Showcasing: Karrikin Youth Mental Health
Living Well domain
- Getting in early
Karrikin Youth Mental Health service is a newly commissioned service that supports young people aged 12-25 experiencing complex mental health issues. Karrikin provides supports to young people who need more assistance than that usually provided by primary care providers such as General Practitioners (GP), headspace centres, school counsellors and private psychologists. Using a multidisciplinary team model, Karrikin provides comprehensive treatment by engaging other service providers to deliver wrap around care for young people and their families.
For young people experiencing mental distress, seeking and finding the right support can be challenging. Access to youth mental health services is typically through an entry level community-based youth program such as headspace, the Child and Adolescent Mental Health Services and the public Child and Adolescent inpatient facilities.
Evidence has shown that there is a group of young people requiring specialised care for their complex to severe mental health concerns that don’t fit within the existing youth service models. An identified need was established for a mobile and assertive outreach mental health treatment service for young people unable to attend office-based appointments.
Karrikin Youth Mental Health service aims to fill the gap by providing support to the ‘missing middle,’ integrating with existing services to develop clear pathways to primary and tertiary care providers. This seamless integration has meant that young people with severe and complex issues receive the right care at the right time through assertive community-based care provided in their homes or any other place they feel comfortable to be seen.
“We bring the care to them”.
Youth peer workers are a significant part of the Karrikin team. Through a lived experience of youth mental health services, they are able to continually support, give feedback and implement change to ensure that the program remains youth friendly and effective. In collaboration with Parramatta Mission's Family and Carers program, a carer's perspective was also included from Karrikin's inception. The service has co-facilitated group programs and has developed family peer work models.
Karrikin is Commonwealth funded, commissioned by the Sydney North Primary Health Network.
To date, Karrikin has had 372 referrals and provided clinical care to 188 young people and their families. Recovery Star2 is the tool used to measure whether the whole person has been considered, including functioning, relationships, values, hopes and goals. This greatly assists young people to get back on track. The psychiatrist-led multidisciplinary team includes five mental health clinicians (psychologists and social workers) and two peer workers. Having a multidisciplinary workforce that works as a team from intake to discharge, is key to Karrikin's success. Peer workers are embedded in every part of the service which has been an important part of the team culture.
As a small team, local partnerships have been key. Developing relationships of trust and transparency with the Primary Health Network and their programs as well as the Local Health District has been a firm foundation for the service. Through the setup of regular meetings, Karrikin can remain agile and flexible to community need. This has included the co-location of a vocational worker from Ability Options with the team to support the large number of Karrikin clients needing more individual support to gain employment.
Many young people have identified difficulty managing their mood, therefore, a partnership was established with Lifeline Hospital to Home to deliver Dialectical Behavioural Therapy groups for young people in the Northern Sydney area.
The program has been assessed against the Quadruple Aim framework along with the use of outcomes measures, which are used widely across NSW Health. The program is continually reviewed to ensure that it is providing effective support to the community and assisting young people who are in need of high level support.
Community feedback has been positive:
"He is safe and being properly looked after at last because of you both. I can’t tell you how amazing, caring, skilful, reassuring and wonderful you have both been in a frightening, desperate time for our family. Thank you. Karrikin has been an oasis in a public mental health desert. We’ve endured incompetence, indifference and been judged as the problem. I’m gobsmacked by the absence of effective mental health care services in 2018. We are way behind the rest of the western world." [Parent]
The vision for Karrikin is to be entirely integrated into primary care working with GPs, headspace centres and schools. To achieve this, capacity building for primary care providers through a training position for junior doctors training to be GPs will be offered. As the most common presentation to GPs is mental health related.
Karrikin would also like to pilot the role of a family peer worker, to coach and support parents of children with school refusal. This role will have the capacity to advocate on behalf of the parents related to the engagement with schools.
Karrikin hope to curate evidence-based apps that can be promoted to young people and their families. A telehealth model to better engage those who live in more remote parts of the catchment area is also proposed.
- Sikka, R., Morath, J.M. and Leape, L., 2015. The Quadruple Aim: care, health, cost and meaning in work. BJM Quality& safety, Vol 24, 10.
- Dickens, G., Weleminsky, J., Onifade, Y. and Sugarman, P., 2012. Recovery star: validating user recovery. The Psychiatrist, 36(2), pp.45-50.