of National Statistics (2004). The Health of Children and Young People. Office of National Statistics: London.Google Scholar
Patel, V, Flisher, AJ, Hetrick, S, McGorry, P (2007). Mental health of young people: a global public-health challenge. Lancet 369, 13021313.CrossRefGoogle ScholarPubMed
Patton, GC, Coffey, C, Romaniuk, H, Mackinnon, A, Carlin, JB, Degenhardt, L, Olsson, CA, Moran, P (2014a). The prognosis of common mental disorders in adolescents: a 14-year prospective cohort study. The Lancet 383, 14041411.CrossRefGoogle ScholarPubMed
Patton, GC, Ross, DA, Santelli, JS, Sawyer, SM, Viner, RM, Kleinert, S (2014b). Next steps for adolescent health: a Lancet commission. The Lancet 383, 385386.CrossRefGoogle ScholarPubMed
Patton, GC, Selzer, R, Coffey, C, Carlin, JB, Wolfe, R (1999). Onset of adolescent eating disorders: population based cohort study over 3 years. British Medical Journal 318, 765768.CrossRefGoogle ScholarPubMed
Petersen, AC, Leffert, N ( 1995). Developmental issues influencing guidelines for adolescent health research: a review. Journal of Adolescent Health 17, 298305.CrossRefGoogle Scholar
Paul, M, Ford, T, Kramer, T, Islam, Z, Harley, K, Singh, SP (2013). Transfers and transitions between child and adolescent mental health services. British Journal of Psychiatry 202, s36s40.CrossRefGoogle Scholar
Pottick, KJ, Bilder, S, Vander Stoep, A, Warner, LA, Alvarez, MF (2008). US patterns of mental health service utilization for transition-age youth and young adults. The Journal of Behavioral Health Services & Research 35, 373389.CrossRefGoogle ScholarPubMed
Roberts, RE, Attkisson, C, Rosenblatt, A (1998). Prevalence of psychopathology among children and adolescents. American Journal of Psychiatry 155, 715725.Google ScholarPubMed
Rushton, JL, Forcier, M, Schecktman, RM (2002). Epidemiology of depressive symptoms in the National Longitudinal Study of Adolescent Health. Journal of the American Academy of Child and Adolescent Psychiatry 41, 199205.CrossRefGoogle ScholarPubMed
Sawyer, SM, Afifi, RA, Bearinger, LH, Blakemore, S-J, Dick, B, Ezeh, AC, Patton, GC (2012). Adolescence: a foundation for future health. The Lancet 379, 16301640.CrossRefGoogle ScholarPubMed
Self-Brown, SR, LeBlanc, M, Kelley, ML, Hanson, R, Laslie, K, Wingate, A (2006). Effects of community violence exposure and parental mental health on the internalizing problems of urban adolescents. Violence and Victims 21, 183198.CrossRefGoogle ScholarPubMed
Silva, PA (1990). The Dunedin Multidisciplinary Health and Developmental Study: a 15 year longitudinal study. Paediatric and Perinatal Epidemiology 4, 96127.CrossRefGoogle Scholar
Singh, SP (2009). Transition of care from child to adult mental health services: the great divide. Current Opinion in Psychiatry 22, 386390.CrossRefGoogle ScholarPubMed
Singh, SP, Cooper, JE, Fisher, HL, Tarrant, CJ, Lloyd, T, Banjo, J, Corfe, S, Jones, P (2005). Determining the chronology and components of psychosis onset: the Nottingham Onset Schedule (NOS). Schizophrenia Research 80, 117130.CrossRefGoogle Scholar
Singh, SP, Paul, M, Ford, T, Kramer, T, Weaver, T, McLaren, S, Hovish, K, Islam, Z, Belling, R, White, S (2010). Process, outcome and experience of transition from child to adult mental healthcare: multiperspective study. British Journal of Psychiatry 197, 305312.CrossRefGoogle ScholarPubMed
Social Care, Local Government and Care Partnership Directorate (2014). Closing the gap: priorities for essential change in mental health. Department of Health: London, UK.Google Scholar
Social Exclusion Unit (2004). Breaking the Cycle. Office of the Deputy Prime Minister: London.Google Scholar
Stafford, MR, Jackson, H, Mayo-Wilson, E, Morrison, AP, Kendall, T (2013). Early intervention to prevent psychosis a systematic review and meta-analysis. British Medical Journal 346, f185, doi: 10.1136/bmj.f185.CrossRefGoogle ScholarPubMed
Stice, E, Rohde, P, Seeley, JR, Gau, JM (2008). Brief cognitive-behavioral depression prevention program for high-risk adolescents outperforms two alternative interventions: a randomized efficacy trial. Journal of Consulting and Clinical Psychology 76, 595606.CrossRefGoogle ScholarPubMed
Taylor, CB, Bryson, S, Luce, KH, Cunning, D, Doyle, AC, Abascal, LB, Rockwell, R, Dev, P, Winzelberg, AJ, Wilfley, DE (2006). Prevention of eating disorders in at-risk college-age women. Archives of General Psychiatry 63, 881888.CrossRefGoogle ScholarPubMed
US Public Health Service (2000). Youth Violence: A Report of the Surgeon General. Department of Health and Human Services: Washington, DC.Google Scholar
Vizard, E, Jones, A, Viding, E, Farmer, E, McCrory, E (2009). Early Intervention in Personality Disorder: MST and Other Treatments for Socially Excluded High Risk/High Harm Children and Families. Department of Health (http://www.personalitydisorder.org.uk/about/pd-resources/emerging-pd/). Accessed 4 August 2014.Google Scholar
Vyas, NS, Gogtay, N (2012). Treatment of early onset schizophrenia: recent trends, challenges and future considerations. Frontiers in Psychiatry 3, 29, doi: 10.3389/fpsyt.2012.00029.CrossRefGoogle ScholarPubMed
Vyas, NS, Hadjulis, M, Vourdas, A, Byrne, P, Frangou, S (2007). The Maudsley early onset schizophrenia study. Predictors of psychosocial outcome at 4-year follow-up. European Society of Child and Adolescent Psychiatry 16, 465470.Google ScholarPubMed
Vyas, NS, Kumra, S, Puri, BK (2010a). What insights can we gain from studying early-onset schizophrenia? The neurodevelopmental pathway and beyond. Expert Review in Neurotherapeutics 10, 12431247.CrossRefGoogle ScholarPubMed
Vyas, NS, Patel, NH, Nijran, KS, Al-Nahhas, A, Puri, BK (2010b). Can PET/CT imaging advance our understanding of the neurobiology of schizophrenia? Nuclear Medicine Communications 31, 9193.CrossRefGoogle ScholarPubMed
Vyas, NS, Patel, NH, Puri, BK (2011). Neurobiology and phenotypic expression in early onset schizophrenia. Early Intervention in Psychiatry 5, 314.CrossRefGoogle ScholarPubMed
Wade, TD, Keski-Rahkonen, A, Hudson, J I (2011). Epidemiology of Eating Disorders. In Textbook of Psychiatric Epidemiology, Third Edition ed. M. T. Tsuang, M. Tohen and P. B. Jones), pp 343360. John Wiley & Sons, Ltd: Chichester, UK.CrossRefGoogle Scholar
Winsper, C, Wolke, D, Lereya, T (2014). Prospective associations between prenatal adversities and borderline personality disorder at 11-12 years. Psychological Medicine 29, 113.Google Scholar
Winsper, C, Zanarini, M, Wolke, D (2012). Prospective study of family adversity and maladaptive parenting in childhood and borderline personality disorder symptoms in a non-clinical population at 11 years. Psychological Medicine 42, 24052420.CrossRefGoogle Scholar
Youth Risk Behaviour Surveillance System, Division of Adolescent and School Health, Centers for Disease Control and Prevention (2007). Youth online (http://apps.nccs.cdc.gov/yrbss/). Accessed 1 September 2014.Google Scholar

Altmetric attention score

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 60
Total number of PDF views: 303 *
View data table for this chart

* Views captured on Cambridge Core between September 2016 - 5th March 2021. This data will be updated every 24 hours.

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Youth services: meeting the mental health needs of adolescents
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Youth services: meeting the mental health needs of adolescents
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Youth services: meeting the mental health needs of adolescents
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *