Cited by 218Psychiatric care and mental health servicesMental Health Treatment and AccessChild and Adolescent Psychosocial and Emotional Development

Integrated Mental Health Services for the Developmental Period (0 to 25 Years): A Critical Review of the Evidence

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Fusar-Poli, Paolo·2019·Frontiers in Psychiatry

Abstract

Background: The developmental period from 0 to 25 years is a vulnerable time during which children and young people experience many psychosocial and neurobiological changes and an increased incidence of mental illness. New clinical services for children and young people aged 0 to 25 years may represent a radical transformation of mental health care. Method: Critical, non-systematic review of the PubMed literature up to 3rd January 2019. Results: Rationale: the youngest age group has an increased risk of developing mental disorders and 75% of mental disorders begin by the age of 24 and prodromal features may start even earlier. Most of the risk factors for mental disorders exert their role before the age of 25, profound maturational brain changes occur from mid-childhood through puberty to the mid-20s and mental disorders that persist in adulthood have poor long-term outcomes. The optimal window of opportunity to improve the outcomes of mental disorders is the prevention or early treatment in individuals aged 0 to 25 within a clinical staging model framework. Unmet needs: children and young people face barriers to primary and secondary care access, delays in receiving appropriate treatments, poor engagement, cracks between child and adult mental health services, poor involvement in the design of mental health services and lack of evidence-based treatments. Evidence: the most established paradigm for reforming youth mental services focuses on people aged 12-25 who experienced early stages of psychosis. Future advancements may include early stages of depression and bipolar disorders. Broader youth mental health services have been implemented worldwide, but no single example constitutes best practice. These services seem to improve access, symptomatic and functional outcomes, and satisfaction of children and young people aged 12-25. However, there are no robust controlled trials demonstrating their impact. Very limited evidence is available for integrated mental health services that focus on people aged 0-12. Conclusions: Children and young people aged 12-25 need youth-friendly mental health services which are sensitive to their unique stage of clinical, neurobiological and psychosocial development. Early intervention for psychosis services may represent the starting platform to refine the next generation of integrated youth mental health services.

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  1. [56]National Institute for Health and Care Excellence Antenatal and postnatal mental health: clinical management and service guidance (update). (2014). https://www.nice.org.uk/guidance/cg192 31990493

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Authors
Fusar-Poli, P.
Venue
Frontiers in Psychiatry
Published
2019-06-07
Volume
10
Pages
355-355
ISSN
1664-0640 (ISSN-L)
OpenAlex
W2968800319
Cited by
218
References
72
Citations by year
2026: 35 · 2025: 24 · 2024: 55 · 2023: 29 · 2022: 22 · 2021: 26 · 2020: 21 · 2019: 6
FWCI
2.97
Type
journal article
Language
en
Open access
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (publishedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
integrated mental health services, child and adolescent mental health services, children and young people, early intervention in psychosis, early psychosis, developmental stages, mental disorder prevention, early treatment, access to mental health care, evidence-based treatment, brain maturation, depression, bipolar disorder

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