Youth mental health responses need a major boost, according to new figures. 

A study has assessed over 1,500 young people aged 12 to 25 years presenting for mental health care at two primary care-based early intervention mental health services. 

The researchers identified four distinct trajectories of social and occupational functioning for the study participants.

Forty-nine per cent were found to be deteriorating and volatile, 16 per cent had persistent impairment, 19 per cent had stable good functioning, 16 per cent were improving, then late recurrence. 

The less favourable trajectories (deteriorating and volatile; persistent impairment) were associated with physical comorbidity, not being in education, employment, or training, having substance-related disorder, having been hospitalised, and having a childhood onset mental disorder, psychosis-like experiences, or a history of self-harm or suicidality.

“Only 35 per cent had good functional outcomes over two years; that is, only one in three people maintained an initially good level of function or substantially improved from a lower level of function,” Dr Frank Iorfino, from the University of Sydney’s Brain and Mind Centre, and colleagues reported.

“In contrast, functional impairment persisted in nearly two-thirds of participants, or their level of function deteriorated and was volatile.

“Our findings suggest that the current primary care-based model meets the needs of only a minority of young people seeking care, and that most require more comprehensive and multidisciplinary approaches because of substantial comorbidity, ambiguous or attenuated symptomatology, and social or occupational complexity.

“Our findings highlight the importance of measurement-based care, whereby outcomes are monitored to inform more personalised and responsive treatment, a core component of the chronic care model that supports more informed clinical decisions.

“Despite evidence for its effectiveness and its feasibility in medical disease management, measurement-based care is largely unused in youth mental health care.”