A 15-year outcome study of children and young people in care attending a tertiary level specialist mental health service

Abstract

Background: Children and young people (C/YP) exposed to abuse and neglect can experience complex mental health problems. Examining interventions and outcomes for C/YP in care receiving mental health treatment could help optimise service delivery to this population.

Objective: The aim of the study was to investigate functioning and mental health outcomes of C/YP in care attending a tertiary level specialist mental health service in Queensland, Australia. In addition, outcomes were explored with Aboriginal and/or Torres Strait Islander status, length of stay (LOS) and age as potential contributing factors.

Participants and setting: This 15-year retrospective cohort study consisted of a sample of 1561C/YP with pre- and post-treatment data attending the mental health service.

Methods: The Children's Global Assessment Scale (CGAS) and the Health of the Nations Outcome Scale for Children and Adolescents (HoNOSCA) were used to examine C/YP's functioning and mental health outcomes. Generalised linear mixed model, linear mixed model and McNemar's test were conducted.

Results: Overall, C/YP improved in mental health concerns and functioning on all domains post-intervention (p < 0.001). Non-Aboriginal and/or Torres Strait Islander C/YP had a greater improvement post-intervention in disruptive/aggressive behaviour, scholastic/language skills, and poor school attendance compared to Aboriginal and/or Torres Strait Islander C/YP (p < 0.05). A reduced length of stay resulted in a greater improvement post-intervention in overall functioning, overactivity/attentional difficulties, peer relationships and poor school attendance (p < 0.05). Younger children had a greater improvement post-intervention in overall functioning, scholastic/language skills, emotional symptoms, peer relationships, self-care/independence and poor school attendance compared to older children (p < 0.05).

Conclusions: Findings from this study demonstrate that the tertiary level specialist mental health service is an effective treatment program for C/YP in care who have experienced severe and complex trauma. There were some differences in outcomes based on Aboriginal and/or Torres Strait Islander status, LOS and age that need to be considered to enhance service delivery for all C/YP. Implications and further research were explored.

Keywords: Child abuse and neglect; Children/young people; Intervention; Mental health; Out of home care; Outcomes.