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Feature Article

Mental ill-health in young people: assessment and early treatment

Patrick D McGorry

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Abstract

A stepped-care approach should be used for young people with mental health issues with the key features being assessment, information, support, shared decision-making, cognitive behavioural therapy and multiple visits. This approach should typically precede prescribing medication unless severe depression, clear-cut psychosis or the risk of self-harm or violence is apparent.

Key Points

  • Mental health issues are very common in young people, with about 25% of Australian adolescents experiencing a diagnosable mental illness in any given year.
  • Anxiety, depression and substance abuse are the leading mental health problems in young people.
  • Early intervention with a preventive focus is appropriate wherever there is a need for clinical care. This can be assessed based on the intensity of the young person’s symptoms and distress and the degree of disruption to relationships and functioning.
  • A stepped-care approach should be used, with education, support and simple evidence-based interventions chosen as the initial therapeutic strategy.
  • Decisions on management should be made with the young person and his or her family, if possible. Use of medications should be reserved for severe stages of mental ill-health and for those who do not respond to psychosocial therapies.

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