Integrated care models for youth mental health: A systematic review and meta-analysis

Author:

McHugh Catherine12ORCID,Hu Nan3,Georgiou Gabrielle3,Hodgins Michael13,Leung Sarah13,Cadiri Mariyam13,Paul Nicola3,Ryall Vikki4,Rickwood Debra45,Eapen Valsamma2ORCID,Curtis Jackie12,Lingam Raghu3

Affiliation:

1. Mindgardens Neuroscience Network, Sydney, NSW, Australia

2. Discipline of Psychiatry, University of New South Wales, Sydney, NSW, Australia

3. Population Child Health Research, University of New South Wales, Sydney, NSW, Australia

4. Headspace National Youth Mental Health Foundation, Melbourne, VIC, Australia

5. Faculty of Health, University of Canberra, Canberra, ACT, Australia

Abstract

Objectives: To evaluate the effectiveness of integrated models of mental healthcare in enhancing clinical outcomes, quality of life, satisfaction with care and health service delivery outcomes in young people aged 12–25 years. A secondary objective was to identify common components of integrated mental health interventions. Methods: A systematic review and meta-analysis of studies published 2001–2023 that assessed clinical or health service use outcomes of integrated care, relative to treatment as usual, for any mental health condition in 12–25 years old accessing community-based care. Results: Of 11,444 titles identified, 15 studies met inclusion criteria and 6 studies were entered in the meta-analysis. Pooled effect size found integrated care was associated with a greater reduction in depressive symptoms relative to treatment as usual at 4–6 months (standardised mean difference = −0.260, 95% confidence interval = [−0.39, −0.13], p = 0.001). Of the seven studies reporting access or engagement, all reported higher rates of both in the intervention arm. The most frequent components of integration were use of a multidisciplinary team (13/15 studies), shared treatment planning (11/15) and workforce training in the model (14/15). Conclusions: Integrated models of mental healthcare are associated with a small, but significant, increase in effectiveness for depressive symptoms relative to treatment as usual. Given integrated care may increase access and engagement, future research should focus on assessing the impact of integrated care in a wider range of settings and outcomes, including clinical and functional recovery, satisfaction with care and system-level outcomes such as cost-effectiveness.

Funder

Mindgardens Neuroscience Network

headspace national

Department of Health and Aged Care, Australian Government

Publisher

SAGE Publications

Reference50 articles.

1. Effectiveness of a Quality Improvement Intervention for Adolescent Depression in Primary Care Clinics

2. Integrated Medical-Behavioral Care Compared With Usual Primary Care for Child and Adolescent Behavioral Health

3. Bartholomeusz C, Randell A (2022) Defining integrated care and its core components in youth mental health. Part 3: Findings from consultations with key stakeholders. Available at: www.orygen.org.au/Training/Resources/integrated-care-models/Findings-from-consultations-with-key-stakeholders (accessed 15 May 2024).

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