The headspace centres that provide enhanced holistic primary care for young Australians need to be resourced so they can better support young people with severe mental ill-health, Professor Patrick McGorry, the executive director of Orygen, the National Centre of Excellence in Youth Mental Health, has written in an editorial for this week’s issue of the Medical Journal of Australia.
Up until 10 years ago, young Australians had poor access to mental healthcare. However, in 2006, Australia led the world by investing in a missing element of the health system – holistic primary mental health care for young people – through headspace, a system of one-stop-shops aimed at integrating health and social care for young people aged 12-25, Professor McGorry said.
This week’s Medical Journal of Australia includes a supplement, written by Professor McGorry, Dr Sarah Hetrick, Dr Matthew Hamilton, and other researchers from Orygen that analyses the evidence in support of integrated youth health care and where future investment should be focussed.
“The data shows that many young people who may not otherwise have sought help are accessing headspace centres, and there are promising outcomes, with short-term outcomes improving for more than 60 per cent of young people,” Professor McGorry said.
“However there are improvements that could be made to the headspace model. Some young people, such as those with more complex and severe presentations, have not benefitted as greatly, because the primary care model of headspace alone is insufficiently resourced to respond.
“The fact that mental ill-health starts so much earlier in life than other major non-communicable diseases means that it has a much more devastating public health and economic impact,” Professor McGorry said. ”Seventy-five per cent of mental disorders emerge before the age of 25 and cause premature death, pave the way to a lifetime of social welfare, or erode human potential on a wide scale.
headspace centres aim to offer at least four streams of care: physical and sexual health, mental health, drug and alcohol expertise, and vocational services, Professor McGorry said.
“However the core headspace grant to centres has never been indexed and hence services have been eroding every year. Defined funding streams for substance use and vocational interventions have not yet been developed. The failure to develop a sound financial model for encouraging general practitioner recruitment means that many centres still lack sufficient on-site GPs.”
“We need the Australian Government to increase and index the core headspace grant, and specifically make it more viable financially for GPs to practice within a youth mental health setting,” Professor McGorry said. Further, he said the government needed to meet the needs of the substantial number of young people with more complex and severe mental health conditions by adopting three key approaches:
- lifting the cap on allied health sessions (currently a maximum of 10 sessions are permitted) so a longer and more intensive tenure of headspace care is possible
- providing more specialised care in areas such as complex mood disorders, psychosis, and eating, personality and substance-use disorders; and
- funding mobile home-based and outreach interventions for young people who cannot access a centre or are difficult to engage.
“The Australian Government has a stream of funds tagged as ‘youth severe’ which is intended to respond to the needs of these patients,” Professor McGorry said. “This stream should be substantially expanded, linked specifically to the headspace system, and funding directed towards these three key areas.”
Orygen, the National Centre of Excellence in Youth Mental Health, is the lead agency for four headspace centres in the north-west of Melbourne. Professor McGorry is a board member of headspace.
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