Youth StepCare for adolescents attending General Practices

Youth StepCare is a digital mental health screening service, clinical decision aid, and monitoring tool designed to help General Practitioners (GPs) better manage common mental health problems in their adolescent patients. The tool also aims to increase GPs’ use of digital mental health interventions when treating adolescents with mental health concerns.

Youth StepCare first provides an opportunity for adolescent patients to complete a digital mental health screener on their smartphone in the practice waiting area. Their results are then sent to their GP in the form of a report, so that they can be reviewed in the upcoming appointment. The report provides the GP with (a) scores on measures of depression, anxiety, and suicidality, (b) severity ranges for each symptom, ranging from nil-to-minimal, mild, moderate, to severe, and (c) treatment recommendations that are matched to the patient’s symptom severity, and which follow a stepped mental health treatment approach. Adolescents who show symptoms of depression and/or anxiety at screening are also monitored every fortnight for 12 weeks, and results are sent to their GP to facilitate follow-up care.

Objectives

Youth StepCare has been evaluated in a pilot study, which showed that GPs found the tool helpful in managing their adolescent patients’ mental health concerns. A larger randomised controlled trial is currently underway, which aims to determine the best methods for implementing Youth StepCare into a General Practice workflow. 

Impact 

Over the past six months, we have: developed two novel approaches to implementation, which we will directly compare in the context of the current research trial. We have also enhanced the Youth StepCare digital screening tool based on critical learnings from the Youth StepCare pilot study. Finally, we have recruited and trained two specialist implementation staff, who will lead the implementation of Youth StepCare into General Practices in NSW, VIC, and ACT as part of the current research trial.

The impacts of this study are anticipated to be: increased knowledge of the factors that affect the successful implementation of digital mental health screening tools for adolescents into General Practice, increased ability to detect and effectively treat adolescent patients who present to their GP with mental health conditions, and increased familiarity and use of low-intensity digital mental health interventions by GPs with their adolescent patients.

Funding

Australian Government Department of Health, through The Prevention Hub, the Paul Ramsay Foundation, and the National Health and Medical Research Council.

Researchers 

• Dr Alexis Whitton
• Dr Belinda Parker

Publications 

Parker, B. L., Achilles, M. R., Subotic-Kerry, M., & O’Dea, B. (2020). Youth StepCare: a pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice. BMC family practice, 21(1), 1-10.
10.1186/s12875-019-1071-z