Constructing a research based pre-care model to improve mental health interventions for young people

ObjectiveThis study had two aims. Firstly, to explore how young people experienced the onset of mental health problems and to investigate their initial interactions with the health system; and secondly, to use thesefindings to construct a pre-care model that can be used by nurses and other health care professionals todesign appropriate interventions.DesignGrounded theory method was used to develop a theory of young peoples experience of the pathway to mental health care. Data were obtained through in-depth semi-structured interviews.SettingParticipants were recruited through two community health centres in a Sydney metropolitan area healthservice.SubjectsThe purposive sample consisted of eight males and twelve females between the ages of eighteen andtwenty five (mean age was 21).Main outcome measures - FindingsThe categories identified from analysis of the interviews were (a) first sign - often involved denialor fear in the early stages and self medication with alcohol or other drugs; (b) recognition - ofthe symptoms as a sign of mental illness; (c) understanding - discovering information about theillness; and (d) resolution - when care is successfully accessed. Barriers and facilitating factors either delay or assist movement from one stage to the next. The maze to care model is suggested as a guide to action for health professionals. It can direct attention to broader social and systems interventions or, at the individual level, assist assessment.ConclusionsThe study offers insights into the experiences of a small group of individuals and hence has limitationshowever the development of a model which can be tested in practice demonstrates that grounded theorycan be a useful research approach when used to develop frameworks for action in nursing and mentalhealth care.