Service Utilisation and Engagement in (removed for peer review): A National Analysis (2017–2022)

2025 · doi:10.22541/au.174548163.38479106/v1
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This preprint reports a national secondary analysis of routine clinical data from 23,227 young people aged 12–25 who accessed Jigsaw youth mental health services in Ireland between 2017 and 2022, using time-series analyses to examine trends in referrals, presenting issues, and wait times. It finds a steady increase in referrals over time, with anxiety consistently predicting greater session attendance in both age groups, while psychological distress predicted lower attendance in the older cohort; wait times showed a larger impact on the older group and seasonal patterns were observed across both groups. The paper notes that it is not peer reviewed and may be preliminary, which limits confidence in the findings. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Background: Early intervention and prevention in youth mental health are essential, with up to 75% of mental illnesses emerging before the age of 25. Over the past two decades, enhanced primary care models, such as Jigsaw in Ireland, have been developed to provide accessible, evidence-based mental health support for young people aged 12–25 years. Understanding trends in service utilisation and factors influencing engagement is critical for optimising service delivery and ensuring equitable access to care. Objectives: This study examines (1) trends in service utilisation within Jigsaw between 2017 and 2022 and (2) factors associated with session attendance, considering demographic, services related and contextual influences. Methods: A secondary analysis of routine clinical data was conducted, including 23,227 young people aged 12–25 who accessed Jigsaw services from 2017-2022. Time series analyses assessed trends in service demand, presenting issues, and wait times. Negative binomial regression models evaluated predictors of session attendance. Results: A steady increase in referrals was found over time. Anxiety was the most consistent predictor of increased attendance across both age groups (12-16 and 17-25), while psychological distress predicted lower attendance in the older cohort. Wait times had a greater impact on the older group, and seasonal patterns were evident across both groups. Gender and referral source effects decreased with age. Conclusions: Findings underscore increasing demand for Jigsaw’s primary care youth mental health services and highlight key factors influencing attendance. Service planners should consider gender-sensitive engagement strategies, the role of referral pathways, and seasonal variations in demand when allocating resources. Addressing long waiting times and enhancing support for highly distressed young people may improve engagement and retention.
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Abstract

Background: Early intervention and prevention in youth mental health are essential, with up to 75% of mental illnesses emerging before the age of 25. Over the past two decades, enhanced primary care models, such as Jigsaw in Ireland, have been developed to provide accessible, evidence-based mental health support for young people aged 12–25 years. Understanding trends in service utilisation and factors influencing engagement is critical for optimising service delivery and ensuring equitable access to care. Objectives: This study examines (1) trends in service utilisation within Jigsaw between 2017 and 2022 and (2) factors associated with session attendance, considering demographic, services related and contextual influences. Methods: A secondary analysis of routine clinical data was conducted, including 23,227 young people aged 12–25 who accessed Jigsaw services from 2017-2022. Time series analyses assessed trends in service demand, presenting issues, and wait times. Negative binomial regression models evaluated predictors of session attendance. Results: A steady increase in referrals was found over time. Anxiety was the most consistent predictor of increased attendance across both age groups (12-16 and 17-25), while psychological distress predicted lower attendance in the older cohort. Wait times had a greater impact on the older group, and seasonal patterns were evident across both groups. Gender and referral source effects decreased with age. Conclusions: Findings underscore increasing demand for Jigsaw’s primary care youth mental health services and highlight key factors influencing attendance. Service planners should consider gender-sensitive engagement strategies, the role of referral pathways, and seasonal variations in demand when allocating resources. Addressing long waiting times and enhancing support for highly distressed young people may improve engagement and retention. Supplementary Material File (service utilization and engagement in jigsaw, the national centre for youth mental health final (2025).docx) - Download - 231.71 KB Information & Authors Information Version history Copyright This work is licensed under a Non Exclusive No Reuse License. Collection

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Authors Metrics & Citations Metrics Article Usage 220views 176downloads Citations Download citation Jeff Moore, Neil Ryan, Siobhan O’Brien. Service Utilisation and Engagement in (removed for peer review): A National Analysis (2017–2022). Authorea. 24 April 2025. DOI: https://doi.org/10.22541/au.174548163.38479106/v1 DOI: https://doi.org/10.22541/au.174548163.38479106/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu.

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