[[Singapore Mental Health Conference 2023]] Prof Pattrick M Youth mental health - More then individual needing to be "stronger", - Mental health of young Australians: dealing with a public health crisis Four questions 1. Why is the mental health of young people deteriorating 2. How to best identify those at risk, earliest stages of illness 3. What are the best interventions to address symptoms and functioning in young people who are at risk of or experiencing mental illness and at what stage 4. what are the systems of care that will best support the delivery evidence-based interventions for young people. The changing landscape of youth mental health Prevention - 15 years old is the onset? (?Is it because we measured them more and created more of this problem?) - Suicide Rate trends is going upward. - Young people have worse mental health trends (the main health problem for youth is mental health) - In Australia, about 40% of young Australians have experienced mental illness. - Lost economic output by disease type 2011-2030, 35% due to mental health. Global economic burden of Non-communicable Diseases. - We don't have the same funds, investment in researching on mental illness compare to physical illness ## Megatrends - Young people feel more pessimistic about the future. - ?Why do we not want to work youth, young people psychiatry? - Is it focused on individuals or societies -- looking at the systemic - we need to create an environment that can sustain health. - Climate Change - how it relates to mental health - Rising inequality - the more unequal in the society, associated with health - Academics are looking at it - looking at different characteristics in Generations. Bobby Duffy. (Generalisation) Trends. More gender fluidiity - Gender Fluidity F to M and trans nonconforming (NB/Enby) More LGB esp B Delayed Adulthood Sex Recession Growing Up Slowly Marriage and Childhood Restricting Speech Interest in Physical and Emotional Safety The Coddling of the American Mind: Lukianoff and Haidt; Trigger Warnings) Racial Consclousness Worse Mental Health & Pessimism "Cards stacked against me" COVID Worse Physical Health Political Polarisation and Activism ---- The current approach for youth psychiatry, psychology is not the main focus.. because we have traditionally start from looking at adult/middle age.. We wait for them to get worse then help them. Forget about the dividing line "18 years old" line.. but look at the transition. Borrow the staging idea from Cancer treatment. to look at youth psychiatry. Stage 0 - Psychiatry now form Youth psychiatry. New approach of care - got to be one stop shop.. holistic - should be primary care -- to take care of youth. ## Staged Care. / Stepped Care approach? - Headspace as enhanced primary care Economist recognise the economic impact of youth mental health. ?? How do clinician/worker re-train, to upskills to learn to work with youth? The challenge is in implementation - Where to find staff - In closing - We don't know enough.. prevention and research. - We got to .... ---- Reflecting: - One stop shop, Integrated, holistic. - Youth are more apt with technology. HOPES is for youth. ------- # Dr Swapna Verma, CMB. IMH # Youth Mental Health Reform: International and National Progress - No universe definition of youth. - Singapore rapid aging population. - Age 18 - 34 in Singapore consider youth. - Median age of onset. increased in 2016 compare to 2010 - increase prevelent. - Our young people are getting younger at getting illed. **National Mental Health Blueprint 2007** - Reach - Children and younger Youths - Chat - Older youths, in uni/poly,army Both initiate is about increasing awareness of youth mental health and treatment. Creating non-stigmatising environment. **REACH** - IMH, KKH, NUH - embedded with school. Community partners - Support clients, schools, community, and IMH. **CHAT** - For older youth, 16-30. - The message is "you are not alone", to support these groups. - Strategy: Build awareness, Build Capability, Improve access, Assessment and support. - Number of WebChat users have improved. Challenges. - Awareness and Accessibility - - Youths need parental consent - Costs and Time concerns - Stigma and lack of mental health literacy - Mental health services not sufficiently differentiated - Increase waiting time for assessment - Over-reliance on tertiary services - Coordinated Care Across services - There are hand-over gaps. Lack of standardised protocols and practises. - PDPA - Uneven standards of care delivered National Youth Mental Health Study - Currently ongoing - Epideomiological Study. - Baseline of youth mental health in Singapore. - Psychosocial Risk and Protective Factors for mental health during life transition - Use of services, unmet needs - burnout. - Funded by MOH. Started in 2021 -- 2024 - We have completed 2600 participants. 15-35 years old Preliminary data: 1. Risk factors: 1. Body Shape Concerns 2. Smoking/Vaping 3. Cyber Bulling 4. Gender 5. Drawing comparisons with others 6. Adverse childhood experiences 7. Education level - Vocational certs vs Degree Protective Factors 1. Percieved social support 2. Resilience 3. Self-esteem 4. Married 5. Higher age Stepped Care Model for Singapore Mental Health Services Upcoming Plans - Developing Training curriculum CREST-Youth and YIT **Ideal Mental Health Service** Focus group interviews of youth people: - they want face-to-face counselling - Immediate support online services - safe space - Trust Government-run services - Specialist/Professional - Can listen and help sort out thought - ==A person, not AI== - Younger relatable - Can be a friend - 24/7 - Affordable - Convenient location - Visible **Key Takeaways** - Listen to important stakeholders - Be willing to come out of your comfort zone - Collaborate - Fighting stigma remains an ongoing mission. ---- Q&A - **One Stop Shop primary care model. How does it look like? any model to model after?** - We don't want young people to go to different places for different services. Refer here and there. Provide services available to the youth in one place. - -- basically sort of like a mini polyclinic for youth (include occupational therapy) - yi shi ju zin. ------ # Designing Mental Health Services for Youth Janhavi - Primary users - Secondary Users - --- We are secondary users in HOPES. Patient is Primary users. - How is youth different from adults? - Severity and impact of the condition - ability to provuide valid self-report - attention span - motivation to seek help - sensitivity to unfamilar enviroments - finances - Youth are sensitive to power differences. # Human-Centered Design (HCD) Methods Identify need and plan and human-centred design - Lyon Et Al. - ==--- we need this!== # Literature Gaps - Current data mainly from the West. limited to specific ethnic groups or immigrant populations - Context in Singapore. - Our youth come from multi-racial culture. ## Research aims - National Youth Mental Health Study - Qualitative study - NVIVO - Themes - - Design of virtual IMH services? --- what's this? - Preliminary Results - Collaborative Discussion ---- - "human library" --- Culture of talking. ---- # Social Media and Youth Mental Health: Unveiling Insights through Qualitative Research.