Youth care at the GP practice

Health professionals, community team members, policy officials, young people and parents are positive about this form of care. The ease of access to (more specialist) knowledge is considered to be particularly beneficial. They indicate that:

• The quality of care has improved, since young people receive help more quickly.
• The offer of short-term and/or low-intensity care for young people has improved.
• Triage has improved, since the Youth Practice Assistant has more time to make a better assessment of the problem.
• Help is offered sooner and more quickly, which can prevent deterioration and thus have a preventive effect.
• More psychoeducation, supportive interviews, parenting support, and mediation or guidance during referral is now being offered within GP practices.  

Those involved believe that referrals to specialist youth mental health services are better justified and more thoroughly considered. The research study shows that the majority of help requests to Youth Practice Assistants concern behavioural and emotional problems. Parents also attend with help requests related to parenting or problems with the family situation. Of the young people who see a Youth Practice Assistant, 41% are found to receive the help they need, without need for further referral. Whether this prevents unjustified referrals cannot be concluded on the basis of this study.

Effective help at an early stage can prevent problems escalating and can ensure individual and societal health benefits at an older age. The results of this research study suggest a number of leads that could enable further optimisation of the effectiveness of the Youth Practice Assistant role:

• We that access to (specialist) knowledge at an early stage of care is very beneficial. Time and money should therefore be made available to invest in acquiring and maintaining specialist knowledge.
• Up-to-date knowledge and understanding of the care network is essential for appropriate referrals. The Youth Practice Assistant should therefore always be given time to invest in developing and maintaining that network. This must be an explicit task for Youth Practice Assistants.
• A low threshold for access is an important success factor. Positioning within the GP practice is beneficial because Youth Practice Assistants are associated with faith in medical confidentiality and the GP’s expertise.
• Since Youth Practice Assistants work across several GP practices, each with their own environment and ways of working, it is essential for them to have adequate time to consult, fine-tune and invest in relationships. 

Rising youth care costs, complex case histories, excessive bureaucracy involved in organising appropriate care... These themes have been comprehensively reviewed in the past year. One of the key ways we think we can tackle such issues is by making specialist knowledge available within care trajectories in an accessible and timely manner. Thus enabling problems to be signalled sooner than is often the case now and the right help to be made available as quickly as possible.

Offering specialist youth care in GP practices is a good example of this. This is done by the so-called Youth Practice Assistants. They have specialist knowledge of predominantly mental health issues in children and young people. Knowledge that a GP could not offer to the same degree.

In the past two years, Accare, Molendrift, Karakter and the Child and Adolescent Psychiatry Knowledge Centre have collected large-scale data on the deployment of this form of youth care in GP practices. How does this type of care work in practice? What results are achieved and what are the experiences of the professionals and clients involved? Over 250 GP practices and around 2,500 clients were involved in the research study.  

We conducted this study in collaboration with Molendrift and Karakter.