Adolescents and young people have the highest incidence of mental ill-health, but are “most neglected by the current system”, Dr Michele Hill, the Chair of the College of Psychiatrists of Ireland’s new Faculty of Youth and Student Psychiatry told its Winter Conference.
The Faculty, which is the first of its type in the world, was officially launched at the meeting.
Dr Hill told delegates: “Mental illness is the number one health issue for young people.”
She commented: “If you look at the disease burden across the lifespan, the course of mental illness is almost like a mirror image to physical illness…the incidence of mental illness is mostly between the age of 15-to-25, which is probably the healthiest physical time in our lives. And yet, services are largely designed across the lifespan to support physical health conditions with mental health as an afterthought.”
Dr Hill said specialist mental health services had largely evolved around the needs of children and adults. She said there was a “divide” between adult and paediatric services as well as a “huge growing issue known as the missing middle”.
The “missing middle” were people in older adolescence and young adulthood whose needs were “beyond what can be safely and effectively managed in a primary care and counselling setting, but not severe and entrenched enough in order to meet access criteria for secondary care and that gap is widening and they would benefit from specialist care”.
She added: “I am not talking about lowering the threshold to either AMS [adult mental health services] or CAMHS [child and adolescent mental health services], what I am talking about is advocating for people with these needs and advocating for more services to support them.”
Dr Hill suggested a “one-stop-shop” available to young people where there was “no wrong door”.
Currently, there were “major access issues… [with] young people and families becoming professional key workers and navigating the system, and delays to appropriate care”.
According to Dr Hill, the new Faculty is aligned with the College’s values of promoting excellence in the practice of psychiatry through education and training, lifelong learning, advocacy, and public education.
“And our position as a Faculty is that there really does need to be a separate committee within the College of Psychiatrists that, in line with all those principles and values of the College, is particularly focused on young people and the needs of young people with moderate-to-severe mental health conditions, but also advocating for the profession and the role they have to play for young people, and
advocating most importantly for additional resources.”
Psychiatrists needed to be trained appropriately to address the needs of older adolescents and young people as there were “gaps” between the two training pathways in adult psychiatry and child and adolescent psychiatry. Dr Hill said she was more familiar with the training gaps that may face an adult psychiatrist in a third-level student health setting, such as in the areas of autism and attention deficit hyperactivity disorder.
“That is something I think needs to be addressed for people who are going to practice in this area down the line and something that we are looking at.”
The priorities for the Faculty included developing a College position paper on youth and student psychiatry. The Faculty would advocate for the needs of under-served groups of young people, the need for specialist services, and new funding in the areas.
Dr Hill underlined that the Faculty was not going to be advocating for pulling resources from adult mental health services, or child and adolescent mental health services, and would be seeking new funding to support young people.
There would also be ongoing work on a future training curriculum for youth and student psychiatry, she told delegates.
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