Met and unmet need in youth mental health

Background: Adolescents and young adults have a high incidence and prevalence of mental disorders, which can be disabling, chronic and lead to the development of further mental health problems. Yet their needs are not being adequately met by existing health structures. We set out to examine the extent of met and unmet need in young people by assessing referrals to a public mental health service for 15 24 year olds. We sought to identify differences between young people who were accepted into the service and those who were not with respect to psychiatric diagnosis, subthreshold symptoms, and psychosocial functioning. Method: All young people aged 15-24 years who were referred to the service from April to September 2003 for assistance with non-psychotic disorders were approached for assessment. Results: 204 individuals were referred to the service with non-psychotic problems over the data collection period, and 150 consented to participate in the study. Fifty nine percent of participants (n = 88) were accepted into the service (the RA group). They were more likely to have a current diagnosis than those not accepted into the service (the RNA group; n = 62). The RA group had higher levels of depression and anxiety, and lower psychosocial functioning, compared to the RNA group. The RNA group group were also unwell: nearly 63% had at least one diagnosis at the time of referral. Both the RA and RNA groups showed functional impairment. Conclusions: Limited services are denying assistance to young people with significant morbidity and associated functional impairment. We suggest a range of reforms that would benefit the mental health of society by focussing on those most in need and those most likely to respond to early intervention: our young people.