Connecting mental health paediatric specialists and community services: The COMPASS project

North Western Melbourne Primary Health Network (NWMPHN), in partnership with The Royal Children’s Hospital (RCH) Health Services Unit and Mental Health team, piloted an integrated system approach to strengthen paediatric mental health care and reduce to burden on specialist services and hospitals in the NWMPHN region.

The result was a project called COMPASS – “Connecting mental health paediatric specialists and community services.” The pilot ran between March and June in 2021, at the height of the COVID-19 pandemic. Assessments of its effects continue today, tracking long-term improvements in treatment and decreases in Child and Adolescent Mental Health Service and ED presentations.

What was involved?

• A community of practice (CoP) involving a paediatric psychiatrist. Guided by RCH child and adolescent psychiatrists, sessions ran fortnightly and were attended by 59 local GPs, psychologists, paediatricians, social workers, mental health nurses, and occupational therapists in paediatric mental health care. CoPs ran in 2021, and 2022.
• A child psychiatry secondary consultation service. In April 2021, the RCH established a child psychiatry consultation liaison service to GPs and community-based paediatricians within the NWMPHN region. It provided advice on diagnostic assessment, risks, management and referral options.
• Support to community-based mental health clinicians. A senior RCH mental health clinician was made available to support NWMPHN commissioned services through primary and secondary consultation, reflective practice, education sessions and training in evidenced-based practice and screening tools/
• Improved referral pathways and information sharing between RCH triage and NWMPHN telephone assessment and referral services. A Memorandum of Understanding was established, supporting better exchange, including for Head to Health.

Evaluation of the pilot program revealed that it:

• built existing workforce capability
• shifted appropriate care to lower cost settings, thus increasing capacity in specialist settings
• improved communication with children seeking help, and their parents
• enabled earlier identification, diagnosis and access to treatment
• started to join up the fragmented care system
• reduced clinician burnout and isolation.

Read the COMPASS project report for more information.

Case study from the secondary consultation service

One of the child psychiatrists recorded primary and secondary consultations concerning 22 patients within a fortnight period. 100 per cent of cases were referred back to the clinicians, thus avoiding Child and Adolescent Mental Health Service or ED presentations. Total cost was $4074. Child and adolescent mental health service costs would have been $5050 more.

*The funding amount and duration above are for the evaluation component of the CoP only. NWMPHN played a significant role in coordinating the other elements of the project, which are continuing to be developed.