Understanding mental health treatment effectiveness in young people
type: CreativeWork
description: Mental disorders are one of the leading causes of non-communicable disease burden worldwide, with distress emerging as a common factor among such disorders. Most lifetime mental disorders emerge during adolescence and young adulthood, yet no studies have robustly assessed changes in common distress over time during this broad developmental epoch. Common distress is particularly pertinent when assessing mental health treatment effectiveness, as comorbidity rates are higher amongst those who seek treatment. In this dissertation, I seek to redress the paucity of evidence regarding mental health treatment effectiveness in young people. Herein I longitudinally validate a common distress factor, enabling me to use specific and broad mental health outcomes to assess the effectiveness of treatment-as-usual mental health services in two separate samples. In chapter 2, I use a community sample of adolescents to test the relationship of age 14 service contact on depressive symptoms by age 17. I found that 14-year-old adolescents who had contact with mental health services in the past year had a greater decrease in depressive symptoms than those without contact. By age 17 years, the odds of reporting clinical depression were higher in individuals without contact than in service users who had been similarly depressed at baseline. In addition to propensity score weighting to adjust for participants’ initial likelihood to access services, I used a clinically relevant cutoff and adjusted for a wide range of time-varying confounding variables. These adjustments give greater confidence than previous studies to the notion that mental health service contact is related to meaningful improvements in subsequent mental health. Policy implications of these findings are addressed. In chapter 3, I develop a transdiagnostic measure of mental health to be used to assess treatment effectiveness with relevancy across multiple disorders. This transdiagnostic measure is the general factor (common d…
abstract: Mental disorders are one of the leading causes of non-communicable disease burden worldwide, with distress emerging as a common factor among such disorders. Most lifetime mental disorders emerge during adolescence and young adulthood, yet no studies have robustly assessed changes in common distress over time during this broad developmental epoch. Common distress is particularly pertinent when assessing mental health treatment effectiveness, as comorbidity rates are higher amongst those who seek treatment. In this dissertation, I seek to redress the paucity of evidence regarding mental health treatment effectiveness in young people. Herein I longitudinally validate a common distress factor, enabling me to use specific and broad mental health outcomes to assess the effectiveness of treatment-as-usual mental health services in two separate samples. In chapter 2, I use a community sample of adolescents to test the relationship of age 14 service contact on depressive symptoms by age 17. I found that 14-year-old adolescents who had contact with mental health services in the past year had a greater decrease in depressive symptoms than those without contact. By age 17 years, the odds of reporting clinical depression were higher in individuals without contact than in service users who had been similarly depressed at baseline. In addition to propensity score weighting to adjust for participants’ initial likelihood to access services, I used a clinically relevant cutoff and adjusted for a wide range of time-varying confounding variables. These adjustments give greater confidence than previous studies to the notion that mental health service contact is related to meaningful improvements in subsequent mental health. Policy implications of these findings are addressed. In chapter 3, I develop a transdiagnostic measure of mental health to be used to assess treatment effectiveness with relevancy across multiple disorders. This transdiagnostic measure is the general factor (common d…
author: Neufeld, Sharon
language: eng
keywords: mental health services, mental health treatment effectiveness, adolescent depression, transdiagnostic mental health, emerging adults, social support, propensity weighting, bifactor modelling, measurement invariance, mediation, accelerated growth modelling
license: https://apollo8-f-pro.lib.cam.ac.uk/bitstreams/f8271b71-db37-49f0-82d9-bb6314782af2/download
license: https://creativecommons.org/licenses/by-nc-nd/4.0/
date published: 2019-09-30
date modified: 2026-07-22T22:24:01Z
provider: Cambridge University
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: University of Cambridge

PropertyValue
property ID: DOI
value: 10.17863/CAM.51278