Predicting Reliable Improvements in Primary Care Youth Mental Health.

Background: Amid a youth mental health crisis, community-based early intervention services have shown promising outcomes. Understanding the specific factors that predict clinical outcomes is crucial for enhancing intervention efficacy, yet these factors remain insufficiently understood.

Aim: This study examined the individual and service-related factors associated with reliable improvement for young people (n = 4565) aged 12-25 years attending a brief primary care youth talk therapy mental health service across 14 sites.

Methods: Reliable improvement was measured using the clinical outcomes in routine evaluation (YP-CORE and CORE-10) measure at baseline and follow up. Poisson regression was used to identify individual and service-related factors associated with reliable improvement.

Results: Higher initial distress levels predicted increased levels of reliable improvement (adjusted risk ratios ranged from 235.7 to 415.1, p < 0.001), indicating that this intervention is particularly effective for individuals with higher initial distress levels. Conversely, extended wait times negatively affected therapeutic outcomes for young people aged 12-16, with waiting times exceeding 60 days associated with lower likelihoods of improvement (adjusted risk ratio = 89.2 for > 60 days, p < 0.01). Waiting times did not significantly impact individuals aged 17-25. Attending nine or more sessions was associated with a lower likelihood of reliable improvement.

Conclusion: This study underscores the critical importance of minimising wait times for young people and the importance of tailored approaches to early intervention services. Addressing these factors can enhance the efficacy of early intervention services and better support the mental well-being of young people.