Abstract
BackgroundNumerous studies across international settings have highlighted a need to improve the appropriateness and continuity of services for young people experiencing mental ill health. This paper examines key features of a sub-acute youth mental health residential service model, Youth Prevention and Recovery Care (Y-PARC) service. Y-PARC provides up to 4 weeks care to 16 to 25 year-olds at risk of hospitalisation and to those transitioning out of hospital inpatient units. The research was conducted at one of three Y-PARCs located in Victoria, Australia.MethodsThis paper presents findings from analysis of two data sources collected during evaluation of a Y-PARC service in 2015–17. Routinely collected administrative data of Y-PARC residents (n = 288) were analysed and semi-structured interviews were conducted with 38 participants: a) former residents (n = 14); b) family members of group a) (n = 5); key stakeholders (n = 9); and, Y-PARC staff (n = 10 respondents in 3 group interviews). Analysis of the qualitative data was thematic and structured by the interview guide, which covered the key service aims.ResultsConsistent with the aims of the service, respondents described practice at Y-PARC that aligns with recovery-oriented care. Key features emphasised were: a safe and welcoming environment for residents and families; provision of person-centred care; promotion of autonomy and self-help; informal interactions with staff allowing for formation of naturalistic relationships; time spent with other young people with similar experiences; and, assurance upon exit that the ‘door is always open.’High levels of satisfaction were reported. Outcomes described included: improved resilience; better understanding of mental health; the importance of seeking help; and, stronger connections to therapeutic services. Longer and multiple stays were associated with progressive and sustained change. Family members and stakeholders widely reported that the service fills a gap between community services and acute inpatient mental health hospital wards.Some challenging areas of practice identified included: integration of evidence-based psychosocial interventions; provision of care within a model that blends clinical and psychosocial support services; and, negotiation of family-inclusive practice.ConclusionsThe Y-PARC service model shows promise with young people experiencing mental ill health, particularly in improving the range and availability of options across a spectrum of need.
Highlights
Numerous studies across international settings have highlighted a need to improve the appropriateness and continuity of services for young people experiencing mental ill health
This paper reports the findings from an independent evaluation of one Youth Prevention and Recovery Care (Y-Prevention and Recovery Care (PARC)) service located in an outer metropolitan area of Melbourne conducted in 2015–2017
The perspectives of Y-PARC users and their carers were gained in in-depth interviews and analysed alongside information given by staff and stakeholders to enrich understanding of the service model, practice elements and impact
Summary
Numerous studies across international settings have highlighted a need to improve the appropriateness and continuity of services for young people experiencing mental ill health. The impact on social, educational, vocational and developmental milestones can be severe [6] and often persist into adulthood. Despite this high level of need, engagement with mental health services by young people aged 12–25 years is the poorest of all age groups [5]. Experts have advocated for systemic change to improve the care provided to children and young people and boost the inclusion of families/significant others [7,8,9]. A key issue identified in numerous studies is that the difficulties involved in transitioning between child and adult health care systems often result in disengagement [10,11,12,13]
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