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Telehealth not the silver bullet for youth mental health crisis

GP says early intervention and prevention is key f
Photo: Telehealth not the silver bullet for youth mental health crisis
Throughout the COVID-19 pandemic, some commentators have pointed to telehealth as the silver bullet for solving the country’s youth mental health crisis. But one GP has told HealthTimes that it’s not the answer to all the problems at play, and that pioritising prevention and early intervention from a young age are the key.

“I feel telehealth definitely has a role in certain situations and for certain people, but it's definitely not the whole answer because young people really value relationships.  Building trust, building continuity of care and feeling that their voice is really being heard is very important for our youth when providing care”, said Dr Sarah Youngson, a GP based in regional WA.

“And that's really hard to do as a telehealth practitioner, who is dialing in from a long way away, to build that very, very vital  relationship with a young person.”
“So yes, certainly, in some contexts where you're just trying to give a young person strategies and some skills, that's great. But it can fall short when you're supporting a young person who's got all sorts of social, financial, educational issues.”

“I think that there are some significant limitations to telehealth – it’s not the answer to our problem.”

Dr Youngson’s comments come after new research into the state of Australia's youth mental health system by the Centre for Social Impact (CSI) and Zurich Financial Services revealed that waiting for young people to be in crisis is not working as an approach.

The effects of COVID-19 have been two-fold – it has shone more light on the flaws and potential of the mental health care system, while also exacerbating mental health issues in the community.

“Most of the young people that I see are struggling with anxiety, depression, self-harm”, Dr Youngson said.

“I wouldn't say that the actual patterns of illness or the diagnoses have changed per se, but there's certainly been a massive escalation in presentations with these conditions through the COVID pandemic.  The pandemic has definitely had an impact on young people's mental health and wellbeing.”

The knock-on effects of the global pandemic have been more far-reaching than some initially expected – also affecting people living in communities who weren’t directly impacted by lockdown measures.

“It's interesting because where I live and work in the southwest WA, we've been relatively unscathed, luckily, by COVID and yet we're definitely seeing an impact on young people's mental health – and that’s even without lockdowns and prolonged social isolation in this area.”

“My feeling is that young people and their incredibly amazing, developing minds, are looking at this COVID-world through an adolescent lens, which is very frightening and very shocking for them.”

“And the uncertainty that they're exposed to all the time through social media is undoubtedly having an impact on their wellbeing.   Family stress and uncertainty around finances and employment is also impacting on our young people.”

Dr Youngson said that geography continues to be a problem for mental health care in communities outside of major cities.

“Access to services in rural communities is a massive problem because a lot of young people don't have transport and particularly when you're looking at at-risk or marginalized people, the cost of travel for their families to take them to services a hundred kilometers away is prohibitive.”

“And if services do reach a small community, they are drive in, drive out. They don't necessarily have a connection with the community.”

“They don't necessarily have an understanding of the context of each individual community, so I'd really love to see rural communities that are geographically isolated, being empowered as communities to provide mental health promotion, prevention and treatment services within the community to really counter that issue of geographic inaccessibility.”

Dr Youngson said that prioritising on prevention and intervention strategies, as opposed to only investing into treatment, is the key to better addressing youth mental health.

“Most of the health resources are focused on treatment, which is completely necessary, but we really need to be focusing on building resilience and coping strategies in our young people, working with our youth so that they feel connected and engaged in their communities and trying to tackle problems before they become an illness.

“It would be really wonderful to have more education in schools and starting really early in schools. And I don't think that we should be expecting our teachers to be experts in this area.”

“It’s about having a really comprehensive program across middle and upper primary school, and then into high school, that provides support and education around help seeking and coping strategies, and resilience building.

On the plus side, Dr Youngson said that as a society, we are getting better at reducing the stigma that surrounds mental health – but that we still have work to do.

“I think schools and communities are getting better at talking about mental health issues.”

“Having said that, it is still a significant problem, particularly in rural communities, and especially with our young and older men who are still very much of that tough upper lip mindset and don't necessarily have the language to talk about feelings or feel empowered to do so”

“We're making steps in the right direction, but we’ve got a long way to go there”, Dr Youngson said.

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Charlotte Mitchell

Charlotte is a published journalist and editor, with 10 years of experience in developing high-quality content for national and international publications.

With an academic background in both science and communications, she specialises in medical and science writing. Charlotte is passionate about creating engaging, evidence-based content that equips the community with important information on issues around healthcare, medicine and research.

Over the years, she has partnered with organisations including the Medical Journal of Australia, Cancer Council NSW, Bupa, the Australasian Medical Publishing Company, Dementia Australia, MDA National, pharmaceutical companies, and state and federal government agencies, to produce high-impact news and clinical content  for different audiences.