Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care?

In the paper

“significant delays in receiving care are also attributable to the reduced ability of services to rapidly deliver specialist mental healthcare for youth in need after a first primary care consultation [21]”

What the sources say

• Supported

  The 'Barriers to Primary Care' section says that young people referred onward after a primary-care consultation frequently face significant delays in receiving specialist care. It also identifies a shortage of specialist youth-service providers as a major barrier for primary-care practitioners. (LLM, conf=0.90)

  cites [21] Fusar-Poli P. Integrated mental health services for the developmental period (0 to 25 Years): a critical review of the evidence. Front Psychiatry. 2019;10:355. source

In the paper

“and an even higher reduction when considering exclusively adolescence- (32.3%) and childhood-onset (38.2%) cases [28]”

What the sources say

• Supported

  Table 4 (indexed under “Implications and future research”; page unavailable) reports population-attributable risk proportions for all disorders of 32.3% for adolescence-onset cases and 38.2% for childhood-onset cases, compared with 29.8% overall. The paper presents these as estimated reductions if childhood adversities were eradicated, not as observed reductions. (LLM, conf=0.93)

  cites [28] Kessler RC, McLaughlin KA, Green JG, Gruber MJ, Sampson NA, Zaslavsky AM, et al. Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. Br J Psychiatry. 2010;197(5):378–85. source

In the paper

“Half of all mental disorders start by 14 years”

• Also stated in: § The need for implementing prevention and early intervention in youth mental health · plain

  “50% of whom being already symptomatic by the age of 14 [14]”

What the sources say

• Not checked yetcites [14] Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593–602. source

In the paper

“stressful life events produce the most ‘toxic’ effect on children’s stress system, raising the risk of subsequent development of stress-related mental difficulties, when experienced in the absence of a stable and supporting environment [34]”

What the sources say

• Not checked yetcites [34] Shonkoff JP. Building a new biodevelopmental framework to guide the future of early childhood policy. Child Dev. 2010;81(1):357–67. source

In the paper

“The relation between attachment difficulties and youth psychological problems is most likely bidirectional”

What the sources say

• Not checked yetcites [38] Kobak R, Zajac K, Herres J, Krauthamer Ewing ES. Attachment based treatments for adolescents: the secure cycle as a framework for assessment, treatment and evaluation. Attach Hum Dev. 2015;17(2):220–39. source

In the paper

“50% of whom being already symptomatic by the age of 14 [14]”

What the sources say

• Not checked yetcites [14] Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593–602. source

In the paper

“Meta-analytic work strongly supports the effectiveness of youth prevention programs addressing child abuse [44], negative consequences of parents’ divorce on children [45], substance abuse [46], and school-related problematic behaviors [47] in reducing rates of psychosocial difficulties later in life [48].”

What the sources say

• Not checked yetcites [44] Davis MK, Gidycz CA. Child sexual abuse prevention programs: a meta-analysis. J Clin Child Psychol. 2000;29(2):257–65. source
• Not checked yetcites [45] Lee CM, Bax KA. Children’s reactions to parental separation and divorce. Paediatr Child Health. 2000;5(4):217–8. source
• Not checked yetcites [46] Tobler NS. Meta-analysis of adolescent drug prevention programs: results of the 1993 meta-analysis. NIDA Res Monogr. 1997;170:5–68.

In the paper

“cross-prediction between anxiety and depression from adolescence to adulthood”

What the sources say

• Not checked yetcites [40] Lancefield KS, Raudino A, Downs JM, Laurens KR. Trajectories of childhood internalizing and externalizing psychopathology and psychotic-like experiences in adolescence: a prospective population-based cohort study. Dev Psychopathol. 2016;28(2):527–36. source

In the paper

“stigma represents a major barrier in this regards [19]”

What the sources say

• Not checked yetcites [19] Gronholm PC, Thornicroft G, Laurens KR, Evans-Lacko S. Mental health-related stigma and pathways to care for people at risk of psychotic disorders or experiencing first-episode psychosis: a systematic review. Psychol Med. 2017;47(11):1867–79. source

In the paper

“most mental health services, as traditionally developed, have proven to be ineffective to provide healthcare during this critical period [16]”

What the sources say

• Not checked yetcites [16] Andrews G, Sanderson K, Corry J, Lapsley HM. Using epidemiological data to model efficiency in reducing the burden of depression*. J Ment Health Policy Econ. 2000;3(4):175–86. source

In the paper

“childhood adversities seem to impact negatively on a number of disorders [28]”

What the sources say

• Not checked yetcites [28] Kessler RC, McLaughlin KA, Green JG, Gruber MJ, Sampson NA, Zaslavsky AM, et al. Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. Br J Psychiatry. 2010;197(5):378–85. source

In the paper

“Neurodevelopmental changes occurring during youth make it a period of both vulnerability and opportunity for mental health.”

In the paper

“depending on their nature, whether risk or protective factors, such environmental determinants may differentially modulate gene expression and stress response, with enduring health effects [32]”

What the sources say

• Not checked yetcites [32] Fox SE, Levitt P, Nelson CA. How the timing and quality of early experiences influence the development of brain architecture. Child Dev. 2010;81(1):28–40. source

In the paper

“When treatments are finally offered, the majority are not evidence-based [16]”

What the sources say

• Not checked yetcites [16] Andrews G, Sanderson K, Corry J, Lapsley HM. Using epidemiological data to model efficiency in reducing the burden of depression*. J Ment Health Policy Econ. 2000;3(4):175–86. source

In the paper

“with a modest use of mental health services despite the high prevalence of mental health problems among young individuals [17]”

What the sources say

• Not checked yetcites [17] Costello EJ, Copeland W, Cowell A, Keeler G. Service costs of caring for adolescents with mental illness in a rural community, 1993–2000. Am J Psychiatry. 2007;164(1):36–42. source

In the paper

“early indicators of later risk are often dimensional [27]”

What the sources say

• Not checked yetcites [27] Cuthbert B. The RDoC framework: facilitating transition from ICD/DSM to dimensional approaches that integrate neuroscience and psychopathology. World Psychiatry. 2014;13(1):28–35. source

In the paper

“young individuals, especially male, socioeconomically disadvantaged, and of ethnic minority, are less likely to establish initial contact with mental health services”

What the sources say

• Not checked yetcites [19] Gronholm PC, Thornicroft G, Laurens KR, Evans-Lacko S. Mental health-related stigma and pathways to care for people at risk of psychotic disorders or experiencing first-episode psychosis: a systematic review. Psychol Med. 2017;47(11):1867–79. source

In the paper

“children carrying specific genetic variants are at increased risk for behavioral problems in later life, but only when raised in dysfunctional families [33]”

What the sources say

• Not checked yetcites [33] Taylor A, Kim-Cohen J. Meta-analysis of gene-environment interactions in developmental psychopathology. Dev Psychopathol. 2007;19(4):1029–37. source

In the paper

“A large survey conducted by the World Health Organization (WHO) among 51,945 adults in 21 countries reported that eradication of childhood adversities, especially those associated with maladaptive family functioning (e.g. parental mental illness, child abuse, neglect), would lead to a 29.8% reduction of any mental disorder lifetime”

What the sources say

• Not checked yetcites [28] Kessler RC, McLaughlin KA, Green JG, Gruber MJ, Sampson NA, Zaslavsky AM, et al. Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. Br J Psychiatry. 2010;197(5):378–85. source

In the paper

“Meeting the child’s physical (i.e. healthy nutrition), psychological (i.e. stable and responsive attachment relationships), and social (i.e. supportive and safe environments) needs is key element to support optimal brain development, emotional regulation, and higher order cognitive function, with long-lasting health benefits [30]”

What the sources say

• Not checked yetcites [30] Maggi S, Irwin LJ, Siddiqi A, Hertzman C. The social determinants of early child development: an overview. J Paediatr Child Health. 2010;46(11):627–35. source

In the paper

“in addition to transition to psychosis, longer-term psychotic disorder, or persistent sub-threshold psychotic symptoms, progression to persistent mood, anxiety, personality and/or substance use disorders is also a very common outcome [25, 26]”

What the sources say

• Not checked yetcites [25] Lin A, Wood SJ, Nelson B, Beavan A, McGorry P, Yung AR. Outcomes of nontransitioned cases in a sample at ultra-high risk for psychosis. Am J Psychiatry. 2015;172(3):249–58. source
• Not checked yetcites [26] Rutigliano G, Valmaggia L, Landi P, Frascarelli M, Cappucciati M, Sear V, et al. Persistence or recurrence of non-psychotic comorbid mental disorders associated with 6-year poor functional outcomes in patients at ultra high risk for psychosis. J Affect Disord. 2016;203:101–10. source

In the paper

“the experience of a mental disorder “kindles” a cascade of events which make recurrence later in life more likely [41]”

What the sources say

• Not checked yetcites [41] Rutter M, Kim-Cohen J, Maughan B. Continuities and discontinuities in psychopathology between childhood and adult life. J Child Psychol Psychiatry. 2006;47(3–4):276–95. source

In the paper

“this is still largely unexplored in the context of common mental disorders, such as depression, anxiety, substance abuse, and eating disorders [23]”

What the sources say

• Not checked yetcites [23] Das JK, Salam RA, Lassi ZS, Khan MN, Mahmood W, Patel V, et al. Interventions for adolescent mental health: an overview of systematic reviews. J Adolesc Health. 2016;59(4S):S49–60. source

In the paper

“with up to 1 in 5 people experiencing clinically relevant mental health problems before the age of 25”

What the sources say

• Not checked yetcites [14] Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593–602. source

In the paper

“While progress has been made for psychotic disorders, also due to the successful application of an at-risk mental state concept [22]”

What the sources say

• Not checked yetcites [22] McGorry PD, Mei C. Ultra-high-risk paradigm: lessons learnt and new directions. Evid Based Ment Health. 2018;21(4):131–3. source

In the paper

“it appears particularly relevant the development of a secure attachment between the child and a protective primary caregiver, in order to facilitate adaptive emotional and behavioral responses to stressful events [35]”

What the sources say

• Not checked yetcites [35] Sroufe LA. Attachment and development: a prospective, longitudinal study from birth to adulthood. Attach Hum Dev. 2005;7(4):349–67. source

In the paper

“following symptom onset, people aged 0–25 experience the greatest delay to initial treatment [18]”

What the sources say

• Not checked yetcites [18] Catania LS, Hetrick SE, Newman LK, Purcell R. Prevention and early intervention for mental health problems in 0–25 year olds: are there evidence-based models of care? Adv Ment Health. 2011;10(1):6–19. source

In the paper

“internalizing and externalizing disorders of childhood are associated with an increased likelihood to develop a psychiatric disorder later in adulthood [39]”

What the sources say

• Not checked yetcites [39] Copeland WE, Shanahan L, Costello EJ, Angold A. Childhood and adolescent psychiatric disorders as predictors of young adult disorders. Arch Gen Psychiatry. 2009;66(7):764–72. source

In the paper

“during development risk factors may contribute to a range of psychopathologies”

What the sources say

• Not checked yetcites [27] Cuthbert B. The RDoC framework: facilitating transition from ICD/DSM to dimensional approaches that integrate neuroscience and psychopathology. World Psychiatry. 2014;13(1):28–35. source

In the paper

“mental health needs during this critical period are still largely unmet”

• Also stated in: § The need for implementing prevention and early intervention in youth mental health · plain

  “with a modest use of mental health services despite the high prevalence of mental health problems among young individuals [17]”

What the sources say

• Not checked yetcites [17] Costello EJ, Copeland W, Cowell A, Keeler G. Service costs of caring for adolescents with mental illness in a rural community, 1993–2000. Am J Psychiatry. 2007;164(1):36–42. source

In the paper

“a trans-diagnostic clinical high-risk mental state (CHARMS) paradigm may increase capacity to intercept a wider range of lower risk cases than those with attenuated psychotic symptoms only, including people with sub-threshold bipolar and borderline personality symptoms as well as mild-moderate depression [22]”

What the sources say

• Not checked yetcites [22] McGorry PD, Mei C. Ultra-high-risk paradigm: lessons learnt and new directions. Evid Based Ment Health. 2018;21(4):131–3. source

In the paper

“adversities during pregnancy and early childhood such as inadequate care, neglect, and trauma, have been shown to negatively impact on academic trajectories, psychosocial skills, physical resilience and the possibility of healthy aging [29, 31]”

What the sources say

• Not checked yetcites [29] Mustard JF. Brain development, child development—adult health and well-being and paediatrics. Paediatr Child Health. 1999;4(8):519–20. source
• Not checked yetcites [31] Fonagy P, Target M. Attachment and reflective function: their role in self-organization. Dev Psychopathol. 1997;9(4):679–700. source

In the paper

“adolescent oppositional defiant disorder, anxiety and substance disorders entirely accounting for the homotypic prediction pattern of depression overtime”

What the sources say

• Not checked yetcites [40] Lancefield KS, Raudino A, Downs JM, Laurens KR. Trajectories of childhood internalizing and externalizing psychopathology and psychotic-like experiences in adolescence: a prospective population-based cohort study. Dev Psychopathol. 2016;28(2):527–36. source

In the paper

“When they do, they show high rates of disengagement [20]”

What the sources say

• Not checked yetcites [20] Kim DJ, Brown E, Reynolds S, Geros H, Sizer H, Tindall R, et al. The rates and determinants of disengagement and subsequent re-engagement in young people with first-episode psychosis. Soc Psychiatry Psychiatr Epidemiol. 2019;54:945–53. source

In the paper

“most mental disorders have their peak of incidence during the transition from childhood to young adulthood”

What the sources say

• Not checked yetcites [14] Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593–602. source

In the paper

“Overall, these findings highlight how single disorder-oriented trajectories offer limited prospects for preventive interventions.”

In the paper

“most risk factors are shared across multiple mental disorders”

What the sources say

• Not checked yetcites [85] Uher R, Zwicker A. Etiology in psychiatry: embracing the reality of poly-gene-environmental causation of mental illness. World Psychiatry. 2017;16(2):121–9. source

In the paper

“Parallel, early intervention models, initially designed to assist people with psychotic disorders, have expanded their area of intervention to mood, personality, eating, and substance use disorders [128].”

What the sources say

• Not checked yetcites [128] Malla A, Iyer S, McGorry P, Cannon M, Coughlan H, Singh S, et al. From early intervention in psychosis to youth mental health reform: a review of the evolution and transformation of mental health services for young people. Soc Psychiatry Psychiatr Epidemiol. 2016;51(3):319–26. source

In the paper

“a Cochrane systematic review has confirmed the need for greater collaboration between primary care sector and specialist mental healthcare services [100]”

What the sources say

• Not checked yetcites [100] Bower P, Sibbald B. Systematic review of the effect of on-site mental health professionals on the clinical behaviour of general practitioners. BMJ. 2000;320(7235):614–7. source

In the paper

“with about a third only in remission [92]”

What the sources say

• Not checked yetcites [92] Simon AE, Borgwardt S, Riecher-Rössler A, Velthorst E, de Haan L, Fusar-Poli P. Moving beyond transition outcomes: meta-analysis of remission rates in individuals at high clinical risk for psychosis. Psychiatry Res. 2013;209(3):266–72. source

In the paper

“a so narrowed approach guarantees a limited detection, approximately 5%, even for those patients who will eventually develop a first episode of psychosis [93]”

What the sources say

• Not checked yetcites [93] Fusar-Poli P, Rutigliano G, Stahl D, Davies C, Bonoldi I, Reilly T, et al. Development and validation of a clinically based risk calculator for the transdiagnostic prediction of psychosis. JAMA Psychiatry. 2017;74(5):493–500. source

In the paper

“reducing the duration of untreated illness has been robustly shown to impact positively on the outcome of first-episode psychosis and schizophrenia in many ways [95]”

What the sources say

• Not checked yetcites [95] Oliver D, Davies C, Crossland G, Lim S, Gifford G, McGuire P, et al. Can we reduce the duration of untreated psychosis? A systematic review and meta-analysis of controlled interventional studies. Schizophr Bull. 2018;44(6):1362–72. source

In the paper

“In the USA, the Massachusetts Child Psychiatry Access Project (MCPAP) promoted the creation of a statewide service favoring collaborations between primary care practices and specialized child and adolescent psychiatry services.”

What the sources say

• Not checked yetcites [129] Connor DF, McLaughlin TJ, Jeffers-Terry M, O’Brien WH, Stille CJ, Young LM, et al. Targeted child psychiatric services: a new model of pediatric primary clinician–child psychiatry collaborative care. Clin Pediatr (Phila). 2006;45(5):423–34. source

In the paper

“With the aim of productively integrating and enhancing collaborative care at all levels of prevention, the Massachusetts Mental Health Services Program for Youth (MHSPY) has also implemented home-based integrated clinical interventions to assist severely impaired youth with mental, social, and substance use problems as well as their families in the community.”

What the sources say

• Not checked yetcites [131] Grimes KE, Mullin B. MHSPY: a children’s health initiative for maintaining at-risk youth in the community. J Behav Health Serv Res. 2006;33(2):196–212. source

In the paper

“some undesired outcomes, such as decreased social functioning, quality of life, and occupational performance, are shared across mental disorders [98, 99]”

What the sources say

• Not checked yetcites [98] Filho AS, Hetem LA, Ferrari MC, Trzesniak C, Martín-Santos R, Borduqui T, et al. Social anxiety disorder: what are we losing with the current diagnostic criteria? Acta Psychiatr Scand. 2010;121(3):216–26. source
• Not checked yetcites [99] Goldney RD, Fisher LJ, Dal Grande E, Taylor AW. Subsyndromal depression: prevalence, use of health services and quality of life in an Australian population. Soc Psychiatry Psychiatr Epidemiol. 2004;39(4):293–8. source

In the paper

“disappointing evidence from studies of the effect of collaborative care on depression indicate that the clinical improvement may not be maintained after discontinuing the multidisciplinary treatment [101]”

What the sources say

• Not checked yetcites [101] Asarnow J, Jaycox L, Tang L, Duan N, LaBorde A, Zeledon L, et al. Long-term benefits of short-term quality improvement interventions for depressed youths in primary care. Am J Psychiatry. 2009;166(9):1002–10. source

In the paper

“a hybrid strategy has been suggested in at-risk states involving symptom relief coupled to a reduction of transition [97]”

What the sources say

• Not checked yetcites [97] Millan MJ, Andrieux A, Bartzokis G, Cadenhead K, Dazzan P, Fusar-Poli P, et al. Altering the course of schizophrenia: progress and perspectives. Nat Rev Drug Discov. 2016;15(7):485–515. source

In the paper

“multimodal preventing programs combining preschool intervention and family support have been associated to the most enduring beneficial effects on a number of social outcomes, including significant better overall academic performances and lower delinquency and antisocial behavior rates [49]”

What the sources say

• Not checked yetcites [49] Yoshikawa H. Long term effects of early childhood programs on social outcomes and delinquency. Future Child. 1995;5(3):51–75. source

In the paper

“some pre-diagnostic symptoms and neurobiological correlates are not specific for psychosis [97]”

What the sources say

• Not checked yetcites [97] Millan MJ, Andrieux A, Bartzokis G, Cadenhead K, Dazzan P, Fusar-Poli P, et al. Altering the course of schizophrenia: progress and perspectives. Nat Rev Drug Discov. 2016;15(7):485–515. source

In the paper

“exercise training to support brain plasticity [66], structure [67] and connectivity [68] as well as cognitive functioning [69]”

What the sources say

• Not checked yetcites [66] Cotman CW, Berchtold NC. Exercise: a behavioral intervention to enhance brain health and plasticity. Trends Neurosci. 2002;25(6):295–301. source
• Not checked yetcites [67] Draganski B, Gaser C, Busch V, Schuierer G, Bogdahn U, May A. Neuroplasticity: changes in grey matter induced by training. Nature. 2004;427(6972):311–2. source
• Not checked yetcites [68] Douw L, Nieboer D, van Dijk BW, Stam CJ, Twisk JW. A healthy brain in a healthy body: brain network correlates of physical and mental fitness. PLoS ONE. 2014;9(2):e88202. source

In the paper

“perinatal phosphatidylcholine [54] and N-acetylcysteine [55] administration to support infants’ brain development and anti-inflammatory neuroprotection”

What the sources say

• Not checked yetcites [54] Ross RG, Hunter SK, McCarthy L, Beuler J, Hutchison AK, Wagner BD, et al. Perinatal choline effects on neonatal pathophysiology related to later schizophrenia risk. Am J Psychiatry. 2013;170(3):290–8. source
• Not checked yetcites [55] Jenkins DD, Wiest DB, Mulvihill DM, Hlavacek AM, Majstoravich SJ, Brown TR, et al. Fetal and neonatal effects of N-acetylcysteine when used for neuroprotection in maternal chorioamnionitis. J Pediatr. 2016;168(67–76):e6.

In the paper

“Psychosis studies have identified in the first 2 years following the manifestation of functional impairment a period of particular risk for transition to full-blown disorder [91]”

What the sources say

• Not checked yetcites [91] Kempton MJ, Bonoldi I, Valmaggia L, McGuire P, Fusar-Poli P. Speed of psychosis progression in people at ultra-high clinical risk: a complementary meta-analysis. JAMA Psychiatry. 2015;72(6):622–3. source

In the paper

“suggesting the poor validity of boundaries between diagnostic categories, at least at this stage [85]”

What the sources say

• Not checked yetcites [85] Uher R, Zwicker A. Etiology in psychiatry: embracing the reality of poly-gene-environmental causation of mental illness. World Psychiatry. 2017;16(2):121–9. source

In the paper

“promising findings suggest that developmental anomalies and behavioral deficits observed during childhood may be, at least partially, modifiable [53]”

What the sources say

• Not checked yetcites [53] Ghosh A, Michalon A, Lindemann L, Fontoura P, Santarelli L. Drug discovery for autism spectrum disorder: challenges and opportunities. Nat Rev Drug Discov. 2013;12(10):777–90. source

In the paper

“MCPAP has a wide area of intervention including attention deficit hyperactivity disorder, depression, anxiety as well as initial psychopharmacological treatment [129].”

What the sources say

• Not checked yetcites [129] Connor DF, McLaughlin TJ, Jeffers-Terry M, O’Brien WH, Stille CJ, Young LM, et al. Targeted child psychiatric services: a new model of pediatric primary clinician–child psychiatry collaborative care. Clin Pediatr (Phila). 2006;45(5):423–34. source

In the paper

“Over the last decade, reforming youth mental health services in the perspective of integration and collaboration between different healthcare professionals has gained increasing interest [127].”

What the sources say

• Not checked yetcites [127] McGorry P, Bates T, Birchwood M. Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. Br J Psychiatry Suppl. 2013;54:s30–5. source

In the paper

“research suggests detrimental psychosocial and functional consequences of each relapse [125, 126]”

What the sources say

• Not checked yetcites [125] Fikreyesus M, Soboka M, Feyissa G. Psychotic relapse and associated factors among patients attending health services in Southwest Ethiopia: a cross-sectional study. Bmc Psychiatry. 2016;16:354. source
• Not checked yetcites [126] Gbiri C, Badru F, Ladapo H, Gbiri A. Socio–economic correlates of relapsed patients admitted in a Nigerian mental health institution. Int J Clin Pract. 2011;15(1):19–26. source

In the paper

“To date, timing school-based mental health assistance, assertiveness training, and stress and anxiety management have the greatest chance to prevent maladaptive behavior and symptomatic manifestations [89].”

What the sources say

• Not checked yetcites [89] Greenberg M, Weissberg R, O’Brien M, Zins J, Fredericks L, Resnik H, et al. Enhancing school-based prevention and youth development through coordinated social, emotional, and academic learning. Am Psychol. 2003;58(6–7):466–74. source

In the paper

“school-based behavioral interventions to minimize risk of bullying and peer rejection [62, 63] as well as substance abuse [64, 65]”

What the sources say

• Not checked yetcites [62] Waasdorp TE, Bradshaw CP, Leaf PJ. The impact of schoolwide positive behavioral interventions and supports on bullying and peer rejection: a randomized controlled effectiveness trial. Arch Pediatr Adolesc Med. 2012;166(2):149–56. source
• Not checked yetcites [63] Nocentini A, Menesini E. KiVa anti-bullying program in italy: evidence of effectiveness in a randomized control trial. Prev Sci. 2016;17(8):1012–23. source
• Not checked yetcites [64] Patnode CD, O’Connor E, Rowland M, Burda BU, Perdue LA, Whitlock EP. Primary care behavioral interventions to prevent or reduce illicit drug use and nonmedical pharmaceutical use in children and adolescents: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med. 2014;160(9):612–20. source
• Not checked yetcites [65] Vogl LE, Newton NC, Champion KE, Teesson M. A universal harm-minimisation approach to preventing psychostimulant and cannabis use in adolescents: a cluster randomised controlled trial. Subst Abuse Treat Prev Policy. 2014;9:24. source

In the paper

“Thus, it has become increasingly possible to offer multidisciplinary and integrated healthcare to young people below the age of 25 with a variety of mental health difficulties as well as support their families.”

In the paper

“a promising strategy has been suggested to be the identification of those young individuals exposed to these risk factors who also have a family history of severe mental illness, in light of the per se higher genetic component for risk of mental disorders [90]”

What the sources say

• Not checked yetcites [90] Fusar-Poli P, McGorry PD, Kane JM. Improving outcomes of first-episode psychosis: an overview. World Psychiatry. 2017;16(3):251–65. source

In the paper

“The absence of validated interventions to prevent multiple relapses highlights the limited protective effect of psychopharmacological treatments in the long-term”

In the paper

“following the manifestation of a first episode of acute psychiatric symptoms, some patients may not reach full recovery, being still symptomatic or functionally impaired.”

In the paper

“Increasing evidence suggests a similar effect for other psychiatric disorders including major depressive disorder, bipolar disorder, panic disorder, generalized anxiety disorder, and obsessive–compulsive disorder [96].”

What the sources say

• Not checked yetcites [96] Dell’Osso B, Glick I, Baldwin D, Altamura A. Can long-term outcomes be improved by shortening the duration of untreated illness in psychiatric disorders? A Conceptual Framework. Psychopathology. 2013;46(1):14–21. source

In the paper

“While the biological evidence for an association between multiple relapse and further deterioration is conflicting [124]”

What the sources say

• Not checked yetcites [124] Jollans L, Whelan R. Neuromarkers for mental disorders: harnessing population neuroscience. Front Psychiatry. 2018;9:242. source

In the paper

“This healthcare model is transferred to other countries at an increasingly rapid rate.”

In the paper

“In Australia, a 2006 government-funded initiative led to creation of ‘Headspace’, a multidisciplinary and integrated service offering early intervention for 12–25-year-old people with emerging mental health difficulties.”

What the sources say

• Not checked yetcites [132] McGorry PD, Tanti C, Stokes R, Hickie IB, Carnell K, Littlefield LK, et al. headspace: Australia’s National Youth Mental Health Foundation–where young minds come first. Med J Aust. 2007;187(7 Suppl):S68–70.

In the paper

“Headspace has a wide area of intervention including mental health, physical health, vocational and educational support, and substance use [132].”

What the sources say

• Not checked yetcites [132] McGorry PD, Tanti C, Stokes R, Hickie IB, Carnell K, Littlefield LK, et al. headspace: Australia’s National Youth Mental Health Foundation–where young minds come first. Med J Aust. 2007;187(7 Suppl):S68–70.

In the paper

“Interestingly, research is following suit, with programs moving from the early identification of states immediately preceding psychosis onset in late adolescence or early adulthood to the investigation of earlier phases of illness in vulnerable children and younger adolescents (e.g. London Child Health and Development Study) [136].”

What the sources say

• Not checked yetcites [136] Laurens KR, Cullen AE. Toward earlier identification and preventative intervention in schizophrenia: evidence from the London Child Health and Development Study. Soc Psychiatry Psychiatr Epidemiol. 2016;51(4):475–91. source

In the paper

“Similar models have been developed or under construction in Denmark, Israel, California, Canada (the ACCESS, Adolescent/young adult Connections to Community-driven Early Strengths-based and Stigma-free services), British Columbia (‘The Foundry’ model), and the Netherlands (@ease) [8].”

What the sources say

• Not checked yetcites [8] McGorry PD, Mei C. Early intervention in youth mental health: progress and future directions. Evid Based Ment Health. 2018;21(4):182–4. source

In the paper

“An independent evaluation of Headspace has shown positive effects of the service in terms of reducing suicide ideation, self-harm, and number of absent school or work days [133].”

What the sources say

• Not checked yetcites [133] Patulny R, Muir K, Powell A, Flaxman S, Oprea I. Are we reaching them yet? Service access patterns among attendees at the headspace youth mental health initiative. Child Adolesc Ment Health. 2013;18(2):95–102. source

In the paper

“In summary, a mix of services is offered among these models of care, in order to target mental health and behavior, situational problems, physical or sexual health, alcohol or other drugs use, and vocational issues.”

In the paper

“In the United Kingdom, a youth-based mental health service called ‘Youth space’ has implemented integrated health benefits for people aged 0–25 years in the Birmingham catchment area [135].”

What the sources say

• Not checked yetcites [135] Birchwood M. Youth space and youth mental health. Eur Psychiatry. 2018;48:S7.

In the paper

“In order to guarantee youth a healthy mental development through promotion, prevention, and early interventions, research evidence supports the implementation of healthcare systems integrating mental, primary, and social care [128].”

What the sources say

• Not checked yetcites [128] Malla A, Iyer S, McGorry P, Cannon M, Coughlan H, Singh S, et al. From early intervention in psychosis to youth mental health reform: a review of the evolution and transformation of mental health services for young people. Soc Psychiatry Psychiatr Epidemiol. 2016;51(3):319–26. source