{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:25:32Z","timestamp":1790630732223,"version":"4.1.0"},"reference-count":50,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T00:00:00Z","timestamp":1726617600000},"content-version":"unspecified","delay-in-days":261,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2045796024000386_sec1a\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>The specific and multifaceted service needs of young people have driven the development of youth-specific integrated primary mental healthcare models, such as the internationally pioneering <jats:italic>headspace<\/jats:italic> services in Australia. Although these services were designed for early intervention, they often need to cater for young people with severe conditions and complex needs, creating challenges in service planning and resource allocation. There is, however, a lack of understanding and consensus on the definition of complexity in such clinical settings.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796024000386_sec2b\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>This retrospective study involved analysis of <jats:italic>headspace<\/jats:italic>\u2019s clinical minimum data set from young people accessing services in Australia between 1 July 2018 and 30 June 2019. Based on consultations with experts, complexity factors were mapped from a range of demographic information, symptom severity, diagnoses, illness stage, primary presenting issues and service engagement patterns. Consensus clustering was used to identify complexity subgroups based on identified factors. Multinomial logistic regression was then used to evaluate whether these complexity subgroups were associated with other risk factors.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796024000386_sec3c\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>A total of 81,622 episodes of care from 76,021 young people across 113 services were analysed. Around 20% of young people clustered into a \u2018high complexity\u2019 group, presenting with a variety of complexity factors, including severe disorders, a trauma history and psychosocial impairments. Two moderate complexity groups were identified representing \u2018distress complexity\u2019 and \u2018psychosocial complexity\u2019 (about 20% each). Compared with the \u2018distress complexity\u2019 group, young people in the \u2018psychosocial complexity\u2019 group presented with a higher proportion of education, employment and housing issues in addition to psychological distress, and had lower levels of service engagement. The distribution of complexity profiles also varied across different <jats:italic>headspace<\/jats:italic> services.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2045796024000386_sec4d\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>The proposed data-driven complexity model offers valuable insights for clinical planning and resource allocation. The identified groups highlight the importance of adopting a holistic and multidisciplinary approach to address the diverse factors contributing to clinical complexity. The large number of young people presenting with moderate-to-high complexity to <jats:italic>headspace<\/jats:italic> early intervention services emphasises the need for systemic change in youth mental healthcare to ensure the availability of appropriate and timely support for all young people.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s2045796024000386","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T09:42:02Z","timestamp":1726652522000},"source":"Crossref","is-referenced-by-count":11,"title":["Capturing the clinical complexity in young people presenting to primary mental health services: a data-driven approach"],"prefix":"10.1017","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0987-2759","authenticated-orcid":false,"given":"Caroline X.","family":"Gao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nic","family":"Telford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6581-5890","authenticated-orcid":false,"given":"Kate M.","family":"Filia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana M.","family":"Menssink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabina","family":"Albrecht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick D.","family":"McGorry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7407-9194","authenticated-orcid":false,"given":"Matthew","family":"Hamilton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengmeng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Gan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Dwyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Prober","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Zbukvic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myriam","family":"Ziou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9386-8348","authenticated-orcid":false,"given":"Sue M.","family":"Cotton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra J.","family":"Rickwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"S2045796024000386_ref30","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1002\/wps.20938","article-title":"Designing and scaling up integrated youth mental health care","volume":"21","author":"McGorry","year":"2022","journal-title":"World Psychiatry: Official Journal of the World Psychiatric Association (WPA)"},{"key":"S2045796024000386_ref48","unstructured":"State of Victoria (2021) Royal Commission into Victoria\u2019s Mental Health System, final report: A new approach to mental health and wellbeing in Victoria, vol. 1. 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