Present address: Population and Community Health; Department of Family Medicine, 2nd Floor Rm 2711; Clinical Skills Building, UWO London ON N6A 5C1.
An engagement and access model for healthcare delivery to adolescents with mood and anxiety concerns
Version of Record online: 16 DEC 2011
© 2011 Blackwell Publishing Asia Pty Ltd
Early Intervention in Psychiatry
Volume 6, Issue 1, pages 97–105, February 2012
How to Cite
Ross, E., Vingilis, E. and Osuch, E. (2012), An engagement and access model for healthcare delivery to adolescents with mood and anxiety concerns. Early Intervention in Psychiatry, 6: 97–105. doi: 10.1111/j.1751-7893.2011.00312.x
- Issue online: 24 JAN 2012
- Version of Record online: 16 DEC 2011
- Received 25 January 2011; accepted 9 September 2011
- anxiety disorder;
- delivery of health care;
- mood disorder;
- programme evaluation
Aim: Mood and anxiety disorders typically begin during adolescence or early adulthood. Yet services targeting this population are frequently lacking. This study implemented an outreach, access and assessment programme for youth with these concerns. The data reported constitute an evaluation of this mental healthcare delivery approach.
Methods: This evaluation included specification of both programme and implementation theories through causal and programme logic models and formative (process) evaluation. Outreach focused on access points for youth such as schools and family physicians' offices. Concerned youth were encouraged to self-refer. Participants completed a semi-structured clinical interview and symptom and function questionnaire package.
Results: Engagement sessions were conducted and results involved 93 youth. The majority of youth self-referred, a process not possible in traditional physician-referral healthcare systems. Interestingly, almost half had received prior treatment and over half had tried a psychiatric medication. Yet participants had significant symptomatology: 81% reported moderate to severe depressive symptoms; 95% reported high levels of trait-anxiety. Functional impairment was substantial: on average, participants missed 2.6 days of school/work and functioned at reduced levels on 4.2 days in the week prior to assessment. Demographic details are presented.
Conclusion: This study evaluated a mental healthcare delivery system that identified individuals with significant distress and functional impairment from mood/anxiety concerns and previous unsuccessful treatment attempts, verifying that they were in need of mental health services. This approach provides a model for outreach and assessment in this population, where earlier intervention has the potential to prevent chronic mental illness and disability.