Primary mental health care services play an important role in prevention and early intervention efforts to reduce the prevalence and impact of mental health problems amongst young people. This paper aimed to (1) investigate whether mental health services commissioned by Australia’s 31 Primary Health Networks provided accessible care and increasingly reached children and youth across Australia, and (2) identify the challenges of, and facilitating factors to, implementing services for youth with, or at risk of, severe mental illness (i.e., youth enhanced services) in 10 PHNs which acted as mental health reform leaders (i.e., Lead Sites). We used mixed methods, sourcing data from: a national minimum data set that captured information on consumers and the services they received via all 31 PHNs from 1 July 2016 to 31 December 2017; consultations with Lead Site staff and their regional stakeholders; and observational data from two Lead Site meetings. Many children and youth receiving services were male and up to 10% were Aboriginal and/or Torres Strait Islander young people. The majority of young people came from areas of greater disadvantage. For most children and youth receiving services their diagnosis was unknown, or they did not have a formal diagnosis. Both child and youth service uptake showed a modest increase over time. Six key themes emerged around the implementation of youth enhanced services: service access and gaps, workforce and expertise, funding and guidance, integrated and flexible service models, service promotion, and data collection, access and sharing. Early findings suggest that PHN-commissioned services provide accessible care and increasingly reach children and youth. Learnings from stakeholders indicate that innovative and flexible service models in response to local youth mental health needs may be a key to success.

中文翻译：

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实施儿童和青少年精神卫生服务：澳大利亚初级卫生网络牵头站点项目的早期课程

初级精神卫生保健服务在预防和早期干预工作中发挥重要作用，以减少年轻人中精神卫生问题的普遍性和影响。本文旨在（1）调查澳大利亚31个初级卫生网络委托的精神卫生服务是否提供可访问的护理并在澳大利亚全国范围内逐步普及儿童和青年；（2）确定在以下地区为青少年实施服务所面临的挑战和促进因素：或有10个PHN处于严重精神疾病（即，青年增强服务）的风险，这些PHN充当了精神健康改革的领导者（即，领导场所）。我们使用混合方法从以下国家/地区采购数据：全国最低数据集，该数据集收集了2016年7月1日至2017年12月31日通过所有31个PHN获得的消费者及其服务信息；与Lead Site工作人员及其区域利益相关者进行磋商；和两次Lead Site会议的观测数据。接受服务的许多儿童和青年是男性，而土著和/或托雷斯海峡岛民的年轻人比例高达10％。大多数年轻人来自处境不利的地区。对于大多数接受服务的儿童和青少年，他们的诊断是未知的，或者他们没有正式的诊断。随着时间的流逝，儿童和青年人对服务的摄取均显示出适度的增加。围绕青年服务的实施，出现了六个关键主题：服务获取和差距，劳动力和专业知识，资金和指导，综合而灵活的服务模式，服务推广以及数据收集，获取和共享。早期发现表明，PHN委托的服务可提供无障碍护理，并越来越多地覆盖儿童和青少年。利益相关者的经验表明，针对当地青年心理健康需求的创新，灵活的服务模式可能是成功的关键。