headspace - Australia's innovation in youth mental health: who are the clients and why are they presenting?

To the Editor: We commend Rickwood and colleagues1 for presenting aggregated data from headspace centres. However, to judge whether headspace is meeting its key policy objectives, more detailed information is required. No performance benchmarks were proposed for the national program or for the constituent centres. Specifically, the variance in key characteristics (age, sex, Aboriginal and Torres Strait Islander populations, rurality, socioeconomic status and current disability) of young people attending the individual centres was not described. As headspace centres were initially placed in areas of need (ie, non-urban, low socioeconomic status, fewer private medical or psychological services, or high Aboriginal and Torres Strait Islander populations), one might expect to see evidence of enhanced access for those with disability or financial hardship. For example, at the University of Sydney-managed headspace sites, 25% of young people were receiving financial assistance and “the same fraction (were) completely disconnected from employment or education” (emphasis added).2 Internationally, youth-targeted mental health services are being encouraged to focus on such disadvantaged individuals.3 In Australia, 12% of youth are in this category, and the proportion varies significantly by geographical region (7%–35%).4 These proportions are not the same as those reported by Rickwood et al1 (29% in the headspace cohort and 27% in the Australian population), where the measure used appears to be that of not participating fully in employment or education. Given that the economic and social justifications for early intervention are focused on enhancing such participation rates,5 clarification of the metrics being reported by headspace is essential.