Detection and intervention in emerging youth mental health issues: Outcomes from the first year of the CASPAR service.

Abstract

There is a recognized gap in mental health service provision for youth, a population in whom emerging mental disorders are prevalent and recognized as a target for early intervention. Comprehensive Assessment Service for Psychosis and At-Risk (CASPAR) is a new, community-based service aiming to address the service gap between headspace and tertiary psychiatric services. CASPAR facilitates assessment and short-term early intervention in youth (aged 12-25 years) with emerging mental health issues. Demographic and clinical characteristics are described in all individuals receiving care from CASPAR in its first year of operation. Changes in psychological distress and psychosocial functioning over the course of a treatment episode are reported. Demographic and clinical data, including measures of functional impairment (Social and Occupational Functioning Assessment Scale [SOFAS]) and psychological distress (Kessler Psychological Distress Scale [K10]), were obtained at baseline and completion of episode of care for all clients. 92 young people (53.3% male, mean age 18.7 years) were included, of whom 20 (21.7%) disengaged before treatment endpoint. Clients who disengaged early were more likely to identify as lesbian, gay, bisexual and transgender+ (LGBT+). At follow-up, 61.1% showed improvements in social functioning (SOFAS) and 64.4% in psychological distress (K10). The majority of clients showed improvements in psychological distress and functioning during an episode of care. LGBT+ youth were less likely to remain engaged with the service. The factors associated with initial and continued engagement with youth early intervention services require further examination, particularly in marginalized groups with high mental illness prevalence such as LGBT+ communities.