Higher rates of disengagement among young adults attending a general adult community mental health team: Time to consider a youth-specific service?

Abstract

The initial onset of mental illness occurs most frequently in adolescence or early adulthood. In order to inform the development of mental health services tailored for youth, we sought to compare the characteristics of young (18-25 years old) and older (over 25 years old) adults following referral to a general adult community mental health team. All individuals referred to a Dublin-based community mental health team and offered an appointment between January 1 and December 31, 2016 were included in the study. Information in relation to engagement patterns, demographic characteristics and clinical characteristics was collected. A total of 298 appointments were offered during the study period among which 94 (31.6%) were for young adults. Significant differences in demographic and clinical characteristics between the two age groups were evident. Young adults were significantly less likely to have been prescribed psychotropic medication at the point of referral (63% vs. 82% respectively, χ2 = 12.30, p < .001). Older adults were four times more likely to demonstrate a good level of early engagement in treatment than young adults (AOR 4.00, 95% CI 1.11-14.37, p = .03). Young adults had distinct clinical needs and a lower level of engagement in the early stage of treatment compared with their older counterparts in this community team. Further research and stakeholder consultation is needed to more clearly identify the issues in relation to patient engagement. These insights will help to inform the development of youth-specific community mental health services.