Jane H RobertsGP and Senior Lecturer University of Sunderland

RCGP Adolescent Health Group

Churchill Fellow 2010Overview of talk

Australian context Adolescent mental

health New developments in

community based service provision

Key findings Conclusions

Aboriginal rock paintings Historical background

‘Old’ and ‘new’ country Aboriginal culture 50

000 years old 1700s British colony 1850s 6 states – with

independent governance

1900 Australian independence

1931 Commonwealth

6th largest country in the worldPopulation 20 million

13th richest economy

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

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’

Melbourne ‘Sunshine’ centre Key points

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

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

Sculpture in Adelaide The big issues

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?

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 ?

Cleland Wildlife Park Key messages

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

http://www.wmct.org.uk