Early intervention and prevention are vital given that 3 in 5 mental disorders develop before age 25 and death by suicide is a major cause of mortality among youth. As a response to the many barriers in accessing services, the @ease walk-in centres were established in The Netherlands in 2017 for youth aged 12-25. @ease has no waitlist or financial costs, is anonymous, and was designed by and for young people. Peers, often with lived experience, are the support providers at @ease. These peer counsellors have been trained in active listening, solution-focused strategies, motivational interviewing and suicide prevention. They recognize, ask about, and act in case of suicide ideations and plans, with a consultable professional on-site and psychiatrist on-call.
Studies at @ease have been conducted as planned in a recently published protocol. To conduct an outcome evaluation (N=754), self- and peer-reported data was analysed using t-tests, x2-tests, mixed model analyses (visit 1-3) and change indicators. Measures included psychological distress (CORE-10), social and occupational functioning (SOFAS), suicidal ideations and plans, and recent support use.
Of the returned visitors, 50.5% was female, 79.4% followed tertiary education and 36.9% was not born in The Netherlands (e.g. international students). Moreover, 30% of all visitors presented with suicidal ideations and within this group, 30% had specific suicide plans. Overall, 97.1% had clinical psychological distress levels (11?), which decreased significantly over three @ease visits (? = 3.79, CI 95% [-5.41; -2.18], p < .001). Likewise, peer-rated functioning improved significantly (? = 3.93, CI 95% [.51; 7.36], p = .025). Among @ease visitors with suicidal ideations, the majority had not received any form of support in the last three months (65.5% of one-time visitors and 57.1% of returned visitors), but support use increased overall (? = 2.74, S.E. = .88, t = 3.13, CI 95% [1.02; 4.47] p = .002). Lastly, counselling satisfaction was rated 4.5 out of 5.
Whilst mental health problems were substantial at presenting, improvements were found over time in the outcome measures and counselling satisfaction was high among @ease visitors. Support by peers (with lived experience) is promising in early intervention and studies on it are fully original in the context of walk-in centres. Upcoming cost-effectiveness research will further inform policy and practice.