Early intervention and integration in youth mental health: Evaluating six years of the Comprehensive Assessment Service for Psychosis and At Risk (CASPAR)

Objective: Timely intervention for emerging mental health disorders in young people remains challenging despite high prevalence rates. This study evaluates the Comprehensive Assessment Service for Psychosis and At Risk (CASPAR) over a 6-year period, identifying predictors of service access, treatment engagement, and clinical outcomes. Methods: We analyzed service utilization, demographic and clinical data for all clients accessing CASPAR between 2017-2023, including social and occupational functioning (SOFAS), and psychosis transition rates. Results: From 1062 referrals, 799 young people completed assessment and 592 were registered for ongoing care. Of these, 496 (83.8%) engaged with treatment while 96 disengaged (16.2 %) early. Among those accepted, 7.1% transitioned to first-episode psychosis, with predictors including male gender, lower baseline functioning, and ultra-high risk status. Of those completing care, 75.2% functioned without significant impairment at discharge, with 45.7% showing reliable SOFAS improvement. Ultra-high risk status predicted treatment engagement, while emotional dysregulation and personality disorder diagnoses predicted poorer social and functional outcomes. Conclusions: CASPAR effectively bridges the gap between primary and tertiary mental health services for young people. High engagement rates demonstrate the success of this integrated care model, particularly for priority populations. Findings regarding predictors of treatment engagement, transition to psychosis, and functional improvement can inform future service development to better support vulnerable youth with emerging mental health issues.