Early intervention with difficult to engage, 'high-risk' youth: evaluating an intensive outreach approach in youth mental health

Abstract

Background: Although intensive outreach (IO) models such as assertive community treatment and intensive case management have a strong evidence base in adult psychiatry, their effectiveness in the early intervention sector is unknown.

Aim: To explore client characteristics and treatment effects in a group of difficult to engage, 'high-risk' young people, seen by the Intensive Mobile Youth Outreach Service (IMYOS, ORYGEN Youth Heath) in Western Metropolitan Melbourne.

Methods: The clinical files of 47 clients were audited, targeting demographic and treatment outcome data prior to and during IMYOS involvement.

Results: Clients typically presented with traumatic childhoods, disrupted education, repeated treatment dropout, poor mental health and 'high-risk' behaviours. Results showed a significant reduction in risk to self and others between referral and discharge, and significantly lower admissions rates and inpatient days compared with the 9 months prior to referral.

Conclusions: IO might be an effective early intervention strategy to minimize risk of harm and decrease hospitalization in young people. However, conclusions are provisional as there was no control group included in this study. Further study is required, perhaps with a waiting list control.