Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-23T23:00:53.121Z Has data issue: false hasContentIssue false

Development and evaluation of an educational intervention in youth mental health for primary care practitioners

Published online by Cambridge University Press:  22 December 2014

J. Birrane
Affiliation:
Graduate Entry Medical School, University of Limerick, Limerick, Ireland
D. Swan
Affiliation:
Graduate Entry Medical School, University of Limerick, Limerick, Ireland
D. Aherne
Affiliation:
Graduate Entry Medical School, University of Limerick, Limerick, Ireland
R. Davis
Affiliation:
Child and Adolescent Mental Health Service, Limerick, Ireland
A. Hannigan
Affiliation:
Graduate Entry Medical School, University of Limerick, Limerick, Ireland
D. McPhillips
Affiliation:
Community Substance Misuse Team, Limerick, Ireland
D. Meagher
Affiliation:
Graduate Entry Medical School, University of Limerick, Limerick, Ireland
A. O’Regan
Affiliation:
Graduate Entry Medical School, University of Limerick, Limerick, Ireland
P. Ryan
Affiliation:
Department of Psychology, University of Limerick, Limerick, Ireland
E. Schaffalitzky
Affiliation:
Graduate Entry Medical School, University of Limerick, Limerick, Ireland
W. Cullen*
Affiliation:
UCD School of Medicine & Medical Science, Belfield, Dublin, Ireland
*
*Address for Correspondence: Professor Walter Cullen, UCD School of Medicine & Medical Science, Belfield, Dublin 4, Ireland. (Email: [email protected])

Abstract

Objectives

Irish adolescents have one of the highest rates of suicide and self-harm in the European Union. Although primary care has been identified as an opportune environment in which to detect and treat mental health problems in adolescents, lack of training among primary care professionals (PCPs) is a barrier to optimum identification and treatment. We describe the development and evaluation of an educational intervention on youth mental health and substance misuse for PCPs.

Methods

Thirty general practitioners and other PCPs working in the Mid-West region participated in an educational session on youth-friendly consultations, and identification and treatment of mental ill-health and substance use. Learning objectives were addressed through a presentation, video demonstration, small group discussions, role play, question-and-answer sessions with clinical experts, and an information pack. Following the session, participants completed an evaluation form assessing knowledge gain and usefulness of different components of the session.

Results

A total of 71% of participants were involved in the provision of care to young people and 55% had no previous training in youth mental health or substance abuse. Participants rated knowledge gains as highest with regard to understanding the importance of early intervention, and primary care, in youth mental health. The components rated as most useful were case studies/small group discussion, the ‘question-and-answer session’ with clinical experts, and peer interaction.

Conclusions

The educational session outlined in this pilot was feasible and acceptable and may represent an effective way to train professionals to help tackle the current crisis in youth mental health.

Type
Original Research
Copyright
© College of Psychiatrists of Ireland 2014 

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

Allen, N, Hetrick, S, Simmons, J, Hickie, I (2007). Early intervention for depressive disorders in young people: the opportunity and the (lack of) evidence. The Medical Journal of Australia 187, S15S17.Google Scholar
Berk, M, Hallam, K, Lucas, N, Hasty, M (2007). Early intervention in bipolar disorders: opportunities and pitfalls. The Medical Journal of Australia 187, S11S14.CrossRefGoogle ScholarPubMed
Biddle, L, Donovan, JL, Gunnell, D, Sharp, D (2006). Young adults’ perceptions of GPs as a help source for mental distress: a qualitative study. British Journal of General Practice 56, 924931.Google Scholar
Bloom, BS (2005). Effects of continuing medical education on improving physician clinical care and patient health: a review of systematic reviews. International Journal of Technology Assessment in Health Care 21, 380385.Google Scholar
Cappelli, M, Gray, C, Zemek, R, Cloutier, P, Kennedy, A, Glennie, E, Doucet, G, Lyons, JS (2012). The HEADS-ED: a rapid mental health screening tool for pediatric patients in the emergency department. Pediatrics 130, e321e327.CrossRefGoogle ScholarPubMed
Carr-Gregg, M, Enderby, KC, Grover, SR (2003). Risk-taking behaviour of young women in Australia: screening for health-risk behaviours. Medical Journal of Australia 178, 601604.Google Scholar
Connolly, D, Leahy, D, Bury, G, Gavin, B, McNicholas, F, Meagher, D, O’Kelly, FD, Wiehe, P, Cullen, W (2012). Can general practice help address youth mental health? A retrospective cross-sectional study in Dublin’s south inner city. Early Intervention in Psychiatry 6, 332340.Google Scholar
Coughlan, H, Tiedt, L, Clarke, M, Kelleher, I, Tabish, J, Molloy, C, Harley, M, Cannon, M (2014). Prevalence of DSM-IV mental disorders, deliberate self-harm and suicidal ideation in early adolescence: an Irish population-based study. Journal of Adolescence 37, 19.Google Scholar
Craig, P, Dieppe, P, Macintyre, S, Michie, S, Nazareth, I, Petticrew, M (2008). Developing and evaluating complex interventions: the new Medical Research Council guidance. British Medical Journal 337, a1655.Google Scholar
Cullen, W, Broderick, N, Connolly, D, Meagher, D (2012). What is the role of general practice in addressing youth mental health? A discussion paper. Irish Journal of Medical Science 181, 189197.Google Scholar
Degenhardt, L, Coffey, C, Romaniuk, H, Swift, W, Carlin, JB, Hall, WD, Patton, GC (2013). The persistence of the association between adolescent cannabis use and common mental disorders into young adulthood. Addiction 108, 124133.Google Scholar
Department of Health & Children (2006). A Vision for Change: Report of the Expert Group on Mental Health Policy in Ireland. Dublin, Ireland.Google Scholar
Fallucco, EM, Conlon, MK, Gale, G, Constantino, JN, Glowinski, AL (2012). Use of a standardized patient paradigm to enhance proficiency in risk assessment for adolescent depression and suicide. The Journal of Adolescent Health 51, 6672.CrossRefGoogle ScholarPubMed
Gilbody, S, Whitty, P, Grimshaw, J, Thomas, R (2003). Educational and organizational interventions to improve the management of depression in primary care: a systematic review. Journal of the American Medical Association 289, 31453151.Google Scholar
Gledhill, J, Kramer, T, Iliffe, S, Garralda, ME (2003). Training general practitioners in the identification and management of adolescent depression within the consultation: a feasibility study. Journal of Adolescence 26, 245250.Google Scholar
Goldenring, BJM, Rosen, DS (2004). Getting into adolescent heads: an essential update. Contemporary Pediatrics 21, 119.Google Scholar
Haller, DM, Sanci, LA, Patton, GC, Sawyer, SM (2007). Toward youth friendly services: a survey of young people in primary care. Journal of General Internal Medicine 22, 775781.Google Scholar
Hawton, K, Saunders, KEA, O’Connor, RC (2012). Self-harm and suicide in adolescents. Lancet 379, 23732382.CrossRefGoogle ScholarPubMed
Iliffe, S, Williams, G, Fernandez, V, Vila, M, Kramer, T, Gledhill, J, Miller, L (2009). Treading a fine line: is diagnosing depression in young people just medicalising moodiness? The British Journal of General Practice 59, 156157.Google Scholar
James, PD, Smyth, BP, Apantaku-Olajide, T (2013). Substance use and psychiatric disorders in Irish adolescents: a cross-sectional study of patients attending substance abuse treatment service. Mental Health and Substance Use 6, 124132.Google Scholar
Katon, W, Russo, J, Richardson, L (2008). Anxiety and depression screening for youth in a primary care population. Ambulatory Pediatrics 8, 182188.Google Scholar
Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 593602.Google Scholar
Klein, DA, Goldenring, JM, Adelman, WP (2014). HEEADSSS 3.0: The Psychosocial Interview for Adolescents Updated for a New Century Fueled by Media. Contemporary Pediatrics. (http://contemporarypediatrics.modernmedicine.com/contemporary-pediatrics/news/probing-scars-how-ask-essential-questions?page=full) Accessed 4 November 2014.Google Scholar
Klimas, J, Lally, K, Murphy, L, Crowley, L, Anderson, R, Meagher, D, McCombe, G, Smyth, BP, Bury, G, Cullen, W (2014). Development and process evaluation of an educational intervention to support primary care of problem alcohol among drug users. Drugs and Alcohol Today 14, 7686.CrossRefGoogle Scholar
Kramer, T, Iliffe, S, Bye, A, Miller, L, Gledhill, J, Garralda, ME (2013). Testing the feasibility of therapeutic identification of depression in young people in British general practice. The Journal of Adolescent Health 52, 539545.CrossRefGoogle ScholarPubMed
Leahy, D, Schaffalitzky, E, Armstrong, C, Bury, G, Cussen-Murphy, P, Davis, R, Dooley, B, Gavin, B, Keane, R, Keenan, E, Latham, L, Meagher, D, McGorry, P, McNicholas, F, O’Connor, R, O’Dea, E, O’Keane, V, O’Toole, TP, Reilly, E, Ryan, P, Sanci, L, Smyth, BP, Cullen, W (2013). Primary care and youth mental health in Ireland: qualitative study in deprived urban areas. BMC Family Practice 14, 194.Google Scholar
Lubman, D, Hides, L (2007). Intervening early to reduce developmentally harmful substance use among youth populations. The Medical Journal of Australia 187, S22S25.Google Scholar
Lynch, F, Hornbrook, M (2005). Cost-effectiveness of an intervention to prevent depression in at-risk teens. Archives of General Psychiatry 62, 12411248.CrossRefGoogle ScholarPubMed
MacKay, M, Vincenten, J (2014). National Action to Address Child Intentional Injury – 2014: Europe Summary. Child Safety Alliance: Birmingham, UK.Google Scholar
McGorry, P, Killackey, E, Yung, A (2007 a). Early intervention in psychotic disorders: detection and treatment of the first episode and the critical early stages. The Medical Journal of Australia 187, S8S10.Google Scholar
McGorry, PD, Killackey, E, Yung, A (2008). Early intervention in psychosis: concepts, evidence and future directions. World Psychiatry 7, 148156.CrossRefGoogle ScholarPubMed
McGorry, PD, Purcell, R, Hickie, IB, Jorm, AF (2007 b). Investing in youth mental health is a best buy. The Medical Journal of Australia 187, S5S7.Google Scholar
McMahon, EM, Keeley, H, Cannon, M, Arensman, E, Perry, IJ, Clarke, M, Chambers, D, Corcoran, P (2014). The iceberg of suicide and self-harm in Irish adolescents: a population-based study. Social Psychiatry and Psychiatric Epidemiology 49, 19291935.Google Scholar
Mihalopoulos, C, Harris, M, Henry, L, Harrigan, S, McGorry, P (2009). Is early intervention in psychosis cost-effective over the long term? Schizophrenia Bulletin 35, 909918.CrossRefGoogle ScholarPubMed
Mihalopoulos, C, McGorry, PD, Carter, RC (1999). Is phase-specific, community-oriented treatment of early psychosis an economically viable method of improving outcome? Acta Psychiatrica Scandinavica 100, 4755.Google Scholar
New South Wales Centre for the Advancement of Adolescent Health (2013). New South Wales Youth Friendly General Practice Training Toolkit. NSW Centre for the Advancement of Adolescent Health, The Children’s Hospital at Westmead: Sydney.Google Scholar
NICE (2005). Depression in Children and Young People: Identification and Management in Primary and Secondary Care. (http://www.nice.org.uk/guidance/cg28/resources/cg28-depression-in-children-and-young-people-full-guideline-2) Accessed 4 November 2014.Google Scholar
Parker, A, Hetrick, S, Purcell, R (2010). Psychosocial assessment of young people - refining and evaluating a youth friendly assessment interview. Australian Family Physician 39, 585588.Google Scholar
Patel, V, Flisher, AJ, Hetrick, S, McGorry, P (2007). Mental health of young people: a global public-health challenge. Lancet 369, 13021313.CrossRefGoogle ScholarPubMed
Roberts, JH, Bernard, PM (2012). “Can he have the test for bipolar, doctor? His dad’s got it’: exploring the potential of general practitioners to work with children and young people presenting in primary care with common mental health problems – a clinical initiative. Mental Health in Family Medicine 9, 115123.Google Scholar
Sanci, L, Coffey, C, Patton, G, Bowes, G (2005). Sustainability of change with quality general practitioner education in adolescent health: a 5-year follow-up. Medical Education 39, 557560.CrossRefGoogle ScholarPubMed
Sanci, LA, Coffey, CM, Veit, FC, Carr-Gregg, M, Patton, GC, Day, N, Bowes, G (2000). Evaluation of the effectiveness of an educational intervention for general practitioners in adolescent health care: randomised controlled trial. British Medical Journal 320, 224230.Google Scholar
Schaffalitzky, E, Leahy, D, Cullen, W, Gavin, B, Latham, L, O’Connor, R, Smyth, BP, O’Dea, E, Ryan, S (2014). Youth mental health in deprived urban areas: a Delphi study on the role of the GP in early intervention. Irish Journal of Medical Science. doi:10.1007/s11845-014-1187-z. [Epub ahead of print]CrossRefGoogle Scholar
Smits, PBA, Verbeek, JHAM, de Buisonjé, CD (2002). Problem based learning in continuing medical education: a review of controlled evaluation studies. British Medical Journal 324, 153156.CrossRefGoogle ScholarPubMed
Royal Australasian College of Physicians (2008). Routine adolescent psychosocial health assessment – position statement. (http://www.racp.edu.au/index.cfm?objectid=B56658DA-08B2-14E3-0EE26F1635D1314E) Accessed 4 November 2014.Google Scholar
Trillingsgaard, T, Trillingsgaard, A, Webster-Stratton, C (2014). Assessing the effectiveness of the ‘Incredible Years(®) parent training’ to parents of young children with ADHD symptoms – a preliminary report. Scandinavian Journal of Psychology 55, 538545.Google Scholar
United Kingdom Department of Children, Schools and Families (2010). Early Intervention: Securing Good Outcomes for All Children and Young People. (http://www.education.gov.uk/publications/eOrderingDownload/DCSF-00349-2010.pdf) Accessed 4 November 2014.Google Scholar
van Amstel, LL, Lafleur, DL, Blake, K (2004). Raising Our HEADSS: adolescent psychosocial documentation in the emergency department. Academic Emergency Medicine 11, 648655.Google Scholar
van Voorhees, BW, Fogel, J, Houston, TK, Cooper, LA, Wang, N-Y, Ford, DE (2005). Beliefs and attitudes associated with the intention to not accept the diagnosis of depression among young adults. Annals of Family Medicine 3, 3846.Google Scholar
Wilson, H, Bostock, N, Phillip, N, Shannon, P, Payne, D, Kennedy, A (2012). Opportunistic adolescent health screening of surgical inpatients. Archives of Disease in Childhood 97, 919921.Google Scholar