Is headspace making a difference to young people’s lives?

4. Outcomes of headspace Clients
change. A reliable change (RC) in K10 scores is one that represents a statistically significant
improvement over the course of the headspace intervention. Significance is measured at the 5%
level. A clinically significant improvement occurs when the change in K10 score is both reliably
significant and also moves the headspace client below the threshold K10 score that represents the
functional benchmark for the general population.
Results of these methods of analyses (DID and CSC) are reported in this chapter. These methods
are complementary and provide similar results, revealing a pattern of small program effect.
4.1 How do young people’s outcomes change after using headspace services?
Overall results for young people attending headspace
The mean baseline K10 score for the 26,058 young people recorded in the hCSA who attended
headspace in the 2013/14 financial year and had more than one recorded K10 score was 28.8.
The mean last K10 score 24 for the sample was 26.5 indicating an average decrease of 2.3 points.
However, as shown in Table 4.1 below, there were significant differences within the sample. Overall,
almost half (47%, n=12,233) of young people’s K10 scores decreased: 13.3% experienced a clinically
significant improvement, 9.4% a reliable improvement and 24.3% an insignificant improvement. Table
4.1 below shows the mean reduction or increase between the first and last recorded K10 scores
for those in each categorization. The mean reduction for those who showed a clinically significant
improvement was 14.6 points. Almost 29% of young people experienced no change in their K10
score. As shown in further analysis presented below (suicidal ideation and self-harm), it is possible
for headspace to make an impact on clients’ wellbeing even if their psychological distress does
not improve. For example, a few parents interviewed for the evaluation commented that while their
young person had not improved noticeably in terms of their mental health functioning, they had not
deteriorated and this for them represented a successful intervention. As one parent commented, ‘if it
wasn’t for headspace my son would be dead or in gaol’.
Almost one in four young people (24.3%) experienced an increase in their K10 score (that is a
deterioration in their psychological distress). Of the latter group, 4.5% experienced a clinically
significant decline, 4.9% a reliable decline and 14.9% an insignificant decline. Overall, the level of
psychological distress reduced significantly (clinically or reliably) for more than double the number of
headspace clients whose psychological distress increased (5,908 compared with 2,457; Table 4.1).
Table 4.1 K10 changes for all young people and by first and last K10 recorded
Characteristics
CS
improve
RS
improve
Insig
improve
no
change
Insig
decline
RS
decline
CS
decline
N=3,455 N=2,453 N=6,325 N=7,477 N=3,891 N=1,274 N=1,183 N=26,058
% % % % % % % %
All young people 13.3 9.4 24.3 28.7 14.9 4.9 4.5 100
K10 Score Mean First 32 36.6 29.6 27 26.6 28.3 18.1 28.8
Mean Last 17.4 25.8 24.8 27 31.3 39.2 32.2 26.5
Change 14.6 10.8 4.8 0 -4.7 -10.9 -14.1 2.3
Notes: Calculations are based on the change in the Kessler K10 measure of psychological distress of headspace clients
between the first and last recorded visit to registered headspace centres. A reliably significant improvement (RS improve)
or decline (RS decline) represents a statistically significant change at a size of 5%. A clinically significant improvement
(CS improve) occurs when the change in K10 is both reliably significant and moves the headspace client below the
threshold (age and gender specific) for the general population. Thresholds for clinical significance are calculated using the
combined (c-threshold) method of Jacobson and Truax (1991). Figures are based on those young people who received
a headspace service within the 2013/14 financial year.
Source: Authors calculations from hCSA data.
Young people who first attended headspace with very high or high levels of psychological distress
(49.1%) were most likely to experience clinically or reliably significant improvements in their levels
of distress. Almost two in three young people (64.9%) who experienced clinically significant
improvements had very high levels of distress when they first attended headspace. The remaining
Total
24
Young people are asked to complete the K10 at each occasion of service. The last recorded K10 score is not always
an exit score and will include young people who are still receiving treatment.
Social Policy Research Centre 2015
headspace Evaluation Final Report
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