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“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: angela.ly@douglas.mcgill.ca
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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 

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