Showcasing: Comprehensive Assessment Service for Psychosis and At Risk (CASPAR)
Central and Eastern Sydney
South Eastern Sydney Local Health District
Living Well domain
Getting in earlier
Comprehensive Assessment Service for Psychosis and At Risk (CASPAR) is a new service that provides in-reach into three local headspace centres (located at Bondi Junction, Hurstville and Miranda) to deliver early identification, care coordination, assertive outreach and targeted interventions to support the ‘missing middle’ youth population. Largely these are young people who have mental health and recovery needs greater than what can be met by headspace alone but do not require the level of care provided by state based public mental health services.
Early detection and intervention for young people experiencing mental health issues is vital in assisting their personal recovery and helping them live well. Youth Mental Health Services in South Eastern Sydney are offered by both public health and community managed organisations. South Eastern Sydney Local Health District (SESLHD) provides hospital based and specialist youth mental health care in the community, with headspace providing early intervention to young people experiencing mild to moderate mental health concerns. However, some young people sit in the ‘middle’, needing a higher level of care than headspace but not requiring the intensity of clinical care provided by public mental health services.
To meet this gap SESLHD co-designed the CASPAR model with the local primary health network to enable this group of young people who are experiencing emerging mental health issues to be effectively assessed, treated, and supported to recover.
Established in early 2017 the CASPAR service was developed through attaining Commonwealth Youth Severe funding administered by the Central and Eastern Sydney Primary Health Network (CESPHN). The service provides collaborative care between public mental health services and the three headspace services providing a holistic person-centred approach to supporting young people.
CASPAR is a multidisciplinary team comprised child, adolescent and youth psychiatrists, psychiatric registrars and nursing and allied health clinicians. By leveraging off headspace community engagement strategies, CASPAR is able to deliver early detection and intervention to young people and their families, at an earlier stage of illness in an environment that is non-stigmatising and youth-friendly.
CASPAR provides regular psychiatry clinics at the three local headspace centres, with additional support from nursing and allied health staff. The team provides extended assessment, comprehensive care planning and coordination and facilitated referral. This includes targeted interventions, care coordination and outreach provided through a holistic model for an average duration of around 3 months.
Since 2017, CASPAR has provided care to 442 young people aged 12 to 25 years and their families (average age being 18yrs). Around 60% of the young people seen by CASPAR were experiencing depressive or anxiety disorders. Over the last year, approximately 3% of the young people engaged with CASPAR identified as Aboriginal or Torres Strait Islander, 18% were born overseas, 10% identified as Lesbian, Gay, Bisexual, Transgender, Intersex and Queer (LGBTIQ+) and 12% were homeless or at risk of homelessness.
CASPAR has shown a clinically significant reduction in symptoms and psychological distress of the people with lived experience it supports as well as improvements in the individuals psychosocial functioning measured through a range of outcome measures including the Social and Occupational Functioning Assessment Scale and Kessler 10 scale1
Positive feedback has also been received from young people accessing the service through the Your Experience of Service (YES) survey further supporting the value CASPAR is providing to young people and their families in the South Eastern Sydney region.
Over the next 3 years CASPAR aims to continue to co-design and evaluate the service with young people and their families and increase engagement with vulnerable groups who identify as Aboriginal, from a culturally and linguistically diverse background, either homeless or at risk of and people who identify as LGBTIQ+.
1Kessler R. Professor of Health Care Policy, Harvard Medical School, Boston, USA.