Mental health services: two-thirds of headspace clients show improvement, Australia

headspace has been associated with improved mental health outcomes for young Australians, according to research published in the Medical Journal of Australia.

Data from 24 034 clients who presented to a headspace centre between April 2013 and March 2014, and from 651 who returned a follow-up survey 90 days after their treatment were examined by researchers from the University of Canberra, headspace and the ORYGEN Youth Health Research Centre in Melbourne.

Prof Debra Rickwood and colleagues, found that the most common mental health problems evident at clients' first presentation to headspace were depressive symptoms and anxiety, which accounted for more than two-thirds of all presentations.

The exceptions were 12 to 14-year-old boys who presented most frequently with anxiety and anger issues. Younger females (12-14 years) had higher presentation rates for deliberate self- harm than other client subgroups.

Cognitive behavior therapy was used most often as treatment, notably in 43.6% of clients with depressive symptoms. Supportive counselling (except for cases of borderline personality cases) and psychoeducation were the second and third most common treatments.

Using measures of psychological distress (Kessler K10) and psychosocial functioning (Social and Occupational Functioning Assessment Scale) take at initial presentation and at last assessment, the researchers found that 60% of headspace clients showed significant improvement on one or both measures.

"Improvements in young people with greater distress and poorer functioning at service entry were noted in those who engaged well with the service (ie, attended more health care sessions)", the researchers wrote.

"The most recent report from the National Outcomes and Casemix Collection (NOCC), which used the Health of the Nation Outcome Scales (HoNOS) family of outcome measures, showed that 37% of those aged 0-17 years and 24% of those aged 18-64 years using community-based public mental health services reported a significant improvement between the first and last occasions of service.

"The outcomes in young people reported here are similar to the child and adolescent results of the NOCC report, but much better than its findings for adults.

"headspace is committed to examining and reporting outcomes for young people using its services, and ... the headspace centre initiative is associated with improved mental health outcomes for a large number of young people assisted by this network across Australia", they concluded.

headspace Performing Well, But Tweaks Needed

A review of services provided to young Australians by headspace centres has found they are providing innovative, direct and indirect access to mental health care in a timely fashion, according to research published in the Medical Journal of Australia.

A team of researchers from headspace, the Faculty of Health at the University of Canberra (UC) and the Orygen Youth Health Research Centre in Melbourne conducted a census of 33 038 young people (aged 12 years to 25) who accessed 55 headspace centres between April 2013 and March 2014.

Prof Debra Rickwood and colleagues, found that the waiting time for a first appointment was 2 weeks or less for 80.1% of clients, with only 5.3% waiting for more than 4 weeks, described by the researchers as "a notable achievement".

"Wait times are a major barrier in traditional mental health services, and minimising waiting is a distinguishing focus of headspace", the researchers, led by Professor Debra Rickwood, professor of psychology at UC, wrote. "Nevertheless, some clients waited longer, and wait times were longer in more established centres. Minimising wait times must remain a constant focus for headspace services."

Almost three-quarters of presentations to headspace specifically involved mental health and behavioural problems, the census revealed; 13.4% were for situational problems and 7.1% for physical or sexual health concerns. Only a small proportion (3.1%) presented primarily for alcohol and other drug (AOD) problems, and very few (1.8%) for vocational reasons.

Funding for headspace relies on a number of sources.

Engagement and assessment services, mental health services and, physical and sexual health services are largely funded by the headspace grant, through the Medical Benefits Scheme, or the Access to Allied Psychological Services program.

However, the main funding source for AOD and vocational services was "in-kind support by co- located services or consortium partners". Although this arrangement was "emphasising the value of the local partnership model that underpins service delivery", wrote the authors, it was "also revealing vulnerability in terms of stable funding". "Building the capacity of the headspace model to better support young people with vocational needs and secondary AOD problems should be a priority."

"Our results confirm patterns that diverge from traditional mental health service delivery, and we argue that these patterns are more appropriate for meeting the social and mental health needs of young people."