The missing middle service gap: Obtaining a consensus definition of the ‘Missing Middle’ in youth mental health

Abstract

Objective: As highlighted in Australia’s Productivity Commission Inquiry into mental health, subgroups of individuals are failing to have their needs met, or are ‘falling through the cracks’ in the current system – a phenomenon increasingly referred to as the ‘missing middle’. A barrier to devising solutions is that the term ‘missing middle’ is not clearly defined. Using the Delphi method, we aimed to define the term and explore acceptability. Method: Three expert groups were recruited: carers and young people with a lived experience of mental ill-health; clinicians and service providers; researchers, policymakers and commissioners of mental health services. Using a three-stage Delphi proces..