How Do Mental Health Services Help Troubled Youth With Complex Needs?

What you need to know

• Young people with complex mental health and behavioral needs often require specialized support beyond standard services
• The consultation-liaison model helped maintain youth in their communities while addressing serious behavioral issues
• High rates of trauma and adverse childhood experiences highlight the need for trauma-informed care approaches

The Challenge of Supporting Troubled Youth

When a young person starts showing serious behavioral problems and mental health challenges, it can be overwhelming for families and care providers. They may be acting aggressively, harming themselves, or engaging in concerning sexual behaviors - all while dealing with conditions like ADHD or autism. These youth often bounce between different services - mental health, social services, youth justice - without getting the coordinated help they need.

A Unique Approach to Complex Cases

The study examined a specialized service in Wales called FACTS that takes a different approach. Rather than directly treating youth, FACTS consultants work alongside other professionals to coordinate care and provide expert guidance. They supported 80 young people over 5 years, mostly teenage boys with multiple serious issues.

Complex Problems Requiring Coordinated Solutions

The challenges these youth faced were substantial:

• All had threatened or actually harmed others
• Half were engaging in sexually harmful behaviors
• Half were self-harming
• Most had experienced multiple childhood traumas
• Many had diagnosed conditions like ADHD and autism

Despite these difficulties, the consultation model helped maintain most youth in community settings rather than institutions. The service provided assessments, coordinated between agencies, and supported local teams in managing complex cases.

Understanding Trauma’s Impact

A striking finding was that 91% of the youth had experienced at least one serious adverse childhood experience like abuse, neglect, or family dysfunction. Over half had four or more such experiences. This highlights the critical need for trauma-informed approaches in youth services.

What This Means for You

If you’re working with or caring for a young person with complex needs:

• Don’t hesitate to seek specialized consultation even if the youth is already receiving services
• Consider how past trauma may be influencing current behaviors
• Focus on maintaining youth in the community when safe, rather than defaulting to institutional care
• Ensure coordination between different services involved in the youth’s care
• Remember that maintaining stability can be a positive outcome with such complex cases

Conclusions

• Youth with serious behavioral and mental health challenges need coordinated care across multiple services
• A consultation model can help maintain troubled youth in their communities while managing risk
• High rates of trauma exposure mean services must be trauma-informed
• Success may mean preventing further deterioration rather than dramatic improvements