Evaluating youth mental health service integration in Australia using the Youth Integration Project framework

Since 2006, the Australian government has expanded access to primary mental healthcare for youth aged 12-25 years through the headspace platform. However, structural barriers exist in the integration of headspace centres with local state-funded specialised mental health services. The aim of this study was to translate an emerging service integration framework (Youth Integration Project (YIP)) into a tool to determine levels of integration between headspace and local specialist services/programme and identify areas for improving service integration.

The Rating of Integrated Health Services (RIHS) survey was developed based on the YIP framework to assess levels of youth mental health service integration in New South Wales (NSW) local health districts (LHDs). Managers of specialist services/programmes across 18 LHDs in NSW were invited to complete the RIHS survey. Responses were coded into indicators of levels of integrated care and aggregated into an overall assessment of service integration.

Validity of the RIHS scales was indicated by positive correlations with independent items of service integration. In relation to integration levels, 41/56 services/programmes had minimal-to-basic levels of integration with headspace centres. The results were consistent across programmes and regions. Three structural areas of interagency collaboration were identified for improving service integration: (i) information systems, communication, products and technology; (ii) financing; and (iii) leadership, governance, policy and values.

The results provide evidence of the significantly fragmented youth mental healthcare system in Australia. There is a need to address structural aspects of service integration to improve integration between headspace and LHD services for young people.