Integrating Substance Misuse Specialists in a Youth Early Psychosis Service: Increasing Mental Health Clinicians' Knowledge and Confidence.

Substance misuse and mental health disorders are commonly occurring co-morbidities in young people. This paper reports on a pilot project to embed three specialist Alcohol and Other Drug (AoD) workers to be embedded in a youth early psychosis service to upskill mental health clinicians in managing substance misuse. Evaluation of the project used a mixed methods approach. Quantitative results showed that clinical staff members' knowledge of substance misuse, knowledge of AoD treatments and services, and overall confidence in working with young people with a substance misuse issue improved following implementation of the project. Qualitative results indicated four themes which emerged: defining the role of the AoD workers; support and upskilling of the mental health staff; openness and effective communication between the embedded workers and mental health teams; and barriers to collaboration. The results provide support for the embedding of specialist alcohol and drug workers in youth mental health services.

Supporting the Support Network: The Value of Family Peer Work in Youth Mental Health Care.

Reported rates of mental illness continue to climb amongst young Australians. In a family environment the carers of these young people play a highly influential role in their recovery process, however this responsibility can also have significant emotional, financial and health impacts on carers. This paper details the findings of an evaluation project examining the impact and effectiveness of a newly developed and implemented Family Peer Support Work model. Benefits were found which included: family care-givers receiving emotional support and empathy; reduced stress, loneliness, isolation and stigma; bridging between the family and the clinical care team; helping families to navigate through the complexities of the care system; and connecting families to other services. Clarity on role definition for the FPSWs evolved over the course of implementation along with a clearer articulation of the model of care and emergent knowledge on useful elements of training, ongoing professional development, mentoring and wellbeing.

The COVID PIVOT - Re-orienting Child and Youth Mental Health Care in the Light of Pandemic Restrictions.

The COVID pandemic required significant changes in the provision of youth mental health services during the period of lockdown/stay at home orders. Things which were identified as changing significantly during this period included: service via telehealth; working from home, split teams (to reduce infection risk), and social (physical) distancing. An online survey of clinicians was conducted involving both closed and open ended questions. Service staff identified significant benefits from the changes to the way services were delivered as well as some impediments and challenges. Advantages in the new way of working revolved around the flexibility of the virtual service, with appointments online enabling families to more easily overcome issues of transport, work commitments, childcare and disruption to routines and timing. The online platforms also enabled some family members to participate who otherwise might not have been able to come to appointments in person. Disadvantages included where there were issues with availability and access to appropriate technology or private spaces, or when the young person was very young, very unwell, unstable, isolated or at higher risk. This study suggests that telehealth and flexible working arrangements have become an essential new element in the clinicians' toolkit to be offered either alone or as a supplement to in person interventions.

General Practitioners' management of young people with mental health conditions in Australia.

AIM: Detecting and diagnosing youth mental health issues can be challenging for General Practitioners (GPs) who are often the first to encounter them. One aim of this study was to understand the challenges GPs faced in identifying, treating and referring young people with mental health issues in Melbourne, Australia. A second aim was to identify gaps in GP knowledge and service provision in order to design a service and training program for GPs that addresses those gaps. METHOD: A representative sampling method was used to invite GPs in south-east Melbourne to complete the study survey. Seventy-seven GPs completed the questionnaire consisting of 10 questions in 3 sections. RESULTS: The results showed that GPs who consulted with young people more often had greater levels of confidence in identifying and treating their mental health issues but not referring. Forty-four percent identified the need for training in regards to youth mental health. GPs considered that the most effective care was provided in youth-friendly spaces but tended to primarily refer young people to private providers. CONCLUSION: GPs need access to ongoing professional development and education programs on youth mental health, in particular more severe issues such as psychosis. Specialist youth mental health services such as CYMHS/CAMHS and headspace can offer GPs support in managing mental health issues in young people. However, there is a need to strengthen the link between GPs and specialist youth mental health service. Stronger links between services will ensure young people have timely and increased access to treatment.

The effect of guidance in the use of routine outcome measures in clinical meetings.

Routine outcome measures (ROM) have now been introduced into all Australian public mental health services, but experience suggests that many clinical staff lack expertise in using them. In 2005 under the Quality Through Outcomes Network (QUATRO), the Victorian Department of Human Services set up three teams aimed at consolidating the use of ROM and furthering sustainability through a variety of peer-support activities. We report on an initiative undertaken by one of these teams. QUATRO team members attended team meetings of four adult community teams (three metropolitan and one rural) fortnightly over about 3 months. QUATRO staff contributed to discussion of outcome measures during routine clinical review, using local and national outcome measurement data and tools, and their own expertise. Attitudes of clinicians toward ROM in general and the specific instruments were assessed at the beginning and end of the period, and again after about 5 months. Qualitative findings consist of observations of factors that assist and hinder use of ROM. The initiative identified steps that staff can take to make ROM more useful in their work.