Adolescent and Youth Health: Development and Future Challenges

Purpose:
To optimize a system focused on early detection and early intervention in psychosis for adolescents and young adults(16y-30y). The goal is to reduce DUP (duration of untreated psychosis) through integrated and trans disciplinary teams, also implementing knowledge and specific skills of professionals, and organizing meetings with general population, The purpose is to reduce stigma and improve accessibility to appropriate care; this should lead to a reduction in both, incidence (short term) and prevalence (long term, 10-20 years) of psychosis in the area of Trieste.

Methods:
To start a collaboration between Children and Adolescents Services and the Department of Mental Health in order to support the 16-30 group (prevention and early intervention in psychosis). The community based system in town has a long history and the emphasis is currently put on facilitating the access of young people to more youth friendly services and trans disciplinary teams. In the initial phase GPs and teachers are vital partners of the project; families and carers are already involved through courses and meetings.
-To organize courses in the local schools focused on health education and detailed information in view of fighting stigma and facilitate contacts or request of help.
-To involve the media
-To start a help-line
-To organize training for GPs about early detection of psychosis and set a strong referral system for young people at risk.
-To start youth friendly services taking care of the environment and settings.

Results/findings:
Expected results from the second year (time zero) on:
-in the first six months, 15% increase of referrals; in the second six months a further 20% increase.
-50% reduction of assessments in the hospital crisis ward
-increase of first contacts at the CMHC (Community Mental Health Centres)
Evaluation of the new pathways of care through:
- RCT
-Self-evaluating questionnaires to GPs
Formal definition and approval of procedures and pathways of the project focused on adolescents and young adults, with particular attention to carers.

Conclusions:
This is a pilot project in the region of Friuli Venezia Giulia.
The methodology is sufficiently flexible, therefore adaptable to various settings.
If successful, it could represent a national model of an integrated multidisciplinary approach to prevention and early detection of psychosis.
The plan is to cooperate with similar initiatives on the national level, e.g. with Rome and Milan.