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Community provision for young people:models of working fromAustralia. Jane H Roberts GP and Senior Lecturer University of Sunderland RCGP Adolescent Health Group . Background. Australian context Adolescent mental health New developments in community based service provision

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community provision for young people models of working fromaustralia

Community provision for young people:models of working fromAustralia

Jane H Roberts

GP and Senior Lecturer University of Sunderland

RCGP Adolescent Health Group

background
Background
  • Australian context
  • Adolescent mental

health

  • New developments in community based service provision
  • Key findings
  • Conclusions

Churchill Fellow 2010

Overview of talk

the australian context
The Australian context
  • ‘Old’ and ‘new’ country
  • Aboriginal culture 50 000 years old
  • 1700s British colony
  • 1850s 6 states – with independent governance
  • 1900 Australian independence
  • 1931 Commonwealth

Aboriginal rock paintings

Historical background

australia
Australia

6th largest country in the world

Population 20 million

13th richest economy

mental health statistics and provision
Mental health statistics and provision
  • 4 in 10 young people and increasing
  • rich country with high rates of relative poverty
  • Blended system of healthcare-public /private No registration with GPs. Medicare covers basic services. Eligible from 15 yrs old
  • 2003 and 2007 national reviews MH-IAPT
  • Focus on YP MH and service shake-up
headspace national community initiative
Headspace: national community initiative
  • Championed by Prof McGorry
  • Funded by Commonwealth (national ) government 2006: National Youth Mental Health Foundation
  • Focused on 12-25 years in 30 ‘one-stop shops’ in pop dense areas
  • Aim to address general and mental health, substance + alcohol counselling, education and employment
  • University support-UoMelbourne ‘Orygen’
headspace on the ground
Headspace on the ground
  • Work with existing services –determines local shape + scope
  • GPs role pivotal-but variable interest
  • Youth workers crucial
  • Main focus on MH
  • Less input in Education Training +Employment

Melbourne ‘Sunshine’ centre

Key points

other community based provision
Other community based provision
  • CAMHS-poorly funded; high rate private psychiatry
  • Inter-state variability re provision and legislation incl. competence regulations
  • Major re-structuring of mental health services in Victoria around 0-11,12-25 yrs
  • Individual models eg ‘Clockwork’, Geelong: multi-agency team working, high workload
  • Education: UME-med students in high schools + PCOs: ‘Docs and teens’
  • Culturally appropriate services limited
the wider debate
The wider debate
  • A generalist or specialist service?
  • Encouraging all clinicians to be youth-friendly or create ‘stand –alone’ services?
  • 12-25 as a ‘core group’?
  • Early intervention or over-medicalization?

Sculpture in Adelaide

The big issues

lessons learnt
Lessons learnt
  • Champions are essential : youth mental health
  • Advocacy and lobbying lead to funding
  • Role of Academic base : Orygen; DGP, UoM; CAAH; Youth Health Research Interest group, Sydney
  • Pros and cons of a youth focused service-EarIy Intervention effective in long term or diverting limited resources ?
conclusions
Conclusions
  • Work closely with client groups: YP , clinicians-what do they want ?
  • Respect local history and geography-context is all important
  • A ‘can-do’ approach is energizing
  • Youth (mental ) health is everyone’s business

Cleland Wildlife Park

Key messages

thank you
Thank you

http://www.wmct.org.uk

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