Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-28T15:20:22.308Z Has data issue: false hasContentIssue false
  • English
  • Français

“What is the efficacy of specialised early intervention in mental health targeting simultaneously adolescents and young adults?’’ An HTA

Published online by Cambridge University Press:  24 April 2019

Angela Ly ,
Gilbert A. Tremblay  and
Sylvie Beauchamp
Angela Ly*
Affiliation:
Centre intégré universitaire de santé et de services sociaux de l'Ouest-de-l’Île-de-Montréal
Gilbert A. Tremblay
Affiliation:
Centre intégré universitaire de santé et de services sociaux de l'Ouest-de-l’Île-de-Montréal
Sylvie Beauchamp
Affiliation:
Centre intégré universitaire de santé et de services sociaux de l'Ouest-de-l’Île-de-Montréal McGill University
*
Author for correspondence: Angela Ly, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

Current service organization is not adapted for youth with or at risk of mental illness. Access, engagement and continuity of care are notorious challenges, particularly during transition from adolescence to adulthood, when youths are transferred to adult services. An HTA was initiated to evaluate the efficacy of programs for which admission is not a function of the legal age of majority.

Methods

A systematic review of systematic reviews identified literature published between 2000 and 2017 in 4 databases. To be selected, studies had to focus on specialised mental healthcare early intervention (EI) programs targeting both adolescents and young adults. Contextual and experiential data were collected through interviews with local leading experts. Article selection and quality assessment using ROBIS were conducted with inter rater agreement. The analytical framework developed includes 4 domains: access, engagement and continuity, recovery as well as meaningfulness and acceptability.

Results

1841 references were identified. Following inclusion/exclusion criteria, 5 studies were selected, 3 of which focused on EI for psyschosis. EI programs alone do not seem to decrease duration of untreated psychosis. EI including a multi focus campaign were more successful. EI does, however, seem to decrease hospitalisation for psychosis. The experience of service users and professionals with inter agency collaboration and person-centred care models were analysed to identify facilitating and inhibiting implementation factors.

Conclusions

Healthcare policies need to support further research and development of EI where admission is not a function of the legal age of majority and diagnostic, particularly for youths at risk.

Keywords

mental health serviceshealth services researchtransition to adult careadolescentyoung adultearly intervention
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 35 , Issue 2 , 2019 , pp. 134 - 140
Copyright
Copyright © Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Kessler, RC, BP, Demler, O, Jin, R, Merikangas, KR and Walters, EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 6, 593–602.Google Scholar
2.Davis, M and Vander Stoep, A (1997) The transition to adulthood for youth who have serious emotional disturbance: Developmental transition and young adult outcomes. J Ment Health Admin 24(4), 400–27. doi: 10.1007/bf02790503.Google Scholar
3.Bédard, M, Connolly, D and Gravel, R (2004) Canadian Community Health Survey - Mental Health and Well Being. Government of Canada.Google Scholar
4.Bergeron, E, Poirier, L-R, Fournier, L, Roberge, P (2005) Determinants of service use among young Canadians with mental disorders. Can J of Psychiat 50, 629–36.Google Scholar
5.Perkins, DO, Gu, H, Boteva, K, Lieberman, JA (2005) Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: a critical review and meta-analysis. Am J Psychiat 261(10), 1785–804.Google Scholar
6.Marshall, M, Lewis, S, Lockwood, A, Drake, R, Jones, P and Croudace, T (2005) Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review. Arch Gen Psychiatry 62(9), 975–83.Google Scholar
7.Addington, D, McKenzie, E, Addington, J, Patten, S, Smith, H and Adair, C (2005) Performance Measures for Early Treatment Services. Psychiatric Services 56, 1570–82.Google Scholar
8.Whitley, R and Drake, R (2010) Recovery: A Dimensional Approach. Psychiatric Services 61, 1248–50.Google Scholar
9.The Joanna Briggs Institute (2005) The JBI Model of Evidence-based Health Care: A Model reconsidered. Australia.Google Scholar
10.Whiting, P, Savović, J, Higgins, JPT, Caldwell, DM, Reeves, BC, Shea, BJ et al. (2016) ROBIS: A new tool to assess risk of bias in systematic reviews was developed. J Clin Epidemiol 69, 225–34.Google Scholar
11.National Autism Center (NAC) (2009) National standards report: The national standards project—Addressing the need for evidence-based practice guidelines for autism spectrum disorders. Randolph, MA: NAC.Google Scholar
12.Institut national d'excellence en santé et en services sociaux (INESSS) (2015) Cadre d’élaboration des guides de pratique dans le secteur des services sociaux. Document rédigé par Sylvie Beauchamp MD, Carmen Dione et Jean-Pierre Duplantie, Institut national d'excellence en santé et en services sociaux (INESSS), 1–81.Google Scholar
13.Beauchamp, S, Drapeau, M, Dionne, C. (2015) The Development of Practice Guidelines in the Social and Human Sciences. Can Psychol.Google Scholar
14.Lloyd-Evans, B, Crosby, M, Stockton, S, Pilling, S, Hobbs, L, Hinton, M et al. (2011) Initiatives to shorten duration of untreated psychosis: systematic review. Brit J Psychiat 198(4), 256–63.Google Scholar
15.Randall, JR, Vokey, S, Loewen, H, Martens, PJ, Brownell, M, Katz, AC et al. (2015) A Systematic Review of the Effect of Early Interventions for Psychosis on the Usage of Inpatient Services. Schizophrenia Bull 41(6), 1379–86.Google Scholar
16.Bond, GR, Drake, RE and Luciano, A (2015) Employment and educational outcomes in early intervention programmes for early psychosis: a systematic review. Epidemiol E Psychiat S 24(5), 446–57.Google Scholar
17.Cooper, M, Evans, Y and Pybis, J (2016) Interagency collaboration in children and young people's mental health: a systematic review of outcomes, facilitating factors and inhibiting factors. Child Care Hlth Dev 42(3), 325–42.Google Scholar
18.Johannessen, JO, McGlashan, TH, Larsen, TK, Horneland, M, Joa, I, Mardal, S et al. (2001) Early detection strategies for untreated first-episode psychosis. Schizophr Res 51(1), 39–46.Google Scholar
19.Melle, I, Larsen, TK, Haahr, U et al. (2004) Reducing the duration of untreated first-episode psychosis: Effects on clinical presentation. Arch Gen Psychiatry 61(2), 143–50.Google Scholar
20.McGorry, PD, Edwards, J, Mihalopoulos, C, Harrigan, SM and Jackson, HJ (1996) EPPIC: an evolving system of early detection and optimal management. Schiz Bull 22.Google Scholar
21.Malla, A, Norman, R, Scholten, D, Manchanda, R, McLean, TS (2005) A community intervention for early identification of First Episode Psychosis. Soc Psych Psych Epid 40(5), 337–44.Google Scholar
22.Killackey, E, Jackson, HJ and McGorry, PD (2008) Vocational intervention in first-episode psychosis: individual placement and support v. treatment as usual. Brit J Psychiat 193(2), 114–20.Google Scholar
23.Killackey, EJ, Allott, KA, Cotton, SM, Chinnery, GL, Sun, P, Collins, Z et al. (2012) Vocational recovery in first-episode psychosis: first results from a large randomized controlled trial of IPS. Early Interv Psychiat 6(13).Google Scholar
24.Garety, PA, Craig, TK, Dunn, G, Fornells-Ambrojo, M, Colbert, S, Rahaman, N (2006) Specialised care for early psychosis: symptoms, social functioning and patient satisfaction Randomised controlled trial. Brit J Psychiat 18, 8.Google Scholar
25.Bertelsen, M, Jeppesen, P, Petersen, L, Thorup, A, Øhlenschlæger, J, Quach, P (2008) Five-year follow-up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness: the OPUS trial. Arch Gen Psychiatry 65.Google Scholar
26.Craig, TK, Garety, P, Power, P, Rahaman, N, Colbert, S and Fornells-Ambrojo, M (2004) The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis. BMJ Brit Med J 329, 1–5.Google Scholar
27.Cocchi, A, Mapelli, V, Meneghelli, A and Preti, A (2011) Cost-effectiveness of treating first-episode psychosis: five-year follow-up results from an Italian early intervention programme. Early Interv Psychiat 5, 203–11.Google Scholar
28.Cullberg, J, Levander, S, Holmqvist, R, Mattsson, M and Wieselgren, IM (2002) One-year outcome in first episode psychosis patients in the Swedish Parachute project. Acta Psychiat Scand 106(4), 276–85. Epub 2002/09/13. PubMed PMID: 12225494.Google Scholar
29.Goldberg, K, Norman, R and Hoch, JS (2006) Impact of a specialized early intervention service for psychotic disorders on patient characteristics, service use, and hospital costs in a defined catchment area. . Can J Psychiat 51, 895–903.Google Scholar
30.Petrakis, M, Penno, S, Oxley, J, Bloom, H, Castle, D (2012) Early psychosis treatment in an integrated model within an adult mental health service. Eur Psychiat 27, 483–8.Google Scholar
31.Singh, SP, Grange, T, Vijaykrishnan, A, Francis, S, White, S, Fisher, H et al. (2007) One-year outcome of an early intervention in psychosis service: a naturalistic evaluation. Early Interv Psychiat 1(3), 282–7.Google Scholar
32.Grawe, R, Falloon, I, Widen, J and Skogvoll, E (2006) Two years of continued early treatment for recent-onset schizophrenia: a randomised controlled study. Acta Psychia Scand 114.Google Scholar
33.Eack, SM, Hogarty, GE, Greenwald, DP, Hogarty, SS, Keshavan, M (2011) Effects of Cognitive Enhancement Therapy on Employment Outcomes in Early Schizophrenia: Results From a Two-Year Randomized Trial. Res Soc Work Practice 21(1), 32–42.Google Scholar
34.Henry, L, Amminger, G, Harris, M, Yuen, H, Harrigan, S, Prosser, A et al. (2010) The EPPIC follow-up study of first-episode psychosis study: effects on 10-year outcome. J Clin Psychiat 71, 716–28.Google Scholar
35.Mihalopoulos, C, Harris, M, Henry, L, Harrigan, S, McGorry, P (2009) Is Early Intervention in Psychosis Cost-Effective Over the Long Term? Schiz Bull 35(5), 909–18.Google Scholar
36.Penn, DL, Uzenoff, SR, Perkins, D, Mueser, KT, Hamer, R, Waldheter, E et al. (2011) A pilot investigation of the Graduated Recovery Intervention Program (GRIP) for first episode psychosis. Schizophr Res 125(2–3), 247–56.Google Scholar
37.Major, BS, Hinton, MF, Flint, A, Chalmers-Brown, A, McLoughlin, K and Johnson, S (2010) Evidence of the effectiveness of a specialist vocational intervention following first episode psychosis: a naturalistic prospective cohort study. Soc Psychiatr Psychiatr Epid 45(1), 1–8.Google Scholar
38.Nuechterlein, KH, Subotnik, KL, Ventura, J, Turner, LR, Gitlin, MJ, Gretchen-Doorly, D et al. (Submitted) Successful return to work or school after a fisrt episode of schizophrenia: the UCLA randomised controlled trial of Individual Place and Support and work place fundamentals module traning.Google Scholar
39.Cullberg, J, Mattsson, M, Levander, S, Holmqvist, R, Tomsmark, L, Elingfors, C et al. (2006) Treatment costs and clinical outcome for first episode schizophrenia patients: a 3-year follow-up of the Swedish ‘Parachute Project’ and Two Comparison Groups. Acta Psychiatr Scand 114(4), 274–81.Google Scholar
40.Agius, M, Shah, S, Ramkisson, R, Murphy, S and Zaman, R (2007). Three year outcomes of an early intervention for psychosis service as compared with treatment as usual for first psychotic episodes in a standard community mental health team - final results. Psychiatr Danub 19(3), 130–8. PubMed PMID: 17914313.Google Scholar
41.Gondek, D, Edbrooke-Childs, J, Velikonja, T, Chapman, L, Saunders, F, Hayes, D et al. (2016) Facilitators and Barriers to Person-centred Care in Child and Young People Mental Health Services: A Systematic Review. Clin Psychol Psychol 24(4)Google Scholar
42.O'Herlihy, A, Oliva, L, Evans, Y and Cooper, M. Parents'and carers’ views of child and adolescent mental health services. (Unpubl data).Google Scholar
43.England, E, Lester, H and Birchwood, M (2009) Collaborating to Provide Early-Intervention Services to Persons in England With First-Episode Psychosis. Psychiat Serv 60(11), 1484–8. PubMed PMID: 19880466.Google Scholar
44.Hamilton, J, Begley, C, Culler, R (2014) Evaluation of partner collaboration to improve community-based mental health services for low-income minority children and their families. Eval Program Plann 45, 50–60.Google Scholar
45.Holmesland, A-L, Seikkula, J and Hopfenbeck, M (2014) Inter-agency work in Open Dialogue: the significance of listening and authenticity. Journal of Interprofessional Care 28(5), 433–9.Google Scholar
46.McLean, S (2012) Barriers to collaboration on behalf of children with challenging behaviours: a large qualitative study of five constituent groups. Child Fam Soc Work 17(4), 478–86.Google Scholar
47.Rivard, JC, Morrissey, JP (2003) Factors Associated with Interagency Coordination in a Child Mental Health Service System Demonstration. Adm Policy Ment Hlth 30(5), 397–415.Google Scholar
48.Spong, S, Waters, R, Dowd, C and Jackson, C (2013) The Relationship between Specialist Child and Adolescent Mental Health Services (CAMHS) and School- and Community-based Counselling for Children and Young People.Google Scholar
49.Flexhaug, M, Noyes, S and Phillips, R (2012) Integrated models of primary care and mental health and substance use care in the community: Literature review and guiding document. Victoria, BC: BC Ministry of Health.Google Scholar
50.Idenfors, H, Kullgren, G and Renberg, ES (2015) Professional Care as an Option Prior to Self-Harm A Qualitative Study Exploring Young People's Experiences. Crisis 36(3), 179–86.Google Scholar
51.Pycroft, A, Wallis, A, Bigg, J and Webster, G (2015) Participation, Engagement and Change: A Study of the Experiences of Service Users of the Unified Adolescent Team. Brit J of Soc Work 45(2), 422–39.Google Scholar
52.Street, C (2004) In-patient mental health services for young people-changing to meet new needs? J R Soc Promo Health 124(3), 115–8. Epub 2004/06/16. PubMed PMID: 15195450.Google Scholar
53.Simmons, MB, Hetrick, SE and Jorm, AF (2011) Experiences of treatment decision making for young people diagnosed with depressive disorders: a qualitative study in primary care and specialist mental health settings. BMC Psychiatry 11(1), 194.Google Scholar
54.Pelto-Piri, V, Engström, K and Engström, I (2013) Paternalism, autonomy and reciprocity: ethical perspectives in encounters with patients in psychiatric in-patient care. BMC Med Ethics 14(1), 49.Google Scholar
55.McGorry, PD, Hickie, IB, Yung, AR, Pantelis, C, Jackson, HJ (2007) Clinical staging of psychiatric disorders: a heuristic framework for choosing earlier, safer and more effective interventions. Aust NZ J Psychiat 40(8), 616–22.Google Scholar
56.Ontario Ministry of Health and Long-Term Care (2004) Program Policy Framework for Early Intervention in Psychosis. Toronto, Canada, 29p.Google Scholar