Does assertive mental health care make a difference to children in out-of-home care? A pilot study

Abstract

Background: Children in out-of-home care (OOHC) experience poor mental health. With the number of Australian children in OOHC rising, accessible and effective interventions are needed to address this escalating predicament. South Western Sydney Child & Adolescent Mental Health Service (CAMHS) collaborated with the local statutory child protection agency, developing a specialized assertive mental health team supporting children in OOHC (OOHC MHT). This study outlines the characteristics of the first cohort of children referred to the OOHC MHT and the impact of intervention in improving outcomes, warranting ongoing provision of this service. Methodology: A two-part study was used to compare the psychosocial and emotional wellbeing of children referred to the OOHC MHT (OOHC group) against CAMHS-referred children who had not experienced OOHC (Control group). Evaluation of the OOHC MHT’s intervention was conducted by measuring Health of the Nation Outcome Scale-Child and Adolescent (HoNOSCA) and Child Global Assessment Scale (CGAS) scores over the first year of treatment. Results: The OOHC group demonstrated significantly higher levels of emotional, behavioural and social problems compared to the control group through their HoNOSCA score on admission (OOHC Group: M = 24.9; SD = 5.3, Control Group: M = 16.7; SD = 5.7; p = .001) and CGAS (OOHC Group: M = 40.5; SD = 7.9, Control Group: M = 50.3; SD = 7.9; p = .001). Significant improvements in the OOHC group’s HoNOSCA (T1 = 24.9, T3 = 17.0) and CGAS (T1 = 40.5, T3 = 52.8) measures were observed over the first year of treatment. Conclusion: Children in OOHC referred to CAMHS present with poorer mental health and psychosocial functioning than referred children who have not experienced OOHC. Assertive intervention was associated with improvement in social, emotional and behavioural problems and reduction in psychosocial impairment, suggesting the benefit of such an intervention both state-wide, and nationally.