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Primary care support for youth mental health: a preliminary evidence base for Ireland’s Mid-West

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Abstract

Background

Mental and substance use disorders are leading causes of morbidity. Prevention/treatment amongst young people are global health priorities. International data have highlighted primary care and general practice as important in addressing these.

Aims

Survey of 128 physicians (GPs) in Ireland’s Mid-West (Counties Limerick, Clare, North Tipperary) to document the spectrum of youth mental health problems, describe strategies adopted by GPs in dealing with these, identify barriers (perceived by GPs) to effective care of young mental health patients and collate GP proposals for improved care of this cohort.

Methods

Self-administered questionnaire on physician and practice demographics, case management and barriers to care in youth mental health.

Results

Thirty-nine GPs (31 %) responded. Mental health and family conflict represented the most frequent reasons why young people attended GPs. Depression, anxiety, family conflict, suicidal thoughts/behaviour, and attention deficit hyperactivity disorder (ADHD) were the most common issues followed by substance abuse and antisocial behaviours. GP referral practices for young people with mental/substance use disorders varied, with distinctions between actual and preferred management due to insufficient access to dedicated youth services and training. GPs stated need for improved access to existing services (i.e., Psychiatry, counseling/psychology, social/educational interventions). A number of GPs surveyed were located, or provided care, in Limerick’s ‘Regeneration Areas’. Young people in these areas predominantly attended GPs due to mental/substance use issues and antenatal care, rather than acute or general medical problems.

Conclusions

GPs play an important role in meeting youth mental health needs in this region and, in particular, in economically deprived urban areas.

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References

  1. McGorry P, Killackey E, Yung A (2008) Early intervention in psychosis: concepts, evidence and future directions. World Psychiatry 7(3):148–156

    PubMed  Google Scholar 

  2. Allen N, Hetrick S, Simmons J, Hickie I (2007) Early intervention for depressive disorders in young people: the opportunity and the (lack of) evidence. Med J Aust 187(7 Suppl):S15–S17

    PubMed  Google Scholar 

  3. Berk M, Hallam K, Lucas N et al (2007) Early intervention in bipolar disorders: opportunities and pitfalls. Med J Aust 187(7 Suppl):S11–S14

    PubMed  Google Scholar 

  4. Chanen A, McCutcheon L, Jovev M, Jackson H, McGorry P (2007) Prevention and early intervention for borderline personality disorder. Med J Aust 187(7 Suppl):S18–S21

    PubMed  Google Scholar 

  5. Lubman D, Hides L, Yucel M, Toumbourou J (2007) Intervening early to reduce developmentally harmful substance use among youth populations. Med J Aust 187(7 Suppl):S22–S25

    PubMed  Google Scholar 

  6. Kessler R, Berglund P, Demler O et al (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62(6):593–602

    Article  PubMed  Google Scholar 

  7. Swendsen J, Burstein M, Case B et al (2012) Use and abuse of alcohol and illicit drugs in US adolescents: results of the National Comorbidity Survey-Adolescent Supplement. Arch Gen Psychiatry 69(4):390–398

    Article  PubMed  Google Scholar 

  8. Swendsen J, Conway K, Degenhardt L et al (2010) Mental disorders as risk factors for substance use, abuse and dependence: results from the 10-year follow-up of the National Comorbidity Survey. Addiction 105(6):1117–1128

    Article  PubMed  Google Scholar 

  9. Australian Institute of Health and Welfare (2011) Young Australians: their health and wellbeing 2011. Australian Institute of Health and Welfare, Canberra. http://www.aihw.gov.au/publication-detail/?id=10737419261&tab=2

  10. National Youth Council of Ireland (2009) The Truth about Youth Survey. National Youth Council of Ireland, Dublin. http://www.youth.ie/sites/youth.ie/files/The_Truth_About_Youth%2009.pdf

  11. Tylee A, Haller D, Graham T, Churchill R, Sanci LA (2007) Youth-friendly primary-care services: how are we doing and what more needs to be done? Lancet 369(9572):1565–1573

    Article  PubMed  Google Scholar 

  12. Rickwood D, Deane F, Wilson C (2007) When and how do young people seek professional help for mental health problems? Med J Aust 187(7 Suppl):S35–S39

    PubMed  Google Scholar 

  13. Biddle L, Donovan J, Gunnell D, Sharp D (2006) Young adults’ perceptions of GPs as a help source for mental distress: a qualitative study. Br J Gen Pract 56(533):924–931

    PubMed  Google Scholar 

  14. Owens C, Lambert H, Donovan J, Lloyd K (2005) A qualitative study of help seeking and primary care consultation prior to suicide. Br J Gen Pract 55(516):503–509

    PubMed  Google Scholar 

  15. Hickie I, Fogarty A, Davenport T, Luscombe G, Burns J (2007) Responding to experiences of young people with common mental health problems attending Australian general practice. Med J Aust 187(7 Suppl):S47–S52

    PubMed  Google Scholar 

  16. Kramer T, Garralda M (1998) Psychiatric disorders in adolescents in primary care. Br J Psychiatry 173:508–513

    Article  PubMed  CAS  Google Scholar 

  17. Zuckerbrot R, Maxon L, Pagar D et al (2007) Adolescent depression screening in primary care: feasibility and acceptability. Paediatrics 119(1):101–108

    Article  Google Scholar 

  18. Gardner W, Kelleher K, Pajer K, Campo J (2003) Primary care clinicians’ use of standardized tools to assess child psychosocial problems. Ambul Pediatr 3(4):191–195

    Article  PubMed  Google Scholar 

  19. Sanci L, Coffey C, Veit F et al (2000) Evaluation of the effectiveness of an educational intervention for general practitioners in adolescent health care: randomised controlled trial. BMJ 320(7229):224–230

    Article  PubMed  CAS  Google Scholar 

  20. Power P, Iacoponi E, Reynolds N et al (2007) The Lambeth Early Onset Crisis Assessment Team Study: general practitioner education and access to an early detection team in first-episode psychosis. Br J Psychiatry (Suppl) 51:S133–S139

    Article  Google Scholar 

  21. Bower P, Garralda E, Kramer T, Harrington R, Sibbald B (2001) The treatment of child and adolescent mental health problems in primary care: a systematic review. Fam Pract 18(4):373–382

    Article  PubMed  CAS  Google Scholar 

  22. Copty M, Whitford D (2005) Mental Health in general practice: assessment of current state and future needs. Ir J Psychol Med 22(3):83–86

    Google Scholar 

  23. Gavin B, Cullen W, O’Donoghue B et al (2005) First episode schizophrenia in general practice: a national survey. Ir J Psychol Med 23(1):6–9

    Google Scholar 

  24. Swendsen J, Conway K, Degenhardt L et al (2009) Socio-demographic risk factors for alcohol and drug dependence: the 10-year follow-up of the national comorbidity survey. Addiction 104(8):1346–1355

    Article  PubMed  Google Scholar 

  25. Kelly A, Teljeur C (2007) The national deprivation index for health and health services research. Small Area Health Research Unit (SAHRU) Technical Report. SAHRU Department of Public Health & Primary Care, Trinity College Dublin. http://www.sahru.tcd.ie/services/deprivation/DeprivationFiles/WebReport07.pdf

  26. Limerick Regeneration Agencies - Southside and Northside, Irish Ministerial Orders, S.I. 275/276/2007 (2007)

  27. Veit F, Sanci L, Coffey C, Young D, Bowes G (1996) Barriers to effective primary health care for adolescents. Med J Aust 165(3):131–133

    PubMed  CAS  Google Scholar 

  28. Gilbert A, Maheux B, Frappier J, Haley N (2006) Adolescent care. Part 1: are family physicians caring for adolescents’ mental health? Can Fam Physician 52(11):1440–1441

    PubMed  Google Scholar 

  29. Wolcott H (1990) Writing up qualitative research. Sage Publications, California

    Google Scholar 

  30. Connolly D, Leahy D, Bury G, et al. Can general practice help address youth mental health? A retrospective cross sectional study in Dublin’s South Inner City. Early Intervention Psychiatry. 2012; In Press

  31. Steele M, Zayed R, Davidson B et al (2012) Referral patterns and training needs in psychiatry among primary care physicians in Canadian rural/remote areas. J Can Acad Child Adolesc Psychiatry 21(2):111–123

    Article  PubMed  Google Scholar 

  32. Copty M, Whitford D (2005) Mental health in general practice: assessment of current state and future needs. Ir J Psych Med 22(3):83–86

    Google Scholar 

  33. Nettle D, Cockerill M (2010) Development of social variation in reproductive schedules: a study from an English urban area. PLoS One 15(5(9)):E12690

    Article  Google Scholar 

  34. French R, Mercer C, Kane R et al (2007) What impact has England’s Teenage Pregnancy Strategy had on young people’s knowledge of and access to contraceptive services? J Adolesc Health 41(6):594–601

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported by a research award from the Limerick Regeneration Agencies.

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Correspondence to C. Dunne.

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Healy, D., Naqvi, S., Meagher, D. et al. Primary care support for youth mental health: a preliminary evidence base for Ireland’s Mid-West. Ir J Med Sci 182, 237–243 (2013). https://doi.org/10.1007/s11845-012-0868-8

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  • DOI: https://doi.org/10.1007/s11845-012-0868-8

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