Early intervention in youth mental health: development of guidelines for general practice

Aims: GPs, as healthcare professionals with whom young people commonly interact, have a central role in early intervention for youth mental health. To support GPs in this important role, we aim to develop clinical guidelines to promote identification and treatment of mental and substance use disorders among young adults (age 16-24). Methods: Following a qualitative study of young people and healthcare professionals in two urban deprived areas, we conducted a modified Delphi study using the following steps: i) Established an Expert Panel involving 18 key stakeholders; ii) Identified key areas which the guidelines should address using a group meeting and survey; iii) Reviewed and synthesised relevant literature; iv) Review of items created again by the stakeholder panel, with another meeting and survey. Results: Twenty-two items were considered important for inclusion in the guidelines and 17 items important for implementing them. These items could be divided into five different domains 1. Prevention, Health Promotion and Access; 2. Assessment and Identification; 3. Interaction with Other Agencies/Referral; 4. Ongoing Support; and 5. Implementation issues. Conclusions: Guidelines which would include all 22 items and 17 implementations would be too unwieldy for reasonable use by GPs. However, once split into the different domains, followed by further literature synthesis and review from the expert panel, it is hoped guidelines more applicable and feasible for use in practice will be created under these headings.