High Distress Across Patient Groups: Equity Analysis of ancora, a Youth Mental Health Service

Background

Approximately 75% of mental health disorders emerge before the age of 25. They significantly contribute to premature mortality, either through physical comorbidities or suicide, if untreated. ancora was established as a low-threshold Integrated Youth Mental Health Service (IYMHS) for people aged 15–29, aiming to improve the trajectory of emerging mental disorders and to reach risk groups equitably.

Methods

We analysed routine clinical data collected between October 2025 and April 2026. Psychological distress was measured via CORE-10 (mean item score 0-4). The sample comprised adults (≥18 yrs) and adolescents (13-17 yrs). To test homogeneity, we used Two One-Sided Tests (TOST) of equivalence with an a priori equivalence margin of ± 0.3 CORE-10 points (clinically irrelevant difference). Comparisons were made across gender, migration background, childhood residential area and employment status.

Results

Among 197 patients (171 adults, 26 adolescents), 96% showed clinically relevant distress (CORE-10 ≥1.0). Mean scores were 2.18 (SD = 0.61, range 0.3-3.6) in adults and 1.97 (SD = 0.60, range 0.6-3.1) in adolescents, with no significant difference in severity distribution between age groups (χ² = 3.51, p = 0.62). Distress levels were statistically equivalent between females and males, patients with and without parental migration background, and those from rural and urban childhood settings. In contrast, unemployed patients reported higher distress than employed patients (mean difference 0.32; Cohen’s d = −0.52).

Conclusions

Patients presented with similarly high distress across diverse sociodemographic groups, suggesting equitable reach of the service. The exception of elevated distress among unemployed patients highlights a key target group for proactive outreach.

Key messages

• Ancora reached diverse youth equitably, with similarly high distress across groups, showing broad accessibility of integrated mental health care.

• Unemployed young people reported higher distress, identifying a need for targeted outreach and support.