title: Youth mental health in deprived urban areas: a Delphi study on the role of the GP in early intervention.
abstract: BACKGROUND
  GPs, as healthcare professionals with whom young people commonly interact, have a central role in early intervention for mental health problems. However, successfully fulfilling this role is a challenge, and this is especially in deprived urban areas.
  
  
  OBJECTIVE
  To inform a complex intervention to support GPs in this important role, we aim to identify the key areas in which general practice can help address youth mental health and strategies to enhance implementation.
  
  
  METHODS
  We conducted a modified Delphi study which involved establishing an expert panel involving key stakeholders/service providers at two deprived urban areas. The group reviewed emerging literature on the topic at a series of meetings and consensus was facilitated by iterative surveys.
  
  
  RESULTS
  We identified 20 individual roles in which GPs could help address youth mental health, across five domains: (1) prevention, health promotion and access, (2) assessment and identification, (3) treatment strategies, (4) interaction with other agencies/referral, and (5) ongoing support. With regard to strategies to enhance implementation, we identified a further 19 interventions, across five domains: (1) training, (2) consultation improvements, (3) service-level changes, (4) collaboration, and (5) healthcare-system changes.
  
  
  CONCLUSIONS
  GPs have a key role in addressing youth mental health and this study highlights the key domains of this role and the key components of a complex intervention to support this role.
authors.affiliation: Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
authors.forename: E
authors.initials: E
authors.lastname: Schaffalitzky
authors.affiliation: Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
authors.forename: D
authors.initials: D
authors.lastname: Leahy
authors.affiliation: Graduate Entry Medical School, University of Limerick, Limerick, Ireland. walter.cullen@ul.ie.|UCD School of Medicine, Dublin, Ireland. walter.cullen@ul.ie.
authors.forename: W
authors.initials: W
authors.lastname: Cullen
authors.affiliation: Department of Child & Adolescent Psychiatry, Lucena Clinic, Rathgar, Dublin 6, Ireland.
authors.forename: B
authors.initials: B
authors.lastname: Gavin
authors.affiliation: Thomas Court Primary Care Centre, Dublin 8, Ireland.
authors.forename: L
authors.initials: L
authors.lastname: Latham
authors.affiliation: Graduate Entry Medical School, University of Limerick, Limerick, Ireland.|HSE Midwest Specialist GP Training Programme, Limerick, Ireland.
authors.forename: R
authors.initials: R
authors.lastname: O'Connor
authors.affiliation: Youth Drug and Alcohol project (YoDA) Service, Health Services Executive, Dublin, Ireland.
authors.forename: B P
authors.initials: BP
authors.lastname: Smyth
authors.affiliation: HSE Dublin Mid-Leinster, Dublin, Ireland.
authors.forename: E
authors.initials: E
authors.lastname: O'Dea
authors.affiliation: HSE Midwest Addiction Services, Dublin, Ireland.
authors.forename: S
authors.initials: S
authors.lastname: Ryan
mesh_terms: D000293:Adolescent; D032921:Consensus; D003697:Delphi Technique; D058006:General Practice / Q000458:organization & administration*; D006801:Humans; D008603:Mental Health; D008605:Mental Health Services / Q000458:organization & administration*; D012017:Referral and Consultation; D011795:Surveys and Questionnaires
keywords: Delphi study; Early; General practice; Intervention; Primary care; Substance addiction; Youth mental health