Jane H Roberts
GP and Senior Lecturer University of Sunderland
RCGP Adolescent Health Group
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Churchill Fellow 2010
Australian context
Adolescent mental
health
New developments in
community based
service provision
Key findings
Conclusions
Overview of talk
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Aboriginal rock paintings
‘Old’ and ‘new’ country
Aboriginal culture 50
000 years old
1700s British colony
1850s 6 states – with
independent
governance
1900 Australian
independence
1931 Commonwealth
Historical background
Australia
6th largest country in the world
Population 20 million
13th richest economy
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4 in 10 young people and increasing
rich country with high rates of relative
poverty
Blended system of healthcare-public /private
No registration with GPs. Medicare covers
basic services. Eligible from 15 yrs old
2003 and 2007 national reviews MH-IAPT
Focus on YP MH and service shake-up
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Championed by Prof McGorry
Funded by Commonwealth (national )
government 2006: National Youth Mental
Health Foundation
Focused on 12-25 years in 30 ‘one-stop
shops’ in pop dense areas
Aim to address general and mental health,
substance + alcohol counselling, education
and employment
University support-UoMelbourne ‘Orygen’
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Melbourne ‘Sunshine’
centre
Work with existing
services –determines
local shape + scope
GPs role pivotal-but
variable interest
Youth workers crucial
Main focus on MH
Less input in Education
Training +Employment
Key points
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CAMHS-poorly funded; high rate private
psychiatry
Inter-state variability re provision and
legislation incl. competence regulations
Major re-structuring of mental health services
in Victoria around 0-11,12-25 yrs
Individual models eg ‘Clockwork’, Geelong:
multi-agency team working, high workload
Education: UME-med students in high schools
+ PCOs: ‘Docs and teens’
Culturally appropriate services limited
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Sculpture in Adelaide
A generalist or
specialist service?
Encouraging all
clinicians to be youthfriendly or create
‘stand –alone’ services?
12-25 as a ‘core
group’?
Early intervention or
over-medicalization?
The big issues
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Champions are essential : youth mental
health
Advocacy and lobbying lead to funding
Role of Academic base : Orygen; DGP, UoM;
CAAH; Youth Health Research Interest group,
Sydney
Pros and cons of a youth focused serviceEarIy Intervention effective in long term or
diverting limited resources ?
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Cleland Wildlife Park
Work closely with client
groups: YP , clinicianswhat do they want ?
Respect local history
and geographycontext is all important
A ‘can-do’ approach is
energizing
Youth (mental ) health
is everyone’s business
Key messages
Thank you
http://www.wmct.org.uk