Effectiveness and public health impact of walk-in Youth mEntal heAltH support centres: a hybrid (cost-)effectiveness-implementation study in seven European countries and Australia
Prevention and early intervention of mental disorders in youth with psychological distress
The YEAH study is a hybrid effectiveness-implementation design conducted as a prospective, multi-country, quasi-experimental cohort study with non-equivalent groups. Study participants will be recruited either for the experimental condition receiving YEAH plus Care as Usual (YEAH+CAU) or a control condition solely receiving Care as Usual (CAU) (n=610 YEAH+CAU vs. n=610 CAU). Due to ethical considerations, randomization is not employed; Controls will be recruited from corresponding catchment areas and statistically matched. Outcome data will be collected at four time points: baseline (t0), 3-months (t1), 6-months (t2), and 12-months (t3) follow-up. The primary and most secondary outcomes rely on self-reported measures. The implementation at a new site will follow a participatory approach by including stakeholder groups as well as ethical and regulatory requirements. The process evaluation exploring contextual and mechanistic factors influencing implementation as well as the ethical research employs qualitative methods (interviews, workshops, observations) guided by i.e., Theory of Change and Realist Evaluation. Control condition (CAU): Participants in the control condition will be provided with CAU (i.e., continue to receive and have access to all public mental health services they received prior to the start of the study). CAU will include all public mental health care delivered according to local and national service guidelines and protocols by general practitioners (primary care doctors), psychiatrists, clinical psychologists, school psychologists, social workers, psychological counsellors, and other public mental health practitioners available in the catchment areas of YEAH. The comparator for the current trial is purposefully selected to reflect CAU, broadly defined, to mirror the naturalistic service landscape and practice to which beneficial effects ought to generalise. Experimental condition (YEAH + CAU): The YEAH are easy-access (i.e., soft-entry, stig
1. Age 12-25 years 2. Experimental condition only: First presentation to YEAH (earlier or consecutive counselling or mental health service use is allowed) 3. Presence of clinically meaningful psychological distress operationalized as a score of >10 on the CORE-10 4. Willingness to participate, 5. Ability to give informed consent 6. Parental consent for minors, if applicable
1. Insufficient command of the local study language(s) to provide valid answers to self-report questionnaires (Estonian, German, Italian, English, Spanish, or Dutch) 2. Acute suicidality or acute threat to others