TY - JOUR
T1 - Integrated care models for youth mental health
T2 - A systematic review and meta-analysis
AU - McHugh, Catherine
AU - Hu, Nan
AU - Georgiou, Gabrielle
AU - Hodgins, Michael
AU - Leung, Sarah
AU - Cadiri, Mariyam
AU - Paul, Nicola
AU - Ryall, Vikki
AU - Rickwood, Debra
AU - Eapen, Valsamma
AU - Curtis, Jackie
AU - Lingam, Raghu
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project was funded by the Mindgardens Neuroscience Network, headspace National and Commonwealth grant funding awarded by the Australian Government Department of Health and Aged Care.
Publisher Copyright:
© The Royal Australian and New Zealand College of Psychiatrists 2024.
PY - 2024/9
Y1 - 2024/9
N2 - 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.
AB - 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.
KW - coordinated care
KW - depression
KW - integrated care
KW - Youth
UR - http://www.scopus.com/inward/record.url?scp=85195470462&partnerID=8YFLogxK
U2 - 10.1177/00048674241256759
DO - 10.1177/00048674241256759
M3 - Article
C2 - 38847297
AN - SCOPUS:85195470462
SN - 0004-8674
VL - 58
SP - 747
EP - 759
JO - Australian and New Zealand Journal of Psychiatry
JF - Australian and New Zealand Journal of Psychiatry
IS - 9
ER -