Current trends in the rehabilitation of juvenile offenders

The Australian Institute of Criminology\u27s recent work on adult male offenders has found that the most serious and persistent adult offenders had been detained as a juvenile. In terms of crime reduction, interventions that focus on reducing the likelihood of juveniles escalating to adult offenders will have significant benefits for the whole of the Australian community. Research conducted in juvenile justice settings around the world consistently shows that young people who come to the attention of criminal justice agencies have multiple problems and experience high levels of need across all areas of functioning. In meeting these needs, correctional agencies have been increasingly influenced by the model of rehabilitation known as the \u27what works\u27 approach. This paper outlines a case management framework for rehabilitating juvenile offenders that includes three of the most important \u27what works\u27 principles, namely the risk principle, the needs principle and the responsivity principle. In the longer term, the implementation of the framework will need to be evaluated to determine what works and what doesn\u27t with rehabilitating juveniles.<br /

Help-seeking for psychological problems in late adolescence

Adolescent responses to psychological problems were examined using a five wave longitudinal design over a 12 month period. A total of 715 adolescents were followed at three monthly intervals from just prior to finishing high school through their first year out of school. Of the total sample, 53.1 percent complied with all five waves of data collection. Compliers were more likely to be girls and those with a greater interest in mental health. These Australian adolescents were shown to confide their psychological problems overwhelmingly to friends, with about 70 percent seeking help from friends at each wave. This compared with 30 percent who sought help from their family, and only 5-10 percent who turned to professional sources of help. The peer group was shown to be the primary source of emotional support. The prevalence of minor psychiatric morbidity was very high, with 20 to 30 percent of the sample suffering from psychological distress at any time. This was comparable with other studies of adolescent mental health, confirming that late adolescence and finishing school was a period of considerable distress. Symptoms of minor affective disorder were more common in girls than boys, also consistent with other findings. Although psychological symptoms were an important predictor of help­ seeking, such behavior was shown to have multiple predictors. A range of variables from the social-psychological approach to illness behavior were hypothesised to increase vulnerability to psychological problems and thereby encourage help­ seeking behavior. The major proposition of illness behavior research, that factors other than symptoms influence illness behavior, was strongly supported. Emotional vulnerability factors were shown to vary in their predictive value over the different help-seeking contexts. Help-seeking from friends, family and professionals were found to be distinct domains with different facilitators and inhibitors. Turning to friends for support was predicted by being female, perceived psychological distress, private self-consciousness and fear of the stigma attached to psychological illness. These factors both facilitated help-seeking from friends and inhibited it in those with symptoms. Seeking help from the peer group, of the help­ seeking behaviors, was most affected by vulnerability factors, but was also shown to be a result of peer group socialisation processes. Family help-seeking was the least affected by vulnerability to psychological problems. Facilitators of family help-seeking were shown to be availability of confiding relationships and being female. Only lacking a confiding relationship inhibited family help-seeking in those who were distressed. Those few adolescents who sought professional help were best predicted by psychological distress and life events. Professional help was the most disorder and problem driven type of help-seeking. So few young people sought professional help partly because their problems may not have been seen as appropriate for professional intervention. Furthering the usual predictive nature of help-seeking studies, the effectiveness of help-seeking, in terms of subsequent psychological distress, was also examined. A disturbing finding was that none of the three types of help-seeking reduced minor affective symptoms three months later. Seeking help was unrelated to mental health outcome. This was discussed as a consequence of the type of help offered in most help-seeking episodes. A focus on the self and how one feels is maladaptive for many adolescents. Self-focus reinforces and encourages an overconcern with the self, which generally results in the amplification, rather than reduction, of psychological symptoms. With so many adolescents clearly suffering from psychological distress, the needs of these young people did not appear to be being met by either their informal social support networks or professional services. The help-seeking habits of adolescents need to be considered to provide appropriate services. There was a need for peer based services where skills could be learned to reduce the emotional arousal caused by the many psychological problems of adolescence

Acceptability and utility of an electronic psychosocial assessment (myAssessment) to increase self-disclosure in youth mental healthcare: A quasi-experimental study

BACKGROUND: Technology is increasingly being used in youth mental healthcare to support service delivery and improve health outcomes. The current study trialed a new electronic psychosocial application (myAssessment) that aims to provide a holistic assessment of relevant risk and protective factors in youth mental healthcare. The study aimed to determine whether myAssessment was acceptable to all users, and whether it affected: reporting of certain behaviors and ratings of self-disclosure; youth ratings of control, fears of judgmental reactions or time-efficiency; clinician ratings of time-efficiency or their ability to formulate a treatment plan; and the therapeutic alliance. METHOD: The application was tested at a youth mental health service using a quasi-experimental two phase Treatment-as-Usual/Intervention design. Three hundred thirty nine youth and 13 clinicians participated across both phases. Reporting of behaviors, self-disclosure, youth control, judgmental reactions, time efficiency, ability to formulate treatment plans, and the therapeutic alliance were compared between groups. RESULTS: myAssessment was found to be widely accepted by both young people and clinicians. Use of myAssessment resulted in reporting of behaviors that were 2.78 through 10.38 times higher for a variety of substances (use of tobacco, alcohol, cannabis, sedatives, hallucinogens, and opioids), in identifying non-heterosexual sexual orientation, having had sex, an STI check, sex without a condom, having felt pressured to have sex in the past, having self-harmed, and in having put themselves in an unsafe situation. Participants who used the application also reported being less likely to lie on past experiences of being bullied, substance use, and self-harm. Use of the application resulted in improved youth ratings of time efficiency in session. The application was found to have no impact on youth control, judgmental reactions, formulation of treatment plans, or the therapeutic alliance. CONCLUSIONS: Electronic psychosocial assessments can increase rates of self-disclosure and, therefore, provide an earlier and more comprehensive picture of young people’s risks without negatively impacting the therapeutic alliance. Additionally, this type of technology has been shown to be widely accepted by both young people and clinicians and can improve youth beliefs that there is enough time in session to speak about what is most important to them

A systematic review of mental health outcome measures for young people aged 12 to 25 years

BACKGROUND: Mental health outcome measures are used to monitor the quality and effectiveness of mental health services. There is also a growing expectation for implementation of routine measurement and measures being used by clinicians as a feedback monitoring system to improve client outcomes. The recent focus in Australia and elsewhere targeting mental health services to young people aged 12–25 years has meant that outcome measures relevant to this age range are now needed. This is a shift from the traditional divide of child and adolescent services versus adult services with a transitioning age at 18 years. This systematic review is the first to examine mental health outcome measures that are appropriate for the 12 to 25 year age range. METHODS: MEDLINE and PsychINFO databases were systematically searched to identify studies using mental health outcome measures with young people aged 12 to 25 years. The search strategy complied with the relevant sections of the PRISMA statement. RESULTS: A total of 184 published articles were identified, covering 29 different outcome measures. The measures were organised into domains that consisted of eight measures of cognition and emotion, nine functioning measures, six quality of life measures, and six multidimensional mental health measures. No measures were designed specifically for young people aged 12 to 25 years and only two had been used by clinicians as a feedback monitoring system. Five measures had been used across the whole 12 to 25 year age range, in a range of mental health settings and were deemed most appropriate for this age group. CONCLUSIONS: With changes to mental health service systems that increasingly focus on early intervention in adolescence and young adulthood, there is a need for outcome measures designed specifically for those aged 12 to 25 years. In particular, multidimensional measures that are clinically meaningful need to be developed to ensure quality and effectiveness in youth mental health. Additionally, outcome measures can be clinically useful when designed to be used within routine feedback monitoring systems. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12888-015-0664-x) contains supplementary material, which is available to authorized users

The role of self-help in the treatment of mild anxiety disorders in young people: an evidence-based review

Anxiety disorders are the most common mental health problems experienced by young people, and even mild anxiety can significantly limit social, emotional, and cognitive development into adulthood. It is, therefore, essential that anxiety is treated as early and effectively as possible. Young people are unlikely, however, to seek professional treatment for their problems, increasing their chance of serious long-term problems such as impaired peer relations and low self-esteem. The barriers young people face to accessing services are well documented, and self-help resources may provide an alternative option to respond to early manifestations of anxiety disorders. This article reviews the potential benefits of self-help treatments for anxiety and the evidence for their effectiveness. Despite using inclusive review criteria, only six relevant studies were found. The results of these studies show that there is some evidence for the use of self-help interventions for anxiety in young people, but like the research with adult populations, the overall quality of the studies is poor and there is need for further and more rigorous research

The development of a core outcome set for crisis helplines:A three-panel Delphi study

Background: Evidence for the effectiveness of crisis helplines is limited by inappropriate and inconsistent outcome measurement. The aim of this study was to develop a core outcome set that reflects the most relevant and important outcomes to help-seekers accessing a crisis helpline via any delivery mode (e.g., phone, SMS text, online chat). Method: We used a three-panel Delphi method to compare and integrate the views of three expert groups: people with lived experience of accessing crisis helplines (n = 32), researchers with experience assessing crisis helpline outcomes (n = 25), and crisis helpline supporters (n = 58). Across two online survey rounds (89 % retention rate), participants rated the importance of 33 potential outcomes for help-seekers accessing a crisis helpline. Participants also provided open-text comments and suggestions. Outcomes that reached consensus (≥75 % agreement) by at least two panels were included in the core outcome set. Results: Ten outcomes met the criteria for inclusion in the core outcome set. In order of importance, these were: distress, feeling heard, suicide risk, connectedness/support, hopelessness, overwhelm, non-suicidal self-injury risk, service experience, helplessness, and next steps. Limitations: Participants self-selected and were mainly from English-speaking countries. Conclusions: We recommend future outcome and evaluation studies minimally measure and report the 10 outcomes identified in this study. Assessing an agreed set of meaningful outcomes will improve comparability and facilitate a deeper understanding of crisis helpline effectiveness. More work is needed to determine how best to assess these outcomes in the crisis helpline context.</p

Social influences on seeking help from mental health services, in-person and online, during adolescence and young adulthood

BACKGROUND: This study provides the first comprehensive empirical evidence of developmental changes in the social influences on seeking mental health care, both in-person and online, during the critical lifestages for mental health of adolescence and young adulthood. METHODS: Main source of help-seeking influence was determined via self-report for all young people accessing youth-targeted mental health services in Australia for a first episode of care over a 12 month period during 2013. This comprised 30,839 young people who accessed in-person services and 7,155 clients of the online service. RESULTS: Results show a major developmental shift in help-seeking influence across the age range, which varied for males and females, and a striking difference between the online and in-person service modalities. The dominant influence online, regardless of age, was the young person themself. In contrast, for in-person services, the dominant influence during adolescence was family, but this changed markedly in late adolescence to favour self-influence, with a lessor, but still substantial effect of family. The influence of friends was surprisingly low. CONCLUSIONS: To support young people with mental health problems to access mental health care, the personal connection of parents and family needs to be engaged to encourage in-person service use through better mental health literacy, particularly for adolescents. In the online environment, ways to ensure that young people themselves are guided to appropriate services are required

Development and Validation of a Routine Session-by-Session Experience Measure for Youth Mental Health Services:My Youth Mental Health Session Experience (MySE)

Purpose: The ‘My youth mental health Session Experience’ (MySE) measure was developed by headspace, Australia’s National Youth Mental Health Foundation, in collaboration with young people, for use as a routine session experience measure across its national centre service network. The measure fills a gap in measures needed to implement measurement-informed care in youth mental health care. Participants and Methods: Routinely collected data from 37,201 young people aged 12 to 25 years who commenced an episode of care at one of the 150 headspace centres between 1 July 2021 and 30 June 2022 were used to validate the five-item measure. Results: MySE demonstrated high internal consistency invariant over age and gender groups. There was one latent factor of session experience that all MySE items relate to, although this factor does not adequately capture all the information present in the individual items. A significant age effect showed that young adults reported more positive session experiences than adolescents. Conclusion: MySE demonstrated strong psychometric properties and is suitable for use in youth mental health care as a routine session-by-session experience measure. Such measures are needed to routinely inform clinicians of how young people are experiencing their treatment sessions, thereby contributing to better retention, engagement, and client outcomes through measurement-informed care.</p