Assessing outcomes and satisfaction in a sustained national primary care youth mental health programme: a brief...

Most mental health difficulties have their onset in early adolescence. Increasingly, community based primary care is recognised as a critical pathway to early intervention. Despite encouraging initial evaluations, there is an ongoing need for evidence of the outcomes of primary care youth mental health programmes delivered at scale. This brief report examines reliable improvements in psychological distress and user satisfaction data from a national primary care youth mental health programme in the sustainment phase of implementation.

This report takes a multi-methods approach to routine evaluation data. Young people (aged 12-25; N = 8,721) completed Clinical Outcomes Routine Evaluation (CORE-10 and YP-CORE) pre- and post-treatment. Clinical cut offs and a reliable change index (based on established guidelines) were used to report rates of reliable improvement. The analysis examined differences in outcomes based on age, gender, and clinical need. Satisfaction was measured using the youth service satisfaction survey (N = 4,267). Natural language processing techniques were employed to objectively analyse qualitative user feedback.

Most young people presented in the clinical range, with almost two-thirds reporting moderate to severe distress. Statistically significant reductions in distress were observed with large effect sizes (d = 1.08-1.28). Young people in the clinical range demonstrated significantly higher rates of reliable improvement compared to those who presented in the healthy range. In line with similar evaluations, young adults were more likely to achieve improvement and report higher satisfaction. Sentiment analysis of satisfaction data indicated a strong skew towards positive sentiment, with trust, anticipation and joy being predominant. Qualitative feedback pointed to waiting times as an improvement area.

The absence of a control group limits our ability to evaluate the effectiveness of the service interventions. Nonetheless after a decade of service delivery, these results indicate that large scale national youth mental health programmes can achieve satisfaction and clinical outcomes in line with international standards. Further research is needed on the predictors of reliable change, differences across demographic groups and approaches to improving waiting times in primary care.