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    Primary care and youth mental health in Ireland: qualitative study in deprived urban areas

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    Authors
    Leahy, Dorothy
    Schaffalitzky, Elisabeth
    Armstrong, Claire
    Bury, Gerard
    Cussen-Murphy, Paula
    Davis, Rachel
    Dooley, Barbara
    Gavin, Blanaid
    Keane, Rory
    Keenan, Eamon
    Latham, Linda
    Meagher, David
    McGorry, Pat
    McNicholas, Fiona
    O’Connor, Ray
    O’Dea, Ellen
    O’Keane, Veronica
    O’Toole, Tom P
    Reilly, Edel
    Ryan, Patrick
    Sanci, Lena
    Smyth, Bobby P
    Cullen, Walter
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    Issue Date
    2013-12-17
    Keywords
    MENTAL HEALTH
    SOCIAL EXCLUSION
    YOUNG PEOPLE
    
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    Citation
    BMC Family Practice. 2013 Dec 17;14(1):194
    URI
    http://dx.doi.org/10.1186/1471-2296-14-194
    http://hdl.handle.net/10147/310937
    Abstract
    Abstract Background Mental disorders account for six of the 20 leading causes of disability worldwide with a very high prevalence of psychiatric morbidity in youth aged 15–24 years. However, healthcare professionals are faced with many challenges in the identification and treatment of mental and substance use disorders in young people (e.g. young people’s unwillingness to seek help from healthcare professionals, lack of training, limited resources etc.) The challenge of youth mental health for primary care is especially evident in urban deprived areas, where rates of and risk factors for mental health problems are especially common. There is an emerging consensus that primary care is well placed to address mental and substance use disorders in young people especially in deprived urban areas. This study aims to describe healthcare professionals’ experience and attitudes towards screening and early intervention for mental and substance use disorders among young people (16–25 years) in primary care in deprived urban settings in Ireland. Methods The chosen method for this qualitative study was inductive thematic analysis which involved semi-structured interviews with 37 healthcare professionals from primary care, secondary care and community agencies at two deprived urban centres. Results We identified three themes in respect of interventions to increase screening and treatment: (1) Identification is optimised by a range of strategies, including raising awareness, training, more systematic and formalised assessment, and youth-friendly practices (e.g. communication skills, ensuring confidentiality); (2) Treatment is enhanced by closer inter-agency collaboration and training for all healthcare professionals working in primary care; (3) Ongoing engagement is enhanced by motivational work with young people, setting achievable treatment goals, supporting transition between child and adult mental health services and recognising primary care’s longitudinal nature as a key asset in promoting treatment engagement. Conclusions Especially in deprived areas, primary care is central to early intervention for youth mental health. Identification, treatment and continuing engagement are likely to be enhanced by a range of strategies with young people, healthcare professionals and systems. Further research on youth mental health and primary care, including qualitative accounts of young people’s experience and developing complex interventions that promote early intervention are priorities. (350 words)
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