The services needed for young people and their families affected by severe and complex youth mental health issues are wide-ranging. There must a fully integrated and comprehensive system available to enable access to treatment, skill development, education, training, financial, accommodation and legal support and more. To partition these services is extremely problematic as no young person deals with their multiple issues in separate compartments – the combined effect creates an individual with unique challenges and therefore, unique needs. And no need can be addressed in isolation.
However, for the purposes of service provision – particularly government services, there are departmental divisions to enable allocation of roles and responsibilities. So, to ensure that these demarcations do not mean that a young person is viewed as having separate and discrete issues, the collaboration between all of these departments, units and groups is ESSENTIAL. Service providers of any kind must have appropriate (ensuring adherence to privacy issues) access to information on what the young person’s issues and needs are across the board. Only if this is the case, will the understand the young person’s situation and be able to provided the most targeted service themselves. The necessary integrated network should include:
- Treatment (ranging from community, residential and hospital services for Children, Adolescents, Families and Adults and including drug and alcohol treatment/rehab)
- Vocational/Academic Consultation, Training and Service Provision
- Training for Independent Living
- Justice/Legal Support services
- Financial/Disability Support Services
- Housing/Accommodation Support
These services must have regular, formalised lines of contact and established forums for communication not only to provide the best service to ‘consumers’ but to provide professional support for practitioners dealing with individuals whose lives encompass the full range of fields of operation and need. Treating a mental illness cannot be done in isolation from the other aspects of a patient’s life so having an understanding of the person as a whole is the most effective way to achieving progress. So anyone treating/teaching/assisting a particular young person should be in regular contact with anyone else treating/teaching/assisting that young person.
Allowing for entry at any level and movement between levels of care as appropriate, services must be mapped and all service providers – both government, private and NGO – must be aware of the full range of services in the continuum. (Clinicians in the acute wards must know what Step Down services are available, private clinicians must know what is available for those young people with more complex, treatment resistant or persistent conditions etc.) And there there must be clear referral pathways to services so that the needs of any young person will be met as quickly and easily as possible. The public too must also have access to clear information on all available services with indications as to who will benefit from each and how the service can be accessed as ‘consumers and carers’ have the most information on each young person’s situation and may need to advocate to have ensure needs are appropriately met.
And to create and then continually evolve such a system, organised and purposeful research must be underway across all aspects of service provision. Methods (e.g. the use of available and emerging technologies) must be explored to access greater input from those whose illness continues to isolate them – not only in order to gather evidence that might prevent future generations from having to endure the multiple effects of severe and complex mental illness, but to establish therapeutic connections that can continue to engage young people and their families in treatment, education and other support services. In addition, greater understanding of the reality of living with the issues of severe and complex adolescent mental illness must be actively facilitated across numerous groups. This would include Emergency Department staff, local GPs/mental health specialists whose experience has never been with the severe and complex adolescent cohort, educators and the wider public. When the multiple daily limitations and challenges begin to be understood by all those who have contact with those affected, improved service is surely inevitable. So consumers/carers undertaking to share personal stories that describe their own experiences through the development of resources and training materials should be supported and facilitated wherever possible.
Services are needed. But so much more is also essential. Structures, systems, education, research projects – and the funding required to to undertake these – must be considered as equally important as specific service options. Because as vital as what increasingly becomes available will always be, it is equally important to ensure that everything is delivered in the best way, ensuring that the young person and those close to him as seen as both individuals and whole people with their own complex needs. And every part of this comprehensive system must continue to evolve to match the needs of those whose struggle can often be so challenging that they can become disillusioned with primary care and disengaged from seeking any support at all.
So, although all services must overlap, blend and work together, the sub-categories of HEALTH, EDUCATION, and OTHER on this site will seek to address the issues being dealt with via the departments where responsibilities have been allocated.