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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 • Key findings • Conclusions Churchill Fellow 2010 Overview of talk
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 6th largest country in the world Population 20 million 13th richest economy
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 • 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 • 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 • 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 • 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 • 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 • 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 http://www.wmct.org.uk