A key goal in psychiatry is to build new diagnostic, therapeutic and translational tools and capacity to reduce the impact of emerging mental disorders in young people on survival, distress, quality of life and productivity. Young people bear the major burden of onset for mental disorders with 75% of such illnesses appearing before age 25 years. This can only be done within a novel non-stigmatising interface between young people and clinical care in mental health such as that recently created by headspace in Australia and increasingly in some other developed nations. We must also develop new terminology enabling early clinical phenotypes of mental disorders to be defined in a normalizing and health-promoting way that will promote trust and confidence. A transdiagnostic strategy is critical, transcending existing subthreshold risk syndromes, with new “pluripotential” criteria capturing clinical high risk for multiple syndromes. This strategy seeks to solve problems with specificity, power and reduce false positives. Secondly, we must focus on novel therapeutics. This starts with the development and evaluation of novel forms of psychosocial intervention for early stage illness. A complementary strategy needs to focus upon candidate biomarkers as therapeutic probes within a reverse translation strategy moving towards biosignatures or profiles of emerging disorder. Relationships between response and baseline levels of and changes in biomarkers may create a pathway to personalised/stratified medicine. Finally translation of existing expertise and systematic reform of clinical practice and cultures of care is something that is achievable with the present state of knowledge yet is poorly implemented.
Research And Development
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