TYPE OF SUPPORT
Background
Due to experiences of abuse, neglect, or family violence, Children and young people (C/YP) are unable to live with their primary caregivers and are subsequently placed in alternative care on a short- or long-term basis. This vulnerable population experience high levels of mental illness, with up to 60 % of C/YP in care receiving a mental health diagnosis.
The disparity in health outcomes and social equality between Aboriginal and/or Torres Strait Islander peoples of Australia and non-Aboriginal and/or Torres Strait Islander Australians is well documented. There is a disproportionate number of Aboriginal and/or Torres Strait Islander C/YP in the child protection system. Following the recommendations of the Queensland, Australia, Crime and Misconduct Commission (CMC) report, Queensland Health (QH) established Evolve Therapeutic Services (ETS) as a tertiary-level mental health intervention service within the continuum of service delivery provided by Child and Youth Mental Health Services (CYMHS).
The key focus of ETS is to provide planned and coordinated therapeutic and behaviour supports to C/YP in care, aimed at improving their emotional wellbeing and the development of skills to enhance participation in school and in the community.
As part of this initiative, a 15‑year retrospective cohort study examined mental health and functional outcomes for C/YP attending ETS, with outcomes explored by Aboriginal and/or Torres Strait Islander status, length of stay, and age.
QCIF Role
Dr Farah Zahir, Head of QCIF Statistics, collaborated with ETS Statewide Service Evaluation and Research Coordinator to design and implement this longitudinal study. The changes in functioning and mental health outcome pre and post care were explored using Multiple Generalised Linear Mixed Model Analysis.
The analyses showed that Overall, C/YP improved in mental health concerns and functioning on all domains post-intervention. 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.
Outcome & Impact
This project’s findings indicate that ETS, as a tertiary specialist mental health service, contributes to improved functioning and mental health outcomes for vulnerable C/YP with care experience.
Moreover, the study showed that non-Aboriginal and/or Torres Strait Islander C/YP had greater improvement on three domains (disruptive/aggressive behaviour, scholastic/language skills, and poor school attendance) compared to Aboriginal and/or Torres Strait Islander C/YP when adjusted for the effect of other confounders in the models.
Guidance and support provided by ETS Indigenous Program Coordinators may contribute to improved outcomes for Aboriginal and/or Torres Strait Islander C/YP.
Publication:
I have now collaborated with Dr Zahir on three projects related to outcomes for the children/young people attending Evolve Therapeutic Services, a specialist mental health service for children and young people involved with Child Safety services. Dr Zahir has provided expert advice on data management and statistical analysis and contributes as a co-author to manuscripts for publication in peer-reviewed journals. She conducts high-level statistical analysis and provides reports of the analysis. She is always available to consult with me about project findings and manuscript preparation. Without her collaboration on these projects, I believe we would not have had manuscripts accepted into top-tier journals. I look forward to working with her this year on our next project and into the future.
Kathryn Eadie, Statewide Service Evaluation and Research Coordinator, Evolve Therapeutic Services, Division of Child and Youth Mental Health Service (CYMHS)
Collaborating Organisations
Kathryn Eadie, Statewide Service Evaluation and Research Coordinator, Evolve Therapeutic Services, Division of Child and Youth Mental Health Service (CYMHS)
