Key features of an innovative sub-acute residential service for young people experiencing mental ill health

Abstract

BackgroundNumerous studies across international settings have highlighted a need to improve the appropriateness and continuity of services for young people experiencing mental ill health. This paper examines key features of a sub-acute youth mental health residential service model, Youth Prevention and Recovery Care (Y-PARC) service. Y-PARC provides up to 4 weeks care to 16 to 25 year-olds at risk of hospitalisation and to those transitioning out of hospital inpatient units. The research was conducted at one of three Y-PARCs located in Victoria, Australia.MethodsThis paper presents findings from analysis of two data sources collected during evaluation of a Y-PARC service in 2015–17. Routinely collected administrative data of Y-PARC residents (n = 288) were analysed and semi-structured interviews were conducted with 38 participants: a) former residents (n = 14); b) family members of group a) (n = 5); key stakeholders (n = 9); and, Y-PARC staff (n = 10 respondents in 3 group interviews). Analysis of the qualitative data was thematic and structured by the interview guide, which covered the key service aims.ResultsConsistent with the aims of the service, respondents described practice at Y-PARC that aligns with recovery-oriented care. Key features emphasised were: a safe and welcoming environment for residents and families; provision of person-centred care; promotion of autonomy and self-help; informal interactions with staff allowing for formation of naturalistic relationships; time spent with other young people with similar experiences; and, assurance upon exit that the ‘door is always open.’High levels of satisfaction were reported. Outcomes described included: improved resilience; better understanding of mental health; the importance of seeking help; and, stronger connections to therapeutic services. Longer and multiple stays were associated with progressive and sustained change. Family members and stakeholders widely reported that the service fills a gap between community services and acute inpatient mental health hospital wards.Some challenging areas of practice identified included: integration of evidence-based psychosocial interventions; provision of care within a model that blends clinical and psychosocial support services; and, negotiation of family-inclusive practice.ConclusionsThe Y-PARC service model shows promise with young people experiencing mental ill health, particularly in improving the range and availability of options across a spectrum of need.

Introducing the youth residential rehabilitation service: An operational and experiential overview of a psychosocial residential support option for young people experiencing mental health challenges

“…Authentic participation of service users in program design and evaluation is increasingly regarded as a crucial element of recovery‐oriented support and research (Heffernan et al, 2017). Service user involvement enhances relevance and responsiveness, whilst redressing power (Faithfull et al, 2019; Green et al, 2019). There is scope to amplify opportunities for young people to design and evaluate the services they use.…”

“…There is an emergent body of literature revealing some common elements of effective youth residential care. These include clearly articulated models embedded in an integrated spectrum of mental health support, individualized services based on a shared understanding of needs, family involvement, naturalistic settings that support relational development, and recovery‐oriented services that promote safety and autonomy (Bath, 2008; Green et al, 2019; James, 2011; McLean, 2018). Yet there is no research on the YRRSs model from the perspective of the young people who use these services, making it difficult to determine how the model might contribute to positive outcomes for young people.…”

The response of the mental health network of the Salamanca area to the COVID-19 pandemic: The role of the telemedicine.

“…The number of hospital admissions was 65% lower during the first 4 weeks, and 37% lower during the following 4 weeks, only two of the admitted patients being suspected to be infected with COVID. The convalescence unit, located in the LHM, has a semi-open, half-stay hospitalization scheme for subacute phases (Green et al, 2019). Eight patients were discharged to their homes and 2 remained hospitalized because of their clinical situation.…”

The Relationship of Adverse Childhood Experience and Clinical Outcomes for Admissions to Child and Adolescent Mental Health Services

“…The present results do not include any definition of the therapeutic type, context, milieu, or quality in relation to age or diagnosis [28]. While the accountability system is presently trauma-informed [10,11], and is possessed of the ability to measure the effect of community-level professional training on the frequency and quality of referrals from primary care [5] to date, there has not been a concerted effort to quantity the type, context, milieu, or quality of therapy with linkage to clinical outcomes. unaccounted for.…”

“…The recent provincial implementation of Alberta Health Services SMART goals (Specific, Measurable, Attainable, Rewarding, and Timely) aligns with recovery-oriented mental health services in respect to patient participation in goal planning and execution [2]. Recovery-oriented services consist of services wherein consumers actively participate in selecting services and developing treatment plans in the process of recovery [2][3][4][5]. Recovery-oriented mental health services are both a philosophy, and evidence-informed approach to practice that requires staff orientation in addition to orientation of patients and their families [3].…”