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Controlled Clinical Trial
. 2016 Dec 7;16(1):436.
doi: 10.1186/s12888-016-1145-6.

A controlled trial of implementing a complex mental health intervention for carers of vulnerable young people living in out-of-home care: the ripple project

Helen Herrman  1   2 , Cathy Humphreys  3 , Stephen Halperin  4 , Katherine Monson  4 , Carol Harvey  5   6 , Cathrine Mihalopoulos  7 , Susan Cotton  1   2 , Penelope Mitchell  8 , Tony Glynn  9 , Anne Magnus  7 , Lenice Murray  4 , Josef Szwarc  10 , Elise Davis  11 , Sophie Havighurst  12 , Patrick McGorry  1   2 , Sam Tyano  13 , Ida Kaplan  10 , Simon Rice  1   2 , Kristen Moeller-Saxone  14   15
Affiliations
Controlled Clinical Trial

A controlled trial of implementing a complex mental health intervention for carers of vulnerable young people living in out-of-home care: the ripple project

Helen Herrman et al. BMC Psychiatry. .

Abstract

Background: Out-of-home care (OoHC) refers to young people removed from their families by the state because of abuse, neglect or other adversities. Many of the young people experience poor mental health and social function before, during and after leaving care. Rigorously evaluated interventions are urgently required. This publication describes the protocol for the Ripple project and notes early findings from a controlled trial demonstrating the feasibility of the work. The Ripple project is implementing and evaluating a complex mental health intervention that aims to strengthen the therapeutic capacities of carers and case managers of young people (12-17 years) in OoHC.

Methods: The study is conducted in partnership with mental health, substance abuse and social services in Melbourne, with young people as participants. It has three parts: 1. Needs assessment and implementation of a complex mental health intervention; 2. A 3-year controlled trial of the mental health, social and economic outcomes; and 3. Nested process evaluation of the intervention.

Results: Early findings characterising the young people, their carers and case managers and implementing the intervention are available. The trial Wave 1 includes interviews with 176 young people, 52% of those eligible in the study population, 104 carers and 79 case managers.

Conclusions: Implementing and researching an affordable service system intervention appears feasible and likely to be applicable in other places and countries. Success of the intervention will potentially contribute to reducing mental ill-health among these young people, including suicide attempts, self-harm and substance abuse, as well as reducing homelessness, social isolation and contact with the criminal justice system.

Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12615000501549 . Retrospectively registered 19 May 2015.

Keywords: Complex intervention; Implementation; Looked after children; Out-of-home care; Prevention; Youth mental health.

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Figures

Fig. 1
Fig. 1
Health and Community Service System for youth in OoHC in Victoria1. Legend - OYH: Orygen Youth Health Clinical Program; RCH IMYOS: Royal Children’s Hospital Intensive Mental Health Youth Outreach Service; YSAS: Youth Support and Advocacy Service; CMY: Centre for Multicultural Youth; CY & FS: Child, Youth and Family Services; CSOs: Community Support Organisations; VACCA: Victorian Aboriginal Child Care Agency. 1Specialist mental health services for young people aged 12-17 years in Victoria are provided by community-based state-funded mental health services [18]. Their contact with young people in OoHC and with the CSOs is typically ad hoc rather than organised systematically. Foundation House (the Victorian Foundation for Survivors of Torture and Trauma), the Centre for Multicultural Youth (CMY) and Take Two (state-provided psychological services for children and young people in OoHC) provide services relevant to some or all of these young people. They are consulting study partners. These organisations all interact with primary health care, hospital emergency and inpatient services, police, justice, education and vocational services. The Ripple intervention region is Melbourne’s North and West Metropolitan Health Region (NWMR). NMWR has a culturally diverse population of 1.7 million people, including 24% of Victoria’s Aboriginal people (0.58% of the region’s population). It comprises Melbourne’s central business district and inner, middle and outer urban areas. OYH, RCH IMYOS, and YSAS provide specialist mental health services for young people in this region. Four major CSOs in this region are study partners: Anglicare, MacKillop Family Services, Westcare and VACCA
Fig. 2
Fig. 2
Design of the Ripple controlled trial of implementing a complex mental health intervention in out-of-home care (OoHC) settings in Melbourne
Fig. 3
Fig. 3
Ripple Project Interviews – Young People; Wave 1. *Note: Young people who were counted in the census but turned 18 during the interview period were deemed ineligible as they were out of age range and had left care. This had the additional effect of preventing follow up as agencies lose contact with young people at this age
See this image and copyright information in PMC

References

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