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.