Should youth mental health become a specialty in its own right? (Poll Closed)

yes , youth mental health is a very important issue , different than child mental health and adult one , and it deserves a special interest.

probably not.

There is some continuation from child mental health issues on to youth and then to adult mental health. As a different speciality, the continuity of care will be compromised and already there are issues with interface of child/adult mental health services and this could worsen with another interface. How long the patients would have contact with this speciality? what age group? what about resources that will be required from child and adult specialities?

and what is achievable with yet another division?

There is indeed much common ground between my views and those of Professor McGorry, despite the major differences. Among these differences is the question of how well the 0-25 year model in Melbourne has really worked. From the point of view of Child Psychiatry, its problems include a ‘transition’ point at 15 years; the different entry criteria of Orygen Youth Health – which are related to its research agenda and disorder-based clinic structure; its time-limited service delivery and its goal of a service system for 12-25 year olds. The 12-25 year ‘zone’ makes no developmental sense, as 12-17 year-olds need a more family-centred model of care than independent 16-25 year olds.

Professor McGorry is a powerful advocate for early intervention, but this does not require fracturing paediatric psychiatry to establish specialist youth mental health services. Early intervention can be delivered through existing primary and secondary services, such as schools, colleges, paediatricians and welfare services, within more integrated systems of care. Our major challenge is to link services better, which will not be achieved by adding new service systems and creating inappropriate age-related boundaries. Adolescents need their parents to support their optimal social and emotional development, as well as children, and there are risks in joining up services for adolescents and young adults.

In Melbourne Australia, there is active exploration of models that can provide more integrated and enhanced services for 0-25 year olds. I suspect that these will not re-align services in the way Professor McGorry proposes, but will instead build prevention and early intervention into existing systems of care. Services must address the needs of pre-school, primary school and secondary school-age populations as well as more independent youth. New arrangements must be informed by knowledge of development and service systems, and be adequately funded to provide evidence-based care, and support functional partnerships to improve access and transition.