Study shows which young people are most likely to discontinue mental health care

Study shows which young people are most likely to discontinue mental health care

16 July 2020

Young people from certain demographic groups may require tailored approaches to fully engage with mental health care delivered through headspace services, an Orygen study has found.

The study of more than 80,000 young people who accessed headspace services throughout Australia, found that young men, heterosexuals, First Nations, and rural and remote young people, were at greater risk of discontinuing their mental health care.

Orygen research fellow Zac Seidler, who led the study, said the findings illustrated the need for community-based mental health services to tailor their approaches to engaging certain groups of young people in mental health treatment to ensure they continued with their mental health care.

“The discontinuation rate is not representative of bad treatment,” Dr Seidler said. “It’s representative of diverse needs, severity of symptoms and a service [headspace] that’s in dire need of expansion and continuity of funding if they’re going to be the place to deal with this distress.”

Dr Seidler said the study’s large and diverse data set offered Australia’s first opportunity to examine how young people navigate Australia’s mental health system.

“The study allowed us to examine the ins and outs of the whole headspace model,” he said. It has been published today in the journal Psychiatric Services.

“We found that headspace functions like other primary care models with young people coming and going depending on their needs,” Dr Seidler said.

“A quarter of the young people who discontinued engaging with headspace during their first episode of care later returned to the same headspace centre and said ‘I need a hand’.

“We also found that the first-session discontinuation rate was not significantly higher than other sessions. This tells us that headspace is providing that first introduction to counselling and their service in a really positive way and young people feel comfortable returning to headspace after their first session.

“Additionally, young people from the LGBTIQ+ community were significantly less likely to discontinue engaging with headspace than heterosexual young people.

“We think this is because headspace has put in a lot of effort to creating a service that asks, listens and responds to the needs of gender and sexuality diverse young people. As a result, headspace have created a service where these young people feel at home and at ease.”

headspace was founded in 2006 by the Australian Government to provide prevention and early intervention support to young people experiencing mild to moderate mental ill-health.

 “headspace is designed to give young people experiencing mild to moderate mental ill-health the tools they need to be able to say: ‘Alright, I’ve got what I need to go and work on this myself. I’ll come back should my situation change’,” he said.

However, Dr Seidler said approximately half of the 80,000 young people in the study reported experiencing severe levels of distress.

 “There is a real lack of services between headspace and the emergency department for young people with severe mental ill-health; there aren’t enough beds or services, so these young people are slipping through the cracks. It’s becoming very evident that something needs to change,” Dr Seidler said.

Professor Patrick McGorry, executive director of Orygen, said the study again highlighted the plight of the ‘missing middle’ - the large number of young people who need access to more sustained and specialised mental health care than is available through headspace.

“Headspace needs to be resourced to move beyond an ‘episode of care’ model to one that offers an outreach option and longer-term care.  A boost in funding is urgently required to ensure specific subgroups of young people can engage more effectively with headspace,” Professor McGorry said.

“The increased need for care created by the COVID-19 pandemic makes this a much more urgent priority.”