Adolescent mental health - exploring trajectories through stepped care

Primary Supervisor: Professor Andrew Page (opens in a new window)

In Australia, mental illness is the largest single cause of disability, with as many as one in five people aged 16 to 85 years experiencing a mental illness in any one year. While mental illness across the life-course requires attention, much of the mental illness experienced in adult life has its onset in childhood or adolescence. This has important implications for social, family, educational and vocational trajectories, and suggests a key target for primary and secondary preventive interventions. In response to the substantial disease burden associated with mental disorder, both State and Federal governments have invested increased funds and specific policy initiatives in prevention and treatment, including in primary mental health care.  A key recommendation of the most recent National Mental Health Commission review of mental health services has led to the shifting of mental health services and suicide prevention to a regional level in order to give more focus to local and context-specific primary and secondary mental health care. This has provided an opportunity to design and arrange locally relevant interventions and treatment options, acknowledging the regional heterogeneity in terms of socio-demographics and service needs.

In this context, Parramatta Mission provides a number of adolescent mental health services across Western Sydney within a stepped-care framework including headspace (primary mental health care) and the Youth Enhanced Support Service (sub-acute mental health care). Parramatta Mission works closely with community partners and peer navigators to wrap support around a young person as they move through the service system, stepping them up when more intensive support is required and stepping them down to lower levels of support as they recover.

This project aims to explore trajectories of recovery for young people accessing the network of mental health services provided by Parramatta Mission. Within this objective there is scope to explore a number of different research questions. What are the optimal or most effective stepped care pathways for young people presenting with low, moderate and severe mental health problems?  What is the impact of shared care on outcomes for young people with differing severity of mental health problems?

Parramatta Mission collects outcome measures as part of the Primary Mental Health Care Minimum Data Set (PMHC MDS) including psychological distress, quality of life, functional impact of mental disorder and goal setting. This has the potential to be linked to other datasets (such as emergency department presentations or hospital admissions data) or combined with qualitative methods to explore experiences of recovery, support and referral pathways through stepped care. Additionally, the project team is currently trialling the use of a mobile app to collect ecological momentary assessments from young people. Collectively this data provides a unique opportunity to explore recovery pathways for young people with varying severity of mental health problems.

This project is suitable for a data scientist, epidemiologist or a student with good quantitative skills who is interested in developing skills in mixed methods research. The quantitative data lends itself to multilevel modelling and this skill can be developed in someone who has an aptitude for statistics, epidemiology or data science.