Need to reimagine health care to address mental health

Mental health therapy that works

The warning bell has been sounded on the state of the health care system and its ability to adequately treat and triage youth mental health conditions.

Former Australian of the Year and prominent psychiatrist Professor Patrick McGorry has called for a reimagining of health care to address the “rising tide” of mental ill health in young Australians.

In a perspective published in The Medical Journal of Australia, Professor McGorry, Professor David Coghill and Professor Michael Berk argue that the mental health of many young Australians is rapidly declining and that young people with more complex conditions need access to intensive secondary care.

“A comprehensive youth mental health system involves much more than entry-level primary care,” they write.

“Young people with more severe, complex or persistent conditions need more expert, sustained and intensive care. Yet this next level of secondary care is largely absent, resulting in a large cohort of young people described as the ‘missing middle’.”

The recent National Study of Mental Health and Wellbeing revealed that the prevalence of mental disorders in 16–24-year-olds has risen by 50% — from 26% in 2007 to 39% in 2021.

The rise in young women is significantly greater than in young men, with rates reaching 48%.

The authors write that early intervention for potentially disabling illnesses safeguards mental wealth, notably with psychosis.

In the Perspective, the authors argue for four solutions.

  1. Prevention and greater global understanding 

The first solution proposed is prevention and an increasing understanding of the trends occurring in a global society.

“The answers are likely to involve a blend of socio-economic and generational changes, rising adversity and inequality, and unforeseen consequences of technological advances,” they write.

2. Early intervention 

The second solution proposed is early intervention, involving integrated primary youth mental health care being the focal point.

“Primary care generally needs reimagining and a new financial model. The surge in need, workforce shortages and the collapse of bulk-billing has created a perfect storm both for GPs and headspace centres,” they write.

3. Multidisciplinary approach 

The third solution states that young people with more severe illnesses need expert, multidisciplinary teams to recover.

“This requires a more specialised tier of care, a back-up system for primary care providers for young people, so far only available in a small number of ‘oasis’ zones,” they write.

4. Changing funding distribution

The fourth solution involves changing how funding is distributed through the National Disability Insurance Scheme (NDIS).

“Young people in the early stages of potentially disabling mental illnesses, including treatable neurodevelopmental disorders such as [attention deficit/hyperactivity disorder (ADHD)], should be prioritised and no longer excluded,” they said.

Text: Medical Journal of Australia.