ArticleInternational journal of mental health systems2023
Bi-stability and critical transitions in mental health care systems: a model-based analysis.
Article in International journal of mental health systems, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 7 citations in OpenAlex.
- Validating an adaptive digital assessment of youth mental health needs: a cross-sectional study.NPJ digital medicine · 2026Article
- Changes in depression, anxiety, and post-traumatic stress symptoms among children and adolescents exposed to adverse childhood experiences following participation in the PROACT intervention in Nairobi, Kenya.Frontiers in psychiatry · 2026Article
- Examining the Impact of Youth Mental Health Services Capacity Growth Trajectories and Digital Interventions on Youth Mental Health Outcomes: System Dynamics Modeling Analysis.Journal of medical Internet research · 2025Article
- Novel youth mental health services in Australia: What differences are being reported about the clinical needs of those who attend and the outcomes achieved?The Australian and New Zealand journal of psychiatry · 2025Article
- Reshaping youth mental health care for optimal system-level outcomes: A dynamic modelling analysis.PLOS mental health · 2025Article
- "It has to be better, otherwise we will get stuck." A Review of Novel Directions for Mental Health Reform and Introducing Pilot Work in the Netherlands.Clinical practice and epidemiology in mental health : CP & EMH · 2023Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelayed initiation and early discontinuation of treatment due to limited availability and accessibility of services may often result in people with mild or moderate mental disorders developing more severe disorders, leading to an increase in demand for specialised care that would be expected to further restrict service availability and accessibility (due to increased waiting times, higher out-of-pocket costs, etc.).
methodsWe developed a simple system dynamics model of the interaction of specialised services capacity and disease progression to examine the impact of service availability and accessibility on the effectiveness and efficiency of mental health care systems.
resultsModel analysis indicates that, under certain conditions, increasing services capacity can precipitate an abrupt, step-like transition from a state of persistently high unmet need for specialised services to an alternative, stable state in which people presenting for care receive immediate and effective treatment. This qualitative shift in services system functioning results from a 'virtuous cycle' in which increasing treatment-dependent recovery among patients with mild to moderate disorders reduces the number of severely ill patients requiring intensive and/or prolonged treatment, effectively 'releasing' services capacity that can be used to further reduce the disease progression rate. We present an empirical case study of tertiary-level child and adolescent mental health services in the Australian state of South Australia demonstrating that the conditions under which such critical transitions can occur apply in real-world services systems.
conclusionsPolicy and planning decisions aimed at increasing specialised services capacity have the potential to dramatically increase the effectiveness and efficiency of mental health care systems, promoting long-term sustainability and resilience in the face of future threats to population mental health (e.g., economic crises, natural disasters, global pandemics).
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