TY - JOUR
AU - C. X. Gao
AU - N. Telford
AU - K. M. Filia
AU - J. M. Menssink
AU - S. Albrecht
AU - P. D. McGorry
AU - M. Hamilton
AU - M. Wang
AU - D. Gan
AU - D. Dwyer
AU - S. Prober
AU - I. Zbukvic
AU - M. Ziou
AU - S. M. Cotton
AU - D. J. Rickwood
A1 - 
AB - AIMS: The specific and multifaceted service needs of young people have driven the development of youth-specific integrated primary mental healthcare models, such as the internationally pioneering headspace services in Australia. Although these services were designed for early intervention, they often need to cater for young people with severe conditions and complex needs, creating challenges in service planning and resource allocation. There is, however, a lack of understanding and consensus on the definition of complexity in such clinical settings. METHODS: This retrospective study involved analysis of headspace's clinical minimum data set from young people accessing services in Australia between 1 July 2018 and 30 June 2019. Based on consultations with experts, complexity factors were mapped from a range of demographic information, symptom severity, diagnoses, illness stage, primary presenting issues and service engagement patterns. Consensus clustering was used to identify complexity subgroups based on identified factors. Multinomial logistic regression was then used to evaluate whether these complexity subgroups were associated with other risk factors. RESULTS: A total of 81,622 episodes of care from 76,021 young people across 113 services were analysed. Around 20% of young people clustered into a 'high complexity' group, presenting with a variety of complexity factors, including severe disorders, a trauma history and psychosocial impairments. Two moderate complexity groups were identified representing 'distress complexity' and 'psychosocial complexity' (about 20% each). Compared with the 'distress complexity' group, young people in the 'psychosocial complexity' group presented with a higher proportion of education, employment and housing issues in addition to psychological distress, and had lower levels of service engagement. The distribution of complexity profiles also varied across different headspace services. CONCLUSIONS: The proposed data-driven complexity model offers valuable insights for clinical planning and resource allocation. The identified groups highlight the importance of adopting a holistic and multidisciplinary approach to address the diverse factors contributing to clinical complexity. The large number of young people presenting with moderate-to-high complexity to headspace early intervention services emphasises the need for systemic change in youth mental healthcare to ensure the availability of appropriate and timely support for all young people.
AD - Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.; Orygen, Parkville, VIC,Australia.; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.; headspace, National Youth Mental Health Foundation, Melbourne, VIC, Australia.; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.; Faculty of Health, University of Canberra, Canberra, ACT, Australia.
AN - 39291560
BT - Epidemiol Psychiatr Sci
C5 - Healthcare Disparities
DA - Sep 18
DO - 10.1017/s2045796024000386
DP - NLM
ET - 20240918
JF - Epidemiol Psychiatr Sci
LA - eng
N2 - AIMS: The specific and multifaceted service needs of young people have driven the development of youth-specific integrated primary mental healthcare models, such as the internationally pioneering headspace services in Australia. Although these services were designed for early intervention, they often need to cater for young people with severe conditions and complex needs, creating challenges in service planning and resource allocation. There is, however, a lack of understanding and consensus on the definition of complexity in such clinical settings. METHODS: This retrospective study involved analysis of headspace's clinical minimum data set from young people accessing services in Australia between 1 July 2018 and 30 June 2019. Based on consultations with experts, complexity factors were mapped from a range of demographic information, symptom severity, diagnoses, illness stage, primary presenting issues and service engagement patterns. Consensus clustering was used to identify complexity subgroups based on identified factors. Multinomial logistic regression was then used to evaluate whether these complexity subgroups were associated with other risk factors. RESULTS: A total of 81,622 episodes of care from 76,021 young people across 113 services were analysed. Around 20% of young people clustered into a 'high complexity' group, presenting with a variety of complexity factors, including severe disorders, a trauma history and psychosocial impairments. Two moderate complexity groups were identified representing 'distress complexity' and 'psychosocial complexity' (about 20% each). Compared with the 'distress complexity' group, young people in the 'psychosocial complexity' group presented with a higher proportion of education, employment and housing issues in addition to psychological distress, and had lower levels of service engagement. The distribution of complexity profiles also varied across different headspace services. CONCLUSIONS: The proposed data-driven complexity model offers valuable insights for clinical planning and resource allocation. The identified groups highlight the importance of adopting a holistic and multidisciplinary approach to address the diverse factors contributing to clinical complexity. The large number of young people presenting with moderate-to-high complexity to headspace early intervention services emphasises the need for systemic change in youth mental healthcare to ensure the availability of appropriate and timely support for all young people.
PY - 2024
SN - 2045-7960 (Print); 2045-7960
SP - e39
ST - Capturing the clinical complexity in young people presenting to primary mental health services: a data-driven approach
T1 - Capturing the clinical complexity in young people presenting to primary mental health services: a data-driven approach
T2 - Epidemiol Psychiatr Sci
TI - Capturing the clinical complexity in young people presenting to primary mental health services: a data-driven approach
U1 - Healthcare Disparities
U3 - 10.1017/s2045796024000386
VL - 33
VO - 2045-7960 (Print); 2045-7960
Y1 - 2024
ER -