1. Jane H Roberts GP and Senior Lecturer University of Sunderland RCGP Adolescent Health Group

2. Churchill Fellow 2010Overview of talk Australian context Adolescent mental health New developments in community based service provision Key findings Conclusions

3. Aboriginal rock paintingsHistorical background Old and new country Aboriginal culture 50 000 years old 1700s British colony 1850s 6 states – with independent governance 1900 Australian independence 1931 Commonwealth

4. 6 th largest country in the world Population 20 million 13 th richest economy

5. 4 in 10 young people and increasing rich country with high rates of relative poverty Blended system of healthcare-public /private No registration with GPs. Medicare covers basic services. Eligible from 15 yrs old 2003 and 2007 national reviews MH-IAPT Focus on YP MH and service shake-up

6. Championed by Prof McGorry Funded by Commonwealth (national ) government 2006: National Youth Mental Health Foundation Focused on 12-25 years in 30 one-stop shops in pop dense areas Aim to address general and mental health, substance + alcohol counselling, education and employment University support-UoMelbourne Orygen

7. Melbourne Sunshine centre Key points Work with existing services –determines local shape + scope GPs role pivotal-but variable interest Youth workers crucial Main focus on MH Less input in Education Training +Employment

8. CAMHS-poorly funded; high rate private psychiatry Inter-state variability re provision and legislation incl. competence regulations Major re-structuring of mental health services in Victoria around 0-11,12-25 yrs Individual models eg Clockwork, Geelong: multi-agency team working, high workload Education: UME-med students in high schools + PCOs: Docs and teens Culturally appropriate services limited

9. Sculpture in AdelaideThe big issues A generalist or specialist service? Encouraging all clinicians to be youth- friendly or create stand –alone services? 12-25 as a core group? Early intervention or over-medicalization?

10. Champions are essential : youth mental health Advocacy and lobbying lead to funding Role of Academic base : Orygen; DGP, UoM; CAAH; Youth Health Research Interest group, Sydney Pros and cons of a youth focused service- EarIy Intervention effective in long term or diverting limited resources ?

11. Cleland Wildlife ParkKey messages Work closely with client groups: YP, clinicians- what do they want ? Respect local history and geography- context is all important A can-do approach is energizing Youth (mental ) health is everyones business

12. http://www.wmct.org.uk