Jane H Roberts
GP and Senior Lecturer University of Sunderland
RCGP Adolescent Health Group
Churchill Fellow 2010
Australian context
Adolescent mental
health
New developments in
community based
service provision
Key findings
Conclusions
Overview of talk
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
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
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’
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
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
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
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 ?
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