Childhood Behavioural Disorders: Partnerships between the Health and Education Sectors

Abstract

Background

Mental health and behavioural disorders affect 20% of children yet only 30% access appropriate care. An integrated school-based health care (SBHC) model was co-designed at a specialised behavioural school to improve access and engagement with health services.

Aims and Methods

The purpose of this thesis was to describe the need for and the co-design, evaluation and potential for scale-up of an SBHC program called Ngaramadhi Space. Using mixed methods, the quantitative phase described the population. The qualitative phases explored the model’s development and implementation facilitators and barriers.

Findings

Quantitative phase

• Multiple unmet needs

• Most students (76%) known to child protection services

• High attendance at school clinic (86%)

• Significant behavioural improvements (Strengths and Difficulty Questionnaire—teacher)

Qualitative themes

a) Integrated People-Centred Health Service framework

Strategy 1: Engaging and empowering people and communities—community driven, improved access, positive outcomes, ‘connection’ and culturally safe

Strategy 2: Strengthening governance and accountability—system integration and evidence base

Strategy 3: Reorienting model of care—reduces inequity

Strategy 4: Coordinating services—multidisciplinary and stable workforce

Strategy 5: Enabling environment—leadership, stakeholder commitment and adequate resourcing

b) Looman’s implementation strategies

Applying collaborative governance

Distribution of leadership

Building positive team culture

Incremental growth models

Balancing flexible and formal structures

‘Integrators’

Conclusion

Support for the SBHC model from community and stakeholders was significant. Using the insights gained from this thesis, a framework called Kalgal Burnbona has been proposed for SBHC implementation across Sydney Local Health District. Future research requires inclusion of education, social and implementation outcomes. Policy needs to reflect integrated care for children across sectors.