Early Intervention in Psychiatry最新文献_第10页

An open pilot trial of a behavioural intervention to reduce violence by young adults with early psychosis receiving treatment in an early intervention services setting: A protocol 为减少在早期干预服务机构接受治疗的患有早期精神病的年轻成年人的暴力行为而进行的行为干预公开试点试验：方案。

IF 2.1 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry

Pub Date : 2024-05-05 DOI: 10.1111/eip.13543

Stephanie A. Rolin, Deirdre Caffrey, Megan G. Flores, Leah G. Pope, Jennifer Mootz, Iruma Bello, Ilana Nossel, Michael T. Compton, Barbara Stanley, Milton Wainberg, Lisa B. Dixon, Paul S. Appelbaum

Aims

Despite the public health impact of violence among young adults with psychosis, behavioural interventions to reduce the risk of engaging in violence remain rare. For young adults with early psychosis, cognitive behavioural therapy (CBT)-based psychotherapy has efficacy in reducing impairment and improving functioning. However, no CBT-based intervention to reduce violence has been formally adapted for young adults with early psychosis. This protocol outlines the first clinical trial of a behavioural intervention to reduce violence for young adults with early psychosis. This study is set in an early intervention services (EIS) setting and seeks to adapt and pilot Psychological Intervention for Complex PTSD and Schizophrenia-Spectrum Disorder (PICASSO), a CBT-based intervention, through an iterative process utilizing mixed-methods assessments.

Methods

All research will occur at OnTrackNY, the largest EIS program in the United States. This study will consist of an open pilot trial, with four EIS clinicians delivering the intervention to one to two EIS participants per round. In this mixed-methods study, both quantitative measures (acceptability, feasibility and hypothesized mediators of target outcome collected on a weekly basis) and qualitative interviews (with EIS clinicians at weeks 4, 8 and 12) will be conducted. Transcripts will be analyzed using thematic content analysis. Two to three rounds of iterative modifications are anticipated (n = 10–16 EIS participants total).

Results

Recruitment began in February 2024 and is expected to continue over a 9–12-month period.

Conclusions

Because violent behaviour causes interpersonal disruptions such as incarceration and increased caregiver burden, an innovative intervention to reduce violence risk could have broader health impact for this vulnerable population. Adapting the PICASSO intervention to the EIS setting will optimize its acceptability and feasibility by the intended target population.

目的：尽管暴力对年轻的成年精神病患者的公共健康造成了影响，但通过行为干预来降低参与暴力的风险仍然很少见。对于患有早期精神病的年轻人来说，以认知行为疗法（CBT）为基础的心理疗法在减少损伤和改善功能方面具有疗效。然而，目前还没有任何基于 CBT 的减少暴力干预措施被正式调整用于患有早期精神病的年轻人。本方案概述了针对患有早期精神病的年轻成年人进行的第一项减少暴力的行为干预临床试验。本研究以早期干预服务（EIS）为背景，旨在通过使用混合方法评估的迭代过程，调整并试点基于 CBT 的干预措施--复杂创伤后应激障碍和精神分裂症谱系障碍心理干预（PICASSO）：所有研究都将在美国最大的 EIS 项目 OnTrackNY 进行。本研究将包括一项公开试点试验，由四名 EIS 临床医生每轮向一至两名 EIS 参与者提供干预措施。在这项混合方法研究中，将同时进行定量测量（每周收集目标结果的可接受性、可行性和假设的中介因素）和定性访谈（在第 4、8 和 12 周对 EIS 临床医生进行访谈）。将采用专题内容分析法对记录誊本进行分析。预计将进行两到三轮反复修改（n = 10-16 名 EIS 参与者）：招募工作于 2024 年 2 月开始，预计将持续 9-12 个月：由于暴力行为会造成人际关系的混乱，如监禁和增加照顾者的负担，因此减少暴力风险的创新干预措施可能会对这一弱势群体产生更广泛的健康影响。将 PICASSO 干预措施调整到 EIS 环境中，将优化目标人群的接受度和可行性。

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引用次数: 0

Delivering a sleep intervention across a youth mental health service using non-expert practitioners: A service evaluation 利用非专业从业人员在青少年心理健康服务中开展睡眠干预：服务评估

IF 2.1 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry

Pub Date : 2024-05-04 DOI: 10.1111/eip.13534

Rebecca Rollinson, Amber Cole, Brioney Gee, Ioana Tofan, Adam Graham, Jude Hatton, Jonathan Lyons, Sarah Reeve, Jonathan Wilson, Kevin Beardsworth, Tim Clarke

Aims

Poor sleep is highly prevalent in young people and increases risk of mental health difficulties, yet access to sleep interventions remains limited. This paper evaluates the use of a sleep intervention delivered by non-expert practitioners in a secondary care youth mental health service.

Method

Assistant psychologists were trained to deliver a six-session 1:1 cognitive-behavioural sleep intervention adapted for use with young people with mental health difficulties. A within-subject design assessed clinical outcomes relating to sleep (Insomnia Severity Index), psychological distress and personal goals (Goal Based Outcome Measures) at four time points.

Results

High referral, intervention take-up (82.82%) and completion (70%) rates were reported, together with high baseline levels of insomnia (Insomnia Severity Index mean 20.47, SD 3.68) and poor sleep efficiency (56.36%, SD 17.23). Fifty-six young people (average age 19.2 years, SD 3.25) were included in the outcome analysis. Statistically and clinically significant improvements were seen across all outcome measures, with 68% no longer meeting clinical threshold (ISI ≥15) for insomnia at endpoint.

Conclusions

This study demonstrates exceptionally high levels of clinical need and engagement with a sleep intervention adapted specifically for young people with mental health difficulties. Whilst limited by the uncontrolled design, large improvements in insomnia and psychological distress support its effectiveness and utility in clinical settings. More robust implementation and evaluation is warranted in broader youth mental health services to promote earlier access.

目的睡眠质量差在青少年中非常普遍，并会增加心理健康问题的风险，但获得睡眠干预的机会仍然有限。本文评估了由非专业从业人员在二级护理青少年心理健康服务中提供睡眠干预的使用情况。方法对心理助理人员进行培训，以提供六节课的 1:1 认知行为睡眠干预，该干预经调整后适用于有心理健康问题的青少年。结果转介率、干预接受率（82.82%）和干预完成率（70%）都很高，同时失眠的基线水平也很高（失眠严重程度指数平均值为 20.47，标准差为 3.68），睡眠效率也很低（56.36%，标准差为 17.23）。56 名青少年（平均年龄 19.2 岁，中位数 3.25）被纳入结果分析。所有结果指标均有统计学和临床意义上的显著改善，68%的人在终点时不再达到失眠的临床阈值（ISI ≥15）。虽然受到非对照设计的限制，但失眠和心理困扰方面的显著改善支持了其在临床环境中的有效性和实用性。有必要在更广泛的青少年心理健康服务中进行更有力的实施和评估，以促进更早地使用该疗法。

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引用次数: 0

Perceived expressed emotion in individuals with a first episode of psychosis from a south Asian background 南亚背景的首次精神病患者的感知情感表达

IF 2.1 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry

Pub Date : 2024-05-04 DOI: 10.1111/eip.13542

Amrita Ramanathan, Syed K. Miah, Lidushi Nagularaj, Hira Salman Sharif, Madiha Shaikh

Aim

To explore perceived expressed emotion in the south Asian context for individuals with a first episode of psychosis (FEP).

Method

Semi-structured interviews were conducted with 16 service users experiencing a FEP to understand their experience of expressed emotion (EE) from their caregivers. Interviews were analysed using inductive thematic analysis.

Results

Four main categories were identified: connection and support, understanding and awareness, boundaries and independence and context and influence. Factors influencing perceived expressed emotion such as acceptance, acculturation, warmth and expressions of love, communication and family values were identified. Findings highlight south Asian's experiences of being cared for, and their perception of EE, including warmth and connection as a strength and resource.

Conclusion

The findings shed light on culturally specific EE within the context of FEP that can be considered when working with south Asian communities within early intervention services. Findings highlight the impact of navigating and negotiating bicultural identities and generational differences in EE in the British south Asian context.

方法对 16 名首次发作精神病（FEP）的服务使用者进行了半结构式访谈，以了解他们从照顾者那里感受到的情感表达（EE）。结果确定了四个主要类别：联系与支持、理解与认识、界限与独立以及环境与影响。确定了影响感知到的情感表达的因素，如接纳、文化适应、温暖和爱的表达、沟通和家庭价值观。研究结果强调了南亚人被照顾的经历，以及他们对情感教育的看法，包括将温暖和联系视为一种力量和资源。研究结果强调了在英国南亚背景下，引导和协商双文化身份和代际差异对幼儿教育的影响。

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引用次数: 0

The role of cognitive disengagement syndrome in non-suicidal self-injury among adolescents with attention deficit hyperactivity disorder 认知脱离综合征在注意力缺陷多动障碍青少年非自杀性自伤中的作用

IF 2.1 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry

Pub Date : 2024-05-03 DOI: 10.1111/eip.13535

Beyza Ergül, Burcu Ersöz Alan

Aims

We aimed to investigate the relationship between Cognitive Disengagement Syndrome (CDS) and non-suicidal self injury (NSSI) in adolescents with attention deficit hyperactivity disorder (ADHD).

Methods

A semi-structured psychiatric interview and an NSSI screening questionnaire were conducted. Questionnaires assessing CDS (with daydreamer, sleepy, and slow subdimensions), depression, anxiety, self-esteem, emotion regulation, coping strategies, and loneliness were administered.

Results

Among 104 participants (n: 63, 60.6% girls), the combined type of ADHD was the most common (66.3%), and 35 adolescents (27 girls) were in the NSSI+ group. Although only depression and ADHD were found to be predictors of NSSI in ADHD, CDS was associated with many risk factors of NSSI in ADHD: depression, anxiety, emotion dysregulation, low self-esteem, and emotion-oriented coping ways. After controlling for the effects of cognitive problems/inattentiveness, depression, and anxiety, CDS still correlated with low self-esteem and emotion dysregulation. The daydreamer and slow sub-dimensions of CSD differed between NSSI+ and NSSI- groups, while sleepy did not.

Conclusions

CDS is associated with several relevant factors, indirectly relating it to self-harm in ADHD. CDS increases the vulnerability to mental health changes that could lead to NSSI in adolescence with ADHD.

目的我们旨在研究注意力缺陷多动障碍（ADHD）青少年的认知分离综合征（CDS）与非自杀性自伤（NSSI）之间的关系。结果在 104 名参与者（63 人，60.6% 为女孩）中，合并型 ADHD 最为常见（66.3%），NSSI+ 组中有 35 名青少年（27 名女孩）。虽然只有抑郁症和多动症是预测多动症 NSSI 的因素，但 CDS 与多动症 NSSI 的许多风险因素有关：抑郁、焦虑、情绪失调、自卑和情绪导向型应对方式。在控制了认知问题/注意力不集中、抑郁和焦虑的影响后，CDS 仍与自卑和情绪失调相关。CDS的白日梦子维度和迟钝子维度在NSSI+组和NSSI-组之间存在差异，而嗜睡则没有差异。CDS会增加青少年ADHD患者心理健康变化的脆弱性，从而导致NSSI。

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引用次数: 0

Psychopathological characteristics in ultra-high risk for psychosis with and without comorbid ADHD 伴有或不伴有多动症的超高危精神病患者的精神病理特征

IF 2.1 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry

Pub Date : 2024-05-01 DOI: 10.1111/eip.13539

Michele Ribolsi, Davide Prosperi Porta, Roberto Sacco, Giorgio Di Lorenzo, Federico Fiori Nastro, Giuliano Albergo, Vincenzo Di Lazzaro, Anna Costa

Aim

This study investigates the psychopathological characteristics of a sample of individuals at ultra-high risk for psychosis with and without comorbid attention-deficit hyperactivity disorder (ADHD).

Methods

Twenty-eight subjects (aged 13–21 years; 13 females) with attenuated psychosis syndrome (APS) were recruited in a cross-sectional study and divided into two groups, each with 14 patients, according to the presence or absence of ADHD.

Results

The APS group showed a significantly higher prevalence of negative symptoms than the APS + ADHD group. Other characteristics investigated (positive symptoms, aberrant salience, psychotic-like experiences and prodromal symptoms) did not differ between groups.

Conclusions

The different profiles of negative symptoms in the APS with or without ADHD might suggest the presence of a specific subtype among individuals at ultra-high risk for psychosis. Longitudinal studies with larger samples will provide information about the role of negative symptoms in determining conversion to full psychosis in those people with ‘pure’ APS and those with APS + ADHD.

目的：本研究调查了患有或未患有注意力缺陷多动障碍（ADHD）的超高风险精神病患者的精神病理学特征。方法在一项横断面研究中招募了 28 名患有减轻性精神病综合征（APS）的受试者（13 至 21 岁；13 名女性），并根据患者是否患有多动症将其分为两组，每组 14 人。结论患有或不患有多动症的 APS 患者的阴性症状不同，这可能表明在精神病超高风险人群中存在一种特殊的亚型。对更大样本的纵向研究将提供信息，说明阴性症状在决定 "纯 "APS患者和APS+ADHD患者向完全精神病转化过程中的作用。

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引用次数: 0

Race/ethnicity and socioeconomic status as predictors of outcome following family therapy in youth at clinical high risk for psychosis 种族/民族和社会经济地位是预测精神病临床高危青少年接受家庭治疗后的结果的因素。

IF 2.1 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry

Pub Date : 2024-04-27 DOI: 10.1111/eip.13541

Bernalyn Ruiz-Yu, Thanh P. Le, Marc J. Weintraub, Jamie Zinberg, Jean Addington, Mary P. O'Brien, Barbara C. Walsh, Michelle Friedman-Yakoobian, Andrea Auther, Cornblatt, Isabel Domingues, Tyrone D. Cannon, David J. Miklowitz, Carrie E. Bearden

Aim

There is limited research on the effects of sociodemographic and socioeconomic factors on treatment outcomes in youth at clinical high risk for psychosis (CHRp). This study examined sociodemographic factors that may affect functional outcomes within this population. Specifically, we investigated the influence of race/ethnicity (dichotomized as non-Hispanic whites [NHW] vs. people of colour [POC]), socioeconomic status (SES; operationalized as parental years of education), and their interaction on change in psychosocial functioning and symptoms over 6 months in a randomized trial of family-focused therapy.

Methods

CHRp youth (N = 128) participated in a randomized trial of family therapy (18 sessions of family therapy vs. 3 sessions of family psychoeducation). Sixty-four participants who self-identified as POC and 64 self-identified NHW participants completed baseline and 6-month follow-up measures of positive and negative symptoms and psychosocial (global, role, and social) functioning. Multiple regression models were conducted to test the main effect of race/ethnicity on changes in positive and negative symptoms and functioning, and whether this effect was moderated by parental education.

Results

There was a significant interaction between race/ethnicity and parental education, such that higher parental education was associated with greater improvement in global functioning in NHW participants, but there was no relationship between parental education and global functioning in POC. Additionally, higher parental education was associated with a decrease in negative symptoms in NHW participants but not in POC. There were no significant effects of race/ethnicity or parental education on positive symptoms, nor on social or role functioning.

Conclusions

Clinicians may consider tailoring psychosocial treatments according to the needs of diverse families who vary in sociodemographic factors such as educational attainment and race/ethnicity.

目的：有关社会人口和社会经济因素对临床高危精神病（CHRp）青少年治疗效果影响的研究十分有限。本研究探讨了可能影响该人群功能性治疗效果的社会人口因素。具体来说，我们调查了种族/民族（二分法为非西班牙裔白人 [NHW] 与有色人种 [POC]）、社会经济地位（SES；以父母受教育年限为操作标准）及其相互作用对以家庭为中心的随机疗法试验中 6 个月内社会心理功能和症状变化的影响：CHRp 青少年（128 人）参加了家庭治疗随机试验（18 次家庭治疗与 3 次家庭心理教育）。64 名自我认定为 POC 的参与者和 64 名自我认定为 NHW 的参与者完成了积极和消极症状以及心理社会（整体、角色和社会）功能的基线和 6 个月随访测量。我们建立了多元回归模型，以检验种族/民族对积极和消极症状及功能变化的主要影响，以及这种影响是否受父母教育的调节：结果：种族/民族与父母教育程度之间存在明显的交互作用，父母教育程度越高，非华裔参与者的整体功能改善越大，但父母教育程度与华裔儿童的整体功能没有关系。此外，父母受教育程度越高，NHW 参与者的负面症状越少，而 POC 参与者的负面症状则没有减少。种族/族裔或父母教育程度对阳性症状、社交或角色功能没有明显影响：临床医生可以考虑根据不同家庭的需求来调整社会心理治疗方法，因为这些家庭的社会人口因素（如教育程度和种族/民族）各不相同。

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引用次数: 0

Pathways to care in youth and young adults at clinical high risk for psychosis in Switzerland: Current situation and clinical implementation of the PsyYoung project 瑞士精神病临床高危青少年的治疗途径：PsyYoung项目的现状和临床实施情况

IF 2.1 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry

Pub Date : 2024-04-27 DOI: 10.1111/eip.13540

Barbara Bailey, Alessandra Solida, Christina Andreou, Kerstin Jessica Plessen, Philippe Conus, Mathieu Mercapide, Afrodite Kasparidi, Caroline Conchon, Elodie Sprüngli-Toffel, Davina Genoud, Camille Caron, Philippe Golay, Logos Curtis, Evelyn Herbrecht, Christian G. Huber, Luis Alameda, Marco Armando

Aim

We aim to give an insight into the current situation in Switzerland concerning the pathways to care of young people with clinical high risk of psychosis. In a second step we propose a procedure of optimizing pathways to care developed within the project PsyYoung.

Methods

A qualitative survey derived and adapted from Kotlicka-Antczak et al. (2020) was conducted in large early detection services of three Swiss cantons (Geneva, Basel-Stadt, Vaud) focusing on pathways to care. More specifically, using questionnaires delivered to the heads of participating services, information was collected on referral sources, on activities to implement outreach campaigns and on the use of a pre-screening tool.

Results

Main results on referral source indicated that sources were variable but seemed to come primarily from the medical sector and more so from the psychiatric sector. Very few referrals came from non-medical sectors. Outreach activities included the contact to other clinics as well as through brochures and posters. All services but one used the Prodromal Questionnaire – 16 as pre-screening tool.

Conclusions

All in all, the results indicate a referral and care pathway system implemented mostly within the medical and particularly mental health sector. Accordingly, the PsyYoung project proposes a procedure for pathways to care which could help overcome the obstacle of referrals being restrained to a narrow field of mental health and to harmonize the referral process within services dedicated to the same aim of helping young people at high risk of developing a psychosis.

目的我们旨在深入了解瑞士有关临床高危精神病青少年护理途径的现状。方法我们在瑞士三个州（日内瓦州、巴塞尔-施塔特州和沃州）的大型早期检测服务机构开展了一项定性调查，该调查源于 Kotlicka-Antczak 等人（2020 年）的研究成果，并对其进行了改编。更具体地说，通过向参与研究的服务机构负责人发放调查问卷，收集了有关转介来源、开展外展运动的活动以及预检工具使用情况的信息。来自非医疗部门的转介很少。外联活动包括与其他诊所联系，以及通过小册子和海报进行宣传。除一家服务机构外，所有服务机构都使用了前驱症状问卷 - 16 作为预检工具。因此，"心理青年 "项目提出了一种护理路径程序，可以帮助克服转介仅限于精神健康这一狭窄领域的障碍，并协调致力于帮助高危精神病青少年这一相同目标的服务机构内部的转介流程。

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引用次数: 0

The associations between daily reports of loneliness and psychotic experiences in the early risk stages for psychosis 精神病早期风险阶段的每日孤独报告与精神病经历之间的关联。

IF 2.1 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry

Pub Date : 2024-04-25 DOI: 10.1111/eip.13537

Esdras Raposo de Almeida, Sara van der Tuin, Merel K. Muller, David van den Berg, Yuan-Pang Wang, Wim Veling, Sanne H. Booij, Johanna T. W. Wigman

Aim

Bi-directional associations between loneliness and psychotic experiences (PEs) have been reported, but the mechanisms underlying these associations are unknown. This study aims to explore associations between daily reports of loneliness and PEs, and test differences in this association across young adult individuals at different levels of risk for psychosis.

Methods

We analysed 90-day diary data on loneliness and PEs from N = 96 participants (mean age 24.7, range 18–35, 77% female) divided into 4 subgroups, each indexing increased levels of risk for psychosis according to the clinical staging model: ‘psychometric’ (n = 25), ‘low’ (n = 27), ‘mild’ (n = 24), and ‘ultra-high’(n = 20) risk. Multilevel vector autoregressive models examined within-day (contemporaneous) and between-day (temporal) associations between loneliness and PEs for the total sample. Next, these associations were compared across subgroups.

Results

Loneliness and PEs were significantly associated contemporaneously (partial correlation B = 0.14) but not temporally. Subgroup membership moderated both contemporaneous and temporal associations. The contemporaneous association between loneliness and PEs was stronger in the low-risk subgroup compared to the mild-risk (B = −0.35, p < .01) and ultra-high-risk (B = −0.36, p < .01) subgroups. The temporal association between loneliness on the previous day and PEs on the current day was stronger in mild-risk subgroup compared to the ultra-high-risk subgroup (B = −0.03, p = .03). After adjusting for multiple testing, only the contemporaneous—but not the temporal—associations remained statistically significant.

Conclusions

Loneliness is associated with PEs in individuals at risk for psychosis, particularly in those with low to mild symptoms. Our findings tentatively suggest that especially individuals with low expressions of PEs may be more sensitive to social context, but future studies are needed to replicate and further unravel the potentially stage-specific interplay between social context and PEs.

目的有报道称孤独感与精神病经历（PEs）之间存在双向联系，但这些联系的内在机制尚不清楚。本研究旨在探讨每日孤独感报告与精神病性体验之间的关联，并测试处于不同精神病风险水平的年轻成年人在这种关联中的差异。方法我们分析了 N = 96 名参与者（平均年龄 24.7 岁，18-35 岁不等，77% 为女性）的 90 天孤独感和精神病性体验日记数据，这些参与者被分为 4 个亚组，每个亚组都根据临床分期模型确定了更高的精神病风险水平：心理 "风险（25 人）、"低 "风险（27 人）、"轻 "风险（24 人）和 "超高 "风险（20 人）。多层次向量自回归模型检验了所有样本中孤独感与 PE 之间的日内（同期）和日间（时间）关联。结果孤独感和 PEs 在当时显著相关（部分相关性 B = 0.14），但在时间上不显著。亚组成员身份调节了当时和时间上的关联。与轻度风险亚组（B = -0.35，p < .01）和超高风险亚组（B = -0.36，p < .01）相比，低风险亚组的孤独感与 PE 之间的同期相关性更强。与超高风险亚组相比，前一天的孤独感与当天的PE之间的时间关联在轻度风险亚组更强（B = -0.03，p = .03）。结论孤独感与精神病高危人群中的PEs有关，尤其是那些症状较轻或较轻的人群。我们的研究结果初步表明，尤其是PEs表现较低的个体可能对社会环境更为敏感，但还需要未来的研究来复制和进一步揭示社会环境与PEs之间可能存在的特定阶段的相互作用。

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引用次数: 0

A supported education programme implemented in youth mental health services: Outcomes and lessons from the first year of COVID-disrupted delivery 在青少年心理健康服务中实施辅助教育计划：受 COVID 影响的第一年的成果和经验教训。

IF 2.1 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry

Pub Date : 2024-04-23 DOI: 10.1111/eip.13530

Jennifer Nicholas, Oliver Ardill-Young, Philippa Levy, Katie Pearce, Gina Chinnery, Esther Sim, Alana Scully, Antonia Ottavio, Jackie Curtis, Eóin Killackey

Aim

Educational attainment is consistently highly valued by young people with mental ill health, yet maintenance and completion of education is a challenge. This paper reports on the implementation of a supported education programme for youth mental health.

Methods

Between 10 October 2019 and 10 October 2020, a supported education programme was delivered within primary and tertiary youth mental health services. A description of the programme, context, and adjustments required due to COVID-19 is presented, and the educational outcomes of young people referred to the programme were explored. Two case studies are also presented.

Results

The programme received 71 referrals over this period, of which 70.4% had not yet completed secondary school and 68% were experiencing multiple mental health conditions. Overall outcomes were positive, with 47.5% of the 40 young people who chose to engage with the programme maintaining or re-engaging with education. However, the remainder of those who engaged withdrew from the programme, often reporting challenges due to COVID-19 such as social isolation or increased uncertainty. Additionally, a number of young people declined or disengaged from the programme to focus on employment.

Conclusion

This report of the experience of integrating a supported employment programme in Australian youth mental health services reinforces the need for such support, and provides preliminary evidence for its successful implementation as part of routine care. The disengagement in response to COVID-19 highlights the real-world challenges of the pandemic, while young people's voicing of employment goals indicates the need for combined educational and vocational support—to assist transition and progression between these goals.

摘要患有精神疾病的年轻人一直非常重视教育成就，但维持和完成学业却是一项挑战。本文报告了一项针对青少年心理健康的辅助教育计划的实施情况。方法在 2019 年 10 月 10 日至 2020 年 10 月 10 日期间，在初级和三级青少年心理健康服务机构内实施了一项辅助教育计划。报告介绍了该计划的背景和因 COVID-19 而需要做出的调整，并探讨了转介到该计划的青少年的教育成果。结果该计划在此期间共接收了 71 名转介者，其中 70.4% 尚未完成中学学业，68% 存在多种心理健康问题。总体结果是积极的，在选择参与该计划的 40 名青少年中，有 47.5%保持或重新参与教育。然而，其余参与计划的青少年则退出了计划，他们往往表示由于 COVID-19 而面临挑战，如社会隔离或不确定性增加。此外，一些年轻人为了专注于就业而放弃或脱离了该计划。结论：这份关于在澳大利亚青少年心理健康服务中整合支持性就业计划的经验报告加强了对此类支持的需求，并为其作为常规护理的一部分成功实施提供了初步证据。在应对 COVID-19 的过程中出现的脱节现象凸显了这一流行病在现实世界中带来的挑战，而年轻人提出的就业目标则表明，有必要将教育和职业支持结合起来，以帮助实现这些目标之间的过渡和进步。

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引用次数: 0

Evaluation of a community-based brief intervention service for youth in crisis with suicidal ideation or self-harm 对针对有自杀倾向或自残行为的危机青少年的社区简短干预服务进行评估

IF 2.1 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry

Pub Date : 2024-04-20 DOI: 10.1111/eip.13531

Scott B. Teasdale, Caitlin Dixon, Jeffrey S. Ball, Natalie A. Bradbury, Claire I. T. Gaskin, Jackie Curtis, Adith Mohan

Aim

To evaluate the implementation of a mixed virtual and in-person brief intervention for young people, aged 12–25 years, presenting to a large urban mental health service in crisis with suicidal ideation and/or self-harm.

Methods

A pragmatic, real-world evaluation was conducted on the Youth Brief Intervention Service between June 2021 (inception) and October 2022. Service users were offered four sessions over an approximate one-month period. Sessions focused on distress tolerance, safety plans and support systems. Implementation outcomes related to service uptake, retention, fidelity of the model and service user experience. Effectiveness outcomes were measured pre-post and included mental health-related hospital service utilization (primary outcome), functioning, mental health status, self-harm, suicidal ideation and quality of life.

Results

Of the 136 young people referred to the Youth Brief Intervention Service, 99 were accepted with 17 disengaging before the first session. Eighty percent of people who commenced, completed the package of care. Young persons' and parent/carers experience of service was high (97% and 88%, respectively). Mental health-related emergency department presentations and inpatient days decreased from 3 months pre-intake to 3 months post-intake (42 vs. 7 presentations, X ² = 25.3, p < .001; 11 vs. 0 inpatient days, X ² = 9.1, p = .01). There were significant improvements in mental health status, days engaging in self-harm, general health and functioning and quality of life.

Conclusions

The Youth Brief Intervention Service is feasible, acceptable, subjectively beneficial and coincided with less mental health-related emergency department presentations and inpatient days, and improved mental health status and behaviour.

目的评估针对 12-25 岁、因自杀意念和/或自残危机而向大型城市心理健康服务机构求助的青少年，实施虚拟和面对面混合简短干预的情况。方法在 2021 年 6 月（开始）至 2022 年 10 月期间，对青少年简短干预服务进行了务实、真实的评估。在大约一个月的时间里，为服务对象提供了四次课程。课程的重点是痛苦耐受、安全计划和支持系统。实施成果涉及服务的吸收、保留、模式的忠实性和服务用户的体验。结果在转介到青少年简易干预服务的 136 名青少年中，有 99 人接受了服务，17 人在第一次疗程前脱离了服务。开始接受服务的青少年中有 80% 完成了一揽子护理计划。青少年和家长/监护人对服务的体验度很高（分别为 97% 和 88%）。从接受服务前的 3 个月到接受服务后的 3 个月，与精神健康相关的急诊就诊次数和住院天数都有所减少（就诊次数 42 对 7，X2 = 25.3，p = .001；住院天数 11 对 0，X2 = 9.1，p = .01）。结论青少年简短干预服务是可行的、可接受的、主观上有益的，同时减少了与精神健康相关的急诊就诊和住院天数，改善了精神健康状况和行为。

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引用次数: 0