Person-centered approaches to informing youth mental health services in Ireland

 
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Presentation First Author: 
Nicholas Peiper
Abstract: 

Rationale: Early intervention among young people 12-25 years old is timely considering that 75% of adult psychopathology has emerged by age 24. Thus, the Jigsaw model of early intervention has been deployed throughout Ireland since 2008 to address the mental health of young people experiencing mild to moderate difficulties. To date, over 8,000 youth have engaged with Jigsaw through case consultations, brief contacts, and brief interventions.

Objectives: Given the high levels of psychological distress experienced among those participating in brief interventions, we sought to empirically derive typologies of youth experiencing differential patterns of symptoms reported at intake from January 1, 2013 to December 31, 2013 (n=1,247). To further facilitate program planning and tailor services, we also explored the relationship between these typologies with demographic characteristics, risk and protective factors, and serviced provided.

Methods: As over 100 symptoms are reported at intake, we performed principal components factor analysis with oblique rotation to arrive at a more manageable set of 41 symptoms. These 41 symptoms were then entered into a latent class model and analyzed sequentially until the most parsimonious model was determined with the following criteria: Akaike information criteria (AIC), adjusted Bayesian information criteria (aBIC), Lo-Mendell-Rubin likelihood ratio test (LMR-LRT), entropy, and theoretical interpretability. Multinomial logistic regression was used to determine significant predictors of class membership, including sociodemographics and risk/protective factors.

Results: Based on the fit criteria and theoretical meaningfulness, the four-class model provided the most parsimonious solution. The typologies of youth included Developmental (n=334; 27%), Comorbid (n=194; 16%), Anxious (n=540; 43%), and Externalizing (n=179; 15%). Significant age- and gender-related differences were found for Comorbid and Externalizing, although general family problems and lack of adult support were very strong predictors for all four typologies. The proportions of all service types also significantly differed between the typologies.

Conclusion: Our study found heterogeneous patterns of mental health symptoms among Irish youth engaging in an innovative early intervention service. These findings highlight the opportunity to further adapt program planning and service delivery to the needs of the four typologies derived from latent class analysis. Recent follow-up analyses have also found significant gender differences in the number and structure of typologies. Overall, our results represent an initial validation for implementation of the Jigsaw model that emphasizes supports tailored to individual needs.

Conference Name: 
Date of Presentation: 
9th Oct 2015
Type of presentation: 
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