Constructing a research based pre-care model to improve mental health interventions for young people

Abstract

Objective: This study had two aims. Firstly, to explore how young people experienced the onset of mental health problems and to investigate their initial interactions with the health system; and secondly, to use these findings to construct a pre-care model that can be used by nurses and other health care professionals to design appropriate interventions.

Design: Grounded theory method was used to develop a theory of young people’s experience of the pathway to mental health care. Data were obtained through in-depth semi-structured interviews.

Setting: Participants were recruited through two community health centres in a Sydney metropolitan area health service.

Subjects: The purposive sample consisted of eight males and twelve females between the ages of eighteen and twenty five (mean age was 21).

Main outcome measures - Findings: The categories identified from analysis of the interviews were (a) first sign - often involved denial or fear in the early stages and self medication with alcohol or other drugs; (b) recognition - of the symptoms as a sign of mental illness; (c) understanding - discovering information about the illness; and (d) resolution - when care is successfully accessed. Barriers and facilitating factors either delay or assist movement from one stage to the next. The ‘‘maze to care’’ model is suggested as a guide to action for health professionals. It can direct attention to broader social and systems interventions or, at the individual level, assist assessment.

Conclusions: The study offers insights into the experiences of a small group of individuals and hence has limitations however the development of a model which can be tested in practice demonstrates that grounded theory can be a useful research approach when used to develop frameworks for action in nursing and mental health care.