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Innovations in Practice: A case control and follow-up study of "hard to reach' young people who suffered from multiple complex mental disorders

Lookup NU author(s): Dr Nigel Camilleri, Professor Dorothy Newbury-Birch, Dr Paul McArdle, Dr Deborah Stocken, Professor Ann Le Couteur


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BackgroundInnovations Project (IP) was a new multidisciplinary team based within an inner city, walk-in health centre, North East England (throughout 2011). The aim was to describe the social and mental disorders of the hard to reach young people (HTRYP) from the IP and compare with a matched sample who attended a Community Mental Health Team (CMHT) and follow-up both samples 24months after discharge.MethodsA retrospective review of clinical case notes of YP who attended the IP and CMHT. A 24-month (postdischarge) follow-up evaluation of the mental state and social function of the YP in both groups using Health of the Nation Outcome Scales for Child and Adolescent Mental Health (HoNOSCA) and Children's Global Assessment Scale (CGAS).ResultsThirty-six referrals were accepted over a one-year period by the IP, 31 met criteria for the HTRYP, 15 were offered individually tailored therapy. The HTRYP who were more deprived compared to the CMHT matched sample (n=115), experienced a higher median number of mental disorders (n=3 compared to CMHT n=1), higher severity scores and lower levels of social function (HTRYP HoNOSCA mean: 19.1 (95% CI 15.9-22.2) and CMHT mean: 11.2 (95% CI 2.0-23.0) p=<.001, and HTRYP CGAS mean: 51.0 (95% CI 46.0-56.2) and CMHT mean: 58.9 (95% CI 52.9-64.8), p=.05). The HTRYP made significantly greater improvement compared to CMHTYP; (HoNOSCA p=<.001 and CGAS p=<.002) at discharge. A total of 13 HTRYP and 9 CMHT YP attended the follow-up review at 24months. There was substantial variability in terms of social function between the YP within each sample.ConclusionsThe term HTR' describes a state that may be often temporary, as opposed tolifelong. A bespoke service offering a developmental theoretical framework, regular reviews and an individualised care plan, was able to engage and had the potential to reduce morbidity suffered by HTRYP.

Publication metadata

Author(s): Camilleri N, Newbury-Birch D, McArdle P, Stocken DD, Thick T, Le Couteur A

Publication type: Article

Publication status: Published

Journal: Child and Adolescent Mental Health

Year: 2017

Volume: 22

Issue: 1

Pages: 49-57

Print publication date: 01/02/2017

Online publication date: 23/11/2016

Acceptance date: 02/10/2016

ISSN (print): 1475-357X

ISSN (electronic): 1475-3588

Publisher: Wiley-Blackwell Publishing Ltd.


DOI: 10.1111/camh.12202


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