Academic journal article Advances in Mental Health

Prevention and Early Intervention for Mental Health Problems in 0-25 Year Olds: Are There Evidence-Based Models of Care?

Academic journal article Advances in Mental Health

Prevention and Early Intervention for Mental Health Problems in 0-25 Year Olds: Are There Evidence-Based Models of Care?

Article excerpt

Approximately 10-20% of children and young people aged 0-25 years have signifi cant mental health problems, with 50% of mental illnesses commencing before the age of 14 and 75% by the age of 24 (Kessler, Berglund, Demler, Jin, & Walters, 2005). Mental disorders account for the highest burden of disease across this age range, led by anxiety and mood disorders and problematic substance use (Australian Institute of Health and Welfare [AIHW], 2007; Kessler et al., 2005). Regrettably, there is an inverse relationship between the prevalence of mental disorders in this age group and the use of health services to improve mental health outcomes, with only a fraction of affected individuals receiving appropriate treatment through psychiatric services (Costello, Copeland, Cowell, & Keeler, 2007; Sawyer et al., 2000). The 2007 Australian National Survey of Mental Health and Wellbeing indicated that the gap between the peak prevalence of disorders and service use is greatest in adolescents and young people (Australian Bureau of Statistics, 2007). Despite over 25% of this age group meeting the diagnostic criteria for a disorder in any year, less than 10% access clinical services. Of those that do receive services, the majority fail to receive an evidence-based treatment (Andrews, Sanderson, Corry, & Lapsley, 2000). There is a pressing need to develop better models of care to ensure greater access to appropriate health services among those with the highest rates and risks for developing mental disorders; in this case, those aged 0-25 years. The aims of this paper are to summarise the development of mental disorders and the mental health needs of children and young people aged 0-25, and to review the evidence for collaborative and integrated service systems that promote better continuity of care and treatment provision across this age spectrum.

THE DEVELOPMENT OF MENTAL HEALTH PROBLEMS

A diverse range of protective and risk factors can infl uence mental health across the 0-25 age span. Healthy prenatal and early childhood development, incorporating stable and responsive attachment relationships, safe and supportive environments, and appropriate nutrition, lay the foundations for well-being throughout life (McCain & Mustard, 1999). In usual circumstances, a child will experience warm and consistent relationships with their caregiver(s) supporting critical neurological and psychological development and the foundations of good mental health. Brain growth occurs at its most rapid rate in the fi rst three years of life with the establishment of neurological pathways needed for affect regulation, learning, memory and cognition. Early development occurs in the context of attachment relationships with a body of evidence pointing to the signifi cance of organised attachment experiences for optimal development (Schore, 2001; Siegel, 2001). Nurturing in the early years has a decisive impact on how children develop, their learning capabilities, their behaviour, their ability to regulate emotions and understand social interaction, and their risks for disease in later life. This development encompasses the equally important domains of physical, social and emotional functioning, and language and cognition, which have been associated with better well-being, mental and physical health, vocational competence, and economic participation throughout life (Irwin, Siddiqi, & Hertzman, 2007). Children who receive inadequate or disruptive care and stimulation are more likely to subsequently develop learning, behavioural and/or emotional diffi culties (McCain & Mustard, 1999). However, detrimental early experiences, such as neglect and trauma, can impact adversely on the developmental course and affect brain architecture (National Scientifi c Council on the Developing Child, 2007). Early relational trauma impacts on the development of core personality functions such as affect recognition and regulation, sense of self and the ability to understand relationships and mental functioning (refl ective functioning; Fonagy & Target, 1997). …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.