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New clinical guideline for youth acute mental health
The Australia-first guideline offers GPs practical advice, covering risk assessments, follow-up care, and evidence-based treatments.
The Australia-first guideline provides a ‘best practice quality care framework’ for young people experiencing mental health issues.
Aiming to address existing gaps in care, new clinical practice guidelines to support healthcare providers manage young people experiencing mental health crises have been published for the first time in Australia.
Developed in partnership with the Murdoch Children’s Research Institute (MCRI) and the University of Melbourne Department of Paediatrics, the resource arms GPs and other healthcare providers with the tools to identify, assess and manage acute mental health symptoms in young patients aged up to 19 years, including for suicidal ideation and non-suicidal self-injury (NSSI).
The guidelines are recognised by the RACGP as an Accepted Clinical Resource, and are intended to be used across healthcare, education, and community settings to deliver ‘safe and timely care’.
Specific recommendations are included for care in non-mental health settings, including general practice and allied health, specialist mental health settings, and emergency or urgent care settings for those presenting in acute crisis or distress. It covers guidance on:
- risk assessment based on a young patient’s circumstances and support network
- evidence-based treatment in specialist and primary care clinics
- support for responding to suicidal distress and NSSI outside of hospitals, including schools and community spaces
- follow-up care
- improved person-centred and culturally safe care.
Guidance around safer prescribing is also included for healthcare providers who prescribe medications to children and adolescents, with recommendations against the use of medications specifically to treat suicidal ideation, attempts, or NSSI, or comprehensive individual assessments first, in line with
current evidence supporting non-pharmacological interventions.
Dr Tim Jones, Chair of RACGP Specific Interests Child and Young Person’s Health, provided feedback on the guidelines.
He says the guidelines should be referenced when GPs are seeing young people with ‘very high-risk profiles’.
‘If we’re seeing young people where there is significant concern about suicidal ideation and suicidal behaviour, these provide a best practice framework for what quality care looks like,’ Dr Jones told
newsGP.
‘It really references what we do as GPs, keeping the person at the centre, being non-judgemental, providing safe spaces, and supporting the whole of families.’
He added that the new guideline ‘speaks to the value of our relationship with our young patients’ and the support GPs can offer.
‘The real value of the guideline for GPs is it reinforces that we’re the safest space for youth who are really struggling with their mental health,’ Dr Jones said.
‘If they are in mental health crisis, if they are experiencing NSSI, they are really finding the experience of being in a hospital or being in a community organisation very confronting and often quite judgemental and stigmatising.
‘These guidelines have been written for under 18s, but these would also apply in our context for patients up to the age of 25.’
A recent systematic review found that gaps remain for specific clinical guidance available for younger people with mental health conditions who present with NSSI.
‘Clinicians rely on clinical practice guidelines to inform evidence-based management of conditions. However, the quality and availability ... for mental health conditions in children and adolescents vary,’ the review states.
Developed in partnership with healthcare providers, researchers, young people, and carers from across Australia, the new MCRI guideline reflects a shared commitment to improving outcomes for children and adolescents experiencing suicide and NSSI.
Young people with a lived experience of an acute mental health episode or hospitalisation were directly involved in development of the guide, to inform approaches to reduce
national rising rates of young people being hospitalised for intentional self-harm.
‘From the beginning, it was critical we listened to young people who had experiences of suicidal ideation and self-harm in order to bridge the gap between evidence and real-world application,’ MCRI researcher and Chair of the guidelines Sydney Stevens said.
‘We wanted to understand where systems have caused harm, where care has fallen short and how services must change to better support vulnerable young people.’
Ms Stevens hopes the new guidelines will be used in conjunction with policymakers, healthcare providers and patients to ‘improve our whole system of care’.
‘These guidelines offer a range of practical and responsive recommendations that can be disseminated and used to improve care,’ she said.
‘It is the next step towards an evidence-informed system that listens to children and families and works collectively to prevent harm and support recovery.’
If you or anyone you know needs support, contact Lifeline on 13 11 14 or Beyond Blue on 1300 22 4636.
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adolescent health child and young person’s health mental health non-suicidal self-injury self-harm
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