1. DOC on Campus: A General Practice Initiative for Early Detection and Intervention of Mental Health Problems in a Rural Australian Secondary School Presented by Dr Anke Doley and Colin Sibly A 15 year old male student expressing his feelings

2. Why consult at a school? Collaboration work with schools provides the opportunity for both the effective delivery of services without stigma and is cost effective. (Manikan 2002, 28) Collaboration work with schools provides the opportunity for both the effective delivery of services without stigma and is cost effective. (Manikan 2002, 28)  If early intervention is going to be effective the service must be ‘youth- friendly’ which means it has to be  Confidential  Accessible  Affordable  The ‘Doc on Campus’ (DOC) program started in May 2004 on campus of a regional high school. Since then over 162 students have accessed the program so far seeking support in a range of mental health issues. Of those 162 students 34% (54) students were male. In 2008 52% (16) were male. For 2009 the male participation rate is 45% so far.  Being located in a rural community, the ‘DOC’ team have formally and informally followed the progress of some of the young people who have been part of the program and reported that a “significant number of ‘troubled’ adolescents have been able to effectively re-engage with learning and with life in our community”(C.Sibly School Counsellor).

3. How does Doctor on Campus work? School counsellor initiates referral to the GP (with comprehensive information supplied to the GP) and organises parental consent if the patient is under the age of 15 years Review by the GP (who visits the school for 1 session fortnightly) and organises If indicated a referral to a psychologist (via a Mental Health Plan and More Allied Health Services Program funding (MAHS) via a local Division of General Practice)

4. General Practitioners are primary care givers in the early intervention of mental health but adolescents are missing out. There is a 14% national prevalence rate of mental health problems for children and adolescents in Australia (Sawyer et al. (2000) There is a 14% national prevalence rate of mental health problems for children and adolescents in Australia (Sawyer et al. (2000) With about 100,000 young people experiencing anxiety or depression. However, over 60% of young people experiencing anxiety or depression don't seek professional help (Mental Health Council of Australia, 2000) With about 100,000 young people experiencing anxiety or depression. However, over 60% of young people experiencing anxiety or depression don't seek professional help (Mental Health Council of Australia, 2000) Only 25% of young people with significant mental health problems attend a service with just 8% reaching a child and adolescent mental health service Sawyer et al. (2000) Only 25% of young people with significant mental health problems attend a service with just 8% reaching a child and adolescent mental health service Sawyer et al. (2000) Due to these increased rates early intervention for young people is a priority and evidence for its effectiveness is emerging (McGorry, & Jackson, 1999; Clarke, et al., 1995). Due to these increased rates early intervention for young people is a priority and evidence for its effectiveness is emerging (McGorry, & Jackson, 1999; Clarke, et al., 1995). 19 year old high school patient who had cut herself

5. Bringing GP’s into schools Manikan (2002, 22-3) concludes that schools are the most powerful contexts to both educate and treat children and adolescents, and yet there are no proper services for assessing and providing intervention in mental health for students. Manikan (2002, 22-3) concludes that schools are the most powerful contexts to both educate and treat children and adolescents, and yet there are no proper services for assessing and providing intervention in mental health for students. General Practitioners are primary care givers in the early intervention of mental health and collaboration work with schools provides the opportunity for both the effective delivery of services without stigma and is cost effective. (Manikan 2002, 28) General Practitioners are primary care givers in the early intervention of mental health and collaboration work with schools provides the opportunity for both the effective delivery of services without stigma and is cost effective. (Manikan 2002, 28)

6. Case conferencing = Teamwork = Resource pooling through: school based intervention psychological intervention and medical intervention = learning from each other

7. Mental disorders among youth people have correspondingly impacts on educational achievement, and increased levels of unemployment. (McGorry et al 2007) General Practitioners are primary care givers in the early intervention of mental health. General Practitioners are primary care givers in the early intervention of mental health. Emotional and behavioural problems among children and young people are widespread. Incidence rates of mental health problems and illness, including those likely to continue into adulthood, elevate in the 12-25 year age group (Commonwealth Department of Health & Aged Care, 2000a). Emotional and behavioural problems among children and young people are widespread. Incidence rates of mental health problems and illness, including those likely to continue into adulthood, elevate in the 12-25 year age group (Commonwealth Department of Health & Aged Care, 2000a). Sawyer et al. (2000) reported a 14% national prevalence rate of mental health problems for children and adolescents. Anxiety and depression are the most common mental health problems for people aged 12 - 17 years. Sawyer et al. (2000) reported a 14% national prevalence rate of mental health problems for children and adolescents. Anxiety and depression are the most common mental health problems for people aged 12 - 17 years. Mental disorders account for 55% of disease burden in those aged 15-24 years. Mental disorders account for 55% of disease burden in those aged 15-24 years.

8. Our vision and hopes To obtain funding for a long term study and follow up To obtain funding for a long term study and follow up To extend this pilot program to other schools, To extend this pilot program to other schools, To gain financial support as adolescent mental health is time intensive with an unreliable patient base, To gain financial support as adolescent mental health is time intensive with an unreliable patient base, To improve the knowledge base in adolescent mental health for GP’s with courses similar to the “headstart” program, To improve the knowledge base in adolescent mental health for GP’s with courses similar to the “headstart” program, To encourage incentives for allied health professionals to consult within schools, To encourage incentives for allied health professionals to consult within schools, To improve the depth of support e.g. through introductory/bridging courses for school counsellors and To improve the depth of support e.g. through introductory/bridging courses for school counsellors and To support rural areas by encouraging psychology and adolescent psychiatric services to consult in rural areas e.g. by providing travel allowances/incentives “rural 291” or teleconferencing. To support rural areas by encouraging psychology and adolescent psychiatric services to consult in rural areas e.g. by providing travel allowances/incentives “rural 291” or teleconferencing.

9. A 15 y.o. male student expressing his feelings Thank you for your support

10. Please consider giving young people a hand