Document No.

Barrett Adolescent Strategy

Expert Clinical Reference Grou

Expert Clinical Reference Group

ProposedServiceModelElements
AdolescentExtendedTreatmentandRehabilitationServices(AETRS)
Details

ServiceDelivered

Theaimofthisplatformofservicesistoprovidemediumterm,
recoveryorientedtreatmentandrehabilitationforyoungpeople
aged1317yearswithsevereandpersistentmentalhealth
problems,whichsignificantlyinterferewithsocial,emotional,
behaviouralandpsychologicalfunctioninganddevelopment.

TheAETRScontinuumisofferedacrossarangeofenvironments
tailoredtotheindividualneedsoftheyoungpersonwithregard
tosafety,security,structure,therapy,communityparticipation,
autonomyandfamilycapacitytoprovidecarefortheyoung
person.

TheAETRSfunctionsaspartofthebroader,integrated
continuumofcareprovidedforyoungQueenslanders,that
includesacuteinpatient,dayprogramandcommunitymental
healthservices(public,privateandothercommunitybased
providers).

ThedeliveryofanAdolescentExtendedTreatmentand
RehabilitationServicecontinuumwill:

IR

OverarchingPrinciples

EL

EA

SE

Attribute

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develop/maintainstablenetworks
promotewellnessandhelpyoungpeopleandtheirfamilies
inayouthorientedenvironment
provideserviceseitherin,orascloseto,theyoungpersons
localcommunity
collaboratewiththeyoungpersonandtheirfamilyand
supportpeopletodeveloparecoverybasedtreatmentplan
thatpromotesholisticwellbeing
collaboratewithotherexternalservicestooffercontinuityof
careandseamlessservicedelivery,enablingtheyoung
personandtheirfamilytotransitiontotheircommunityand
serviceswithease
integratewithChildandYouthMentalHealthServices
(CYMHS),andasrequired,AdultMentalHealthServices
recognisethatyoungpeopleneedhelpwithavarietyof
issuesandnotjustillness
utiliseandaccesscommunitybasedsupportsandservices

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EA

wheretheyexist,ratherthanrecreateallsupportsand
serviceswithinthementalhealthsetting
treatconsumersandtheirfamilies/carersinasupportive
therapeuticenvironmentprovidedbyamultidisciplinary
teamofcliniciansandcommunitybasedstaff
provideflexibleandtargetedprogramsthatcanbedelivered
acrossarangeofcontextsandenvironments
havethecapacitytodeliverservicesinatherapeuticmilieu
withfamilymembers;supportandworkwiththefamilyin
theirownenvironment;andkeepthefamilyengagedwith
theyoungpersonandthementalhealthproblemstheyface
havecapacitytoofferintensivefamilytherapyandfamily
support
haveflexibleoptionsfrom24hourinpatientcaretopartial
hospitalisationanddaytreatmentwithambulant
approaches;stepup/stepdown
acknowledgetheessentialrolethateducational/vocational
activitiesandnetworkshaveontherecoveryprocessofa
youngperson
engagewitharangeofeducationalorvocationalsupport
servicesappropriatetotheneedsoftheyoungpersonand
therequirementsoftheirtreatmentenvironment,and
encourageengagement/reengagementofpositiveand
supportivesocial,family,educationalandvocational
connections.

IR

Servicesareaccessedviaatiered,leastrestrictiveapproach,and
mayinvolvecombinationsofservicetypesacrossthetiers.

Tier1:
PublicCommunityMentalHealthServices(Sessional)
ExistingLocations:AllHospitalandHealthServices(HHSs).
Accessambulatorycareatapubliccommunitybasedmental
healthservice,withinthelocalarea.
Interventionsshouldconsidersharedcareoptionswith
communitybasedserviceproviders,e.g.General
Practitionersandheadspace.

Tier2a:Level5CSCF.
DayProgramServices(MonFribusinesshours).
ExistingLocations:Townsville(nearcompletion),Mater,
Toowoomba,BarrettAdolescentCentre(BAC).
PossibleNewLocations:GoldCoast,RoyalChildrensHospital
CYMHScatchment,SunshineCoast.Fundsfromexisting

RT

KeyDistinguishing
FeaturesofanAETRS

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operationalfundsofBACandRedlandsFacility.Final
locationsandbudgettobedeterminedthroughaformal
planningprocess.
Individual,familyandgrouptherapy,andrehabilitation
programsoperatingthroughout(butnotlimitedto)school
terms.
Coreeducationalcomponentforeachyoungperson
partnershipwithEducationQueenslandandvocational
servicesrequired.Thismaybeprovidedattheyoungpersons
school/vocationalsetting,orfromthedayprogramsite.
Flexibleandtargetedprogramswithattendanceupto5days
(duringbusinesshours)aweek,incombinationwith
integrationintoschool,communityand/orvocational
programs.

IntegratedwithlocalCYMHS(acuteinpatientandpublic
communitymentalhealthteams).

Programsaredeliveredinatherapeuticmilieu(fromarange
ofsettingsincludingdayprogramservicelocation,thefamily
home,schoolsettingetc.).
Programswillsupportandworkwiththefamily,keeping
themengagedwiththeyoungperson'srecovery.
ConsumersmayrequireadmissiontoAdolescentAcute
InpatientUnit(andattendtheDayProgramduringbusiness
hours).

EL

EA

Proposalof1215programplacesperDayProgram(final
placesandbudgetshouldbedeterminedaspartofformal
planningprocess).

RT

IR

Tier2b:
1
CommunityResidentialService(24h/7d).
ExistingLocations:Nilservicescurrently.Note:CairnsTime
OutHouseInitiativefor18y+.
PossibleNewLocations:SiteswhereDayProgramsare
currentlydelivered;Townsvilleidentifiedasapriorityinorder
tomeettheneedsofNorthQueenslandfamilies.Funding
fromexistingoperationalfundsofBACandRedlandsFacility.
Finallocationsandbudgettobedeterminedthroughaformal

Note:TheDepartmentofHealthtakesaprovideragnosticviewindeterminingnonclinicalsupport
andaccommodationservices.Decisionstocontractserviceproviderswillbedeterminedbyservice
merit,consumerneedandformalplanningandprocurementprocesses.

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planningprocess.
DayProgramattendanceasinTier2aduringbusinesshours.

Thistierincorporatesabedbasedresidentialandrespite
serviceforadolescentsafterhoursandonweekends(inthe
community).

Thereispotentialforoneormoreoftheseservicesto
providefamilyrooms,thatwilltemporarilyaccommodate
familymemberswhiletheiryoungpersonattendstheDay
ProgramortheAdolescentAcuteInpatientUnit(for
example,inTownsville).

IntegratedwithlocalCYMHS(acuteinpatient,dayprogram
andpubliccommunitymentalhealthteams).

Residentialtobeapartnershipmodelforservicedelivery
betweenacommunitybasedserviceproviderandQH
multidisciplinarystaffingprofileincludingclinical(Day
Program)andcommunitysupportstaff(communitybased
provider).Partnershiptoincludeclinicalgovernance,training
andinreachbyCYMHS.

Residentialcomponentonlyprovidesaccommodation;itis
nottheinterventionserviceproviderbutwillworkclosely
withtheinterventionserviceprovidertomaintain
consistencyinthetherapeuticrelationshipwiththeyoung
person.

OnsiteextendedhoursvisitingservicefromCYMHSDay
Programstaff.

RT

IR

EL

EA

SE

Tier3:Level6CSCF.
StatewideInpatientExtendedTreatmentandRehabilitation
Service(24h/7d) 2 .
PossibleLocation:S.E.Qld.Sourceofcapitalfundingand
potentialsitenotavailableatcurrenttime 3 .Acknowledge

TheDepartmentofHealthacknowledgesthededicatedschoolandexpertiseprovidedbythe
DepartmentofEducationTrainingandEmployment(DETE).TheDepartmentofHealthvaluesand
supportspartnershipwithDETEtoensurethatadolescentshaveaccesstoappropriate
educationalandvocationaloptionstomeettheireducational/vocationalneeds.
3
UntilfundingandlocationisavailableforTier3,allyoungpeoplerequiringextendedtreatment
andrehabilitationwillreceiveservicesthroughTiers1and2a/b(i.e.,utilisingexistingCYMHS
communitymentalhealth,DayProgramsandAcuteInpatientUnitsuntilthenewDayPrograms
andresidentialserviceprovidersareestablished).Itisemphasisedthatthisisnotproposedtobe
aclinicallypreferredoroptimalsolution,andsignificantrisksareassociatedwiththisinterim
measure.
4
Theprovisionofeducationatthislevelrequiresfocusedconsideration;anonsiteschooland
educationprogramisproposedasapriority.

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accessibilityissuesforyoungpeopleoutsideS.E.Qld.
ForyoungpeoplewhoseneedscouldnotbemetbyTiers1
and2above,duetorisk,severityorneedforinpatient
extendedtreatmentandcare.Theseyoungpeoplesneeds
arenotabletobemetinanacutesetting.
Inpatienttherapeuticmilieu,withcapacityforfamily/carer
admissions(i.e.familyrooms).
Allotherappropriateandlessrestrictiveinterventions
considered/testedfirst.
Proposalforapproximately15bedsthisrequiresformal
planningprocesses.
Mediumtermadmissions(approximatelyupto12months;
however,lengthofstaywillbeguidedbyindividualconsumer
needandwillthereforevary).
DeliversintegratedcarewiththelocalCYMHSoftheyoung
person.
Individualised,familyandgrouprehabilitationprograms
deliveredthroughdayandeveningsessions,available7
days/week.Thesemustincludeactivitybasedprogramsthat
enhancetheselfesteemandselfefficacyofyoungpeopleto
aidintheirrehabilitation.Assymptomsreduce,thereisa
focusonassistingyoungpeopletoreturntoatypical
developmentaltrajectory.
Consumerswillonlyaccessthedaysessions(i.e.DayProgram
components)oftheserviceiftheyareanadmittedconsumer.
Programsmaintainfamilyengagementwiththeyoung
person,andwhereverpossibleadolescentswillremain
closelyconnectedwiththeirfamiliesandtheirown
community.
Youngpeoplewillhaveaccesstoarangeofeducationalor
vocationalsupportservicesdeliveredbyonsiteschool
teachersandwillbeabletocontinuetheircurrenteducation
option 4 .Thereisanintentionalgoalthatyoungpeopleare
integratedbacktomainstreamcommunityand
educational/vocationalactivities.
Flexibleandtargetedprogramswillbedeliveredacrossa
rangeofcontextsincludingindividual,school,community,
groupandfamily.

EA

IR

RT

Servicespecificationsandotherdescriptorstoillustrateserviceelements
TargetAge

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1317years,withflexibilityinupperagelimitdependingon
presentingissueanddevelopmental(asopposedto

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chronological)age.

Severeandpersistentmentalhealthproblemsthat
significantlyinterferewithsocial,emotional,behaviouraland
psychologicalfunctioninganddevelopment.
Treatmentrefractory/nonresponsivetotreatmenthavenot
beenabletoremediatewithmultidisciplinarycommunity,
dayprogramoracuteinpatienttreatment.
Mentalillnessispersistentandtheconsumerisariskto
themselvesand/orothers.
Mediumtohighlevelofacuityrequiringextendedtreatment
andrehabilitation.

Suggestedmodellingattributes
Tier2a:

Level5DayProgramServices(MonFribusinesshours)
Upto12months;flexibilitywillbeessential.
Therewillbewidevariationinindividualconsumerneedand
theirtreatmentprogram;lengthofstaywillneedtobe
responsivetothis.

Tier2b:
CommunityResidential(24h/7d)
Upto12months;flexibilitywillbeessential.
Therewillbewidevariationinindividualconsumerneedand
theirtreatmentprogram;lengthofstaywillneedtobe
responsivetothis.
Accesstoacommunityresidentialservicerequirestheyoung
persontobeactivelyparticipatinginaprogramwithCYMHS.

Tier3:
Level6StatewideInpatientExtendedTreatmentand
RehabilitationService(24h/7d)
Upto12months;flexibilitywillbeessential.
Therewillbewidevariationinindividualconsumerneedand
theirtreatmentprogram;lengthofstaywillneedtobe
responsivetothis.
YoungpeoplemaybedischargedfromthisServicetoaDay
Programintheirlocalcommunity.

RT

IR

EL

Averagedurationof
treatment

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EA

DiagnosticProfile

StaffingProfile
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Tier2a:

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Level5DayProgramServices(MonFribusinesshours)
Multidisciplinary,clinical.
Plusstaffingfromcommunitysector.
DETE.

Tier2b:
CommunityResidentialService(24h/7d)
Multidisciplinary,clinical.
Plusstaffingfromcommunitysector.

Tier3:
Level6StatewideInpatientExtendedTreatmentand
RehabilitationService(24h/7d)
Multidisciplinary,clinical.
DETE.

Additionalnotes

WhileserviceprovisionacrossallTiersofthisAETRScontinuumis
basedoninterdisciplinarycollaborationandcrossagency
contribution,areferraltoTiers2a,2band/or3willrequirea
CYMHSassessment(i.e.,singlepointofentry).

EL

ReferralSourcesand
Pathways

IncreasedaccessibilitytoAETRSforconsumersandtheirfamilies
acrosstheStateisakeypriority.

IR

TheTier3statewideservicewillestablishaStatewideClinical
ReferralPanel.Allreferralswillbereceivedandassessedbythe
Panel,whichhasstatewiderepresentationfrommultidisciplinary
mentalhealthcliniciansandthecommunitysector.

Voluntaryandinvoluntarymentalhealthconsumers.
Thehighestlevelofriskandcomplexity.

RT

Complexitiesof
Presentation

ThisdocumentwasendorsedbytheExpertClinicalReferenceGroupoftheBarrett
AdolescentStrategyon8May2013.
Pleasereadinconjunctionwiththev5Preamble.

___________________________
DrLeanneGeppert
Chair,ExpertClinicalReferenceGroup

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ProposedServiceModelElements
AdolescentExtendedTreatmentandRehabilitationServices(AETRS)

Preamble

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EA

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Mentalhealthdisordersarethemostprevalentillnessesaffectingadolescentstoday.Ofparticular
noteistheconsiderableevidencethatadolescentswithpersistingandseveresymptomatologyare
those most likely to carry the greatest burden of illness into adult life. Despite this, funding for
adolescent(andchild)mentalhealthservicesisnotproportionaltotheidentifiedneedandburden
ofdiseasethatexists.

In the past 25 years, a growing range of child and youth mental health services have been
established by Queensland Health (and other service providers) to address the mental health
needs of children and adolescents. These services deliver mental health assessment and
treatment interventions across the spectrum of mental illness and need, and as a service
continuum, provide care options 24 hours a day, seven days a week. No matter where an
adolescentandtheirfamilyliveinQueensland,theyareabletoaccessaChildandYouthMental
Health Service (CYMHS) community clinic or clinician (either via direct access through their
HospitalandHealthService,orthroughtelehealthfacilities).DayProgramshavebeenestablished
for adolescents in South Brisbane, Toowoomba and Townsville. Acute mental health inpatient
units for adolescents are located in North Brisbane, Logan, Robina, South Brisbane and
Toowoomba, and soon in Townsville (May/June 2013). A statewide specialist multidisciplinary
assessment,andintegratedtreatmentandrehabilitationprogram(TheBarrettAdolescentCentre
[BAC]) is currently delivered at The Park Centre for Mental Health (TPCMH) for adolescents
between13and17yearsofagewithsevere,persistentmentalillness.Thisservicealsooffersan
adolescent Day Program for BAC consumers and nonBAC consumers of West Moreton Hospital
andHealthService.

Consistentwithstateandnationalmentalhealthreforms,thedecentralisationofservices,andthe
reform of TPCMH site to offer only adult forensic and secure mental health services, the BAC is
unable to continue operating in its current form at TPCMH. Further to this, the current BAC
building has been identified as needing substantial refurbishment. This situation necessitates
carefulconsiderationofoptionsfortheprovisionofmentalhealthservicesforadolescents(and
their families/carers) requiring extended treatment and rehabilitation in Queensland.
Consequently, an Expert Clinical Reference Group (ECRG) of child and youth mental health
clinicians,aconsumerrepresentative,acarerrepresentative,andkeystakeholderswasconvened
by the Barrett Adolescent Strategy Planning Group to explore and identify alternative service
optionsforthistargetgroup.

Between1December2012and24April2013theECRGmetregularlytodefinethetargetgroup
and their needs, conduct a service gap analysis, consider community and sector feedback, and
reviewarangeofcontemporary,evidencebasedmodelsofcareandservicetypes.Thisincluded
thepotentialforanexpandedrangeofdayprogramsacrossQueenslandandcommunitymental
healthservicemodelsdeliveredbynongovernmentand/orprivateserviceproviders.TheECRG
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haveconsideredevidenceanddatafromthefield,nationalandinternationalbenchmarks,clinical
expertiseandexperience,andconsumerandcarerfeedbacktodevelopaservicemodelelements
document for Adolescent Extended Treatment and Rehabilitation Services in Queensland. This
elementsdocumentisnotamodelofserviceitisaconceptualdocumentthatdelineatesthekey
components of a service continuum type for the identified target group. As a service model
elementsdocument,itwillnotdefinehowthekeycomponentswillfunctionataservicedelivery
level,anddoesnotincorporatefundingandimplementationplanningprocesses.

The service model elements document proposes four tiers of service provision for adolescents
requiringextendedmentalhealthtreatmentandrehabilitation:
Tier1PublicCommunityChildandYouthMentalHealthServices(existing);
Tier2aAdolescentDayProgramServices(existing+new);
Tier2bAdolescentCommunityResidentialService/s(new);and
Tier3StatewideAdolescentInpatientExtendedTreatmentandRehabilitationService(new).

Thefinalservicemodelelementsdocumentproducedwascognisantofconstraintsassociatedwith
funding and other resources (e.g., there is no capital funding available to build BAC on another
site). The ECRG was also mindful of the current policy context and direction for mental health
servicesasinformedbytheNationalMentalHealthPolicy(2008)whicharticulatesthatnonacute
bedbasedservicesshouldbecommunitybasedwhereverpossible.Akeyprincipleforchildand
youth mental health services, which is supported by all members of the ECRG, is that young
people are treated in the least restrictive environment possible, and one which recognises the
need for safety and cultural sensitivity, with the minimum possible disruption to family,
educational,socialandcommunitynetworks.

The ECRG comprised of consumer and carer representatives, and distinguished child and youth
mentalhealthcliniciansacrossQueenslandandNewSouthWaleswhowerenominatedbytheir
peersasleadersinthefield.TheECRGwouldliketoacknowledgeanddrawattentiontotheinput
oftheconsumerandcarerrepresentatives.Theyhighlightedtheessentialrolethataservicesuch
asBACplaysinrecoveryandrehabilitation,andthestaffskillandexpertisethatisinherenttothis
particular service type. While there was also validation of other CYMHS service types, including
community mental health clinics, day programs and acute inpatient units, it was strongly
articulated that these other service types are not as effective in providing safe, mediumterm
extendedcareandrehabilitationtothetargetgroupfocussedonhere.ItisunderstoodthatBAC
cannotcontinueinitscurrentformatTPCMH.However,itistheviewoftheECRGthatlikethe
Community Care Units within the adult mental health service stream, a designspecific and
clinically staffed bedbased service is essential for adolescents who require mediumterm
extendedcareandrehabilitation.Thistypeofcareandrehabilitationprogramisconsideredlife
savingforyoungpeople,andisavailablecurrentlyinbothQueenslandandNewSouthWales(e.g.,
TheWalkerUnit).

The service model elements document (attached) has been proposed by the ECRG as a way
forwardforadolescentextendedtreatmentandrehabilitationservicesinQueensland.

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SE

There are seven key messages and associated recommendations from the ECRG that need to
underpinthereadingofthedocument:

1. Broaderconsultationandformalplanningprocessesareessentialinguidingthenextsteps
required for service development, acknowledging that services need to align with the
NationalMentalHealthServicePlanningFramework

The proposed service model elements document is a conceptual document, not a model of
service.Formalconsultationandplanningprocesseshavenotbeencompletedaspartofthe
ECRGcourseofaction.

Inthisconceptproposal,Tier2mapstotheClinicalServicesCapabilityFrameworkforPublic
andLicensedPrivateHealthFacilitiesVersion3.1(CSCF)Level5andTier3mapstoCSCFLevel
6.

EA

Recommendations:

a) Furtherworkwillberequiredatastatewideleveltotranslatetheseconceptsintoamodel
ofserviceandtodevelopimplementationandfundingplans.
b) Formalplanningincludingconsultationwithstakeholdergroupswillberequired.

EL

2. Inpatient extended treatment and rehabilitation care (Tier 3) is an essential service

component

Itisunderstoodthatthecombinationofdayprogramcare,residentialcommunitybasedcare
andacuteinpatientcarehasbeenidentifiedasapotentialalternativetothecurrentBACor
theproposedTier3inthefollowingservicemodelelementsdocument.

FromtheperspectiveoftheECRG,Tier3isanessentialcomponentoftheoverallconcept,as
thereisasmallgroupofyoungpeoplewhoseneedscannotbesafelyandeffectivelymet
throughalternativeservicetypes(asrepresentedbyTiers1and2).

Thetargetgroupischaracterisedbyseverityandpersistenceofillness,verylimitedorabsent
community supports and engagement, and significant risk to self and/or others. Managing
these young people in acute inpatient units does not meet their clinical, therapeutic or
rehabilitationneeds.

Theriskofinstitutionalisationisconsideredgreateriftheyoungpersonreceivesmediumterm
careinanacuteunit(versusadesignspecificextendedcareunit).

Clinicalexperienceshowsthatprolongedadmissionsofsuchyoungpeopletoacuteunitscan
haveanadverseimpactonotheryoungpeopleadmittedforacutetreatment.

Managingthistargetgrouppredominantlyinthecommunityisassociatedwithcomplexitiesof
risktoselfandothers,andalsotheriskofdisengagingfromtherapeuticservices.

RT

IR

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Recommendation:
a) ATier3serviceshouldbeprioritisedtoprovideextendedtreatmentandrehabilitationfor
adolescentswithsevereandpersistentmentalillness.

3. InterimserviceprovisionifBACclosesandTier3isnotavailableisassociatedwithrisk

Interimarrangements(afterBACclosesandbeforeTier3isestablished)areatriskofoffering
suboptimalclinicalcareforthetargetgroup,andattentionshouldbegiventothetherapeutic
principlesofsafetyandtreatmentmatching,aswellasefficientuseofresources(e.g.,
inpatientbeds).

InthecaseofBACbeingclosed,andparticularlyifTier3isnotimmediatelyavailable,ahigh
priorityandconcernfortheECRGwasthetransitioningofcurrentBACconsumers,andthose
onthewaitinglist.

OfconcerntotheECRGisalsothedissipationandlossofspecialiststaffskillsandexpertisein
the area of adolescent extended care in Queensland if BAC closes and a Tier 3 is not
establishedinatimelymanner.Thisincludesbothclinicalstaffandeducationstaff.

EA

SE

IR

EL

Recommendations:
a) Safe,highqualityserviceprovisionforadolescentsrequiringextendedtreatmentand
rehabilitationrequiresaTier3servicealternativetobeavailableinatimelymannerifBAC
isclosed.
b) InterimserviceprovisionforcurrentandwaitlistconsumersofBACwhileTier3service
optionsareestablishedmustprioritisetheneedsofeachoftheseindividualsandtheir
families/carers.Wraparoundcareforeachindividualwillbeessential.
c) BACstaff(clinicalandeducational)mustreceiveindividualcareandcasemanagementif
BACcloses,andtheirspecialistskillandknowledgemustberecognisedandmaintained.

4. Durationoftreatment

AliteraturesearchbytheECRGidentifiedaweakandvariableevidencebaseforthe
recommendeddurationoftreatmentforinpatientcareofadolescentsrequiringmentalhealth
extendedtreatmentandrehabilitation.

Predominantly,durationoftreatmentshouldbedeterminedbyclinicalassessmentand
individualconsumerneed;thelengthofinterventionmostlikelytoachievelongterm
sustainableoutcomesshouldbeofferedtoyoungpeople.

As with all clinical care, duration of care should also be determined in consultation with the
youngpersonandtheirguardian.Rapportandengagementwithserviceprovidersispivotal.

RT

Recommendation:
a) Upto12monthshasbeenidentifiedbytheECRGasareasonabledurationoftreatment,
butitwasnotedthatthisdependsontheavailabilityofeffectivestepdownservicesanda
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suitable community residence for the young person. It is important to note that like all
mentalhealthserviceprovision,therewillbearangeinthedurationofadmission.

5. Educationresourceessential:onsiteschoolforTiers2and3

Comprehensiveeducationalsupportunderpinssocialrecoveryanddecreasesthelikelihoodof
the long term burden of illness. A specialised educational model and workforce is best
positionedtoengagewithandteachthistargetgroup.

Rehabilitation requires intervention to return to a normal developmental trajectory, and

successfuloutcomesaremeasuredinpsychosocialfunctioning,notjustabsenceofpsychiatric
symptoms.

Educationisanessentialpartoflifeforyoungpeople.Itisvitalthatyoungpeopleareableto
accesseffectiveeducationservicesthatunderstandandcanaccommodatetheirmentalhealth
needsthroughoutthecareepisode.

For young people requiring extended mental health treatment, the mainstream education
system is frequently not able to meet their needs. Education is often a core part of the
interventionrequiredtoachieveapositiveprognosis.

EA

SE

EL

Recommendations:

a) Accesstoonsiteschooling(includingsuitablyqualifiededucators),isconsideredessential
for Tiers 2 (day programs) and 3. It is the position of the ECRG that a Band 7 Specific
Purpose School (provided by Department of Education, Training and Employment) is
requiredforaTier3service.

IR

b) As an aside, consideration should also be given to the establishment of a multisite,

statewideeducationserviceforchildren/adolescentsinacuteunits(hubandspokemodel).

6. Residential Service: Important for governance to be with CYMHS; capacity and capability
requiresfurtherconsideration

There is no true precedent set in Queensland for the provision of residential or bedbased
therapeuticcommunitycare(bynongovernmentorprivateproviders)foradolescents(aged
upto18years)requiringextendedmentalhealthcare.

ThemajorityofECRGmembersidentifiedconcernswithregardtosimilarservicesavailablein
thechildsafetysector.Theseconcernswereassociatedwith:
Variablyskilled/trainedstaffwhooftenhadlimitedaccesstosupportandsupervision;
Highstaffturnover(impactingonconsumertrustandrapport);and
VariableengagementincollaborativepracticewithspecialistservicessuchasCYMHS.

RT

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Recommendations:
a) It is considered vital that further consultation and planning is conducted on the best
servicemodelforadolescentnongovernment/privateresidentialandtherapeuticservices
incommunitymentalhealth.Apilotsiteisessential.
b) GovernanceshouldremainwiththelocalCYMHSortreatingmentalhealthteam.

Equity of access for North Queensland consumers and their families is considered a high
prioritybytheECRG.

EA

SE

c) It is essential that residential services are staffed adequately and that they have clear
serviceandconsumeroutcometargets.

7. EquitableaccesstoAETRSforalladolescentsandfamiliesishighpriority;needtoenhance
serviceprovisioninNorthQueensland(andregionalareas)

Recommendations:

EL

a) LocalserviceprovisiontoNorthQueenslandshouldbeaddressedimmediatelybyensuring
a full range of CYMHS services are available in Townsville, including a residential
communitybasedservice.

RT

IR

b) IfadecisionismadetocloseBAC,thisshouldnotbefinalisedbeforetherangeofservice
optionsinTownsvilleareopenedandavailabletoconsumersandtheirfamilies/carers.

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