Responding to serious and complex mental health problems in youth: the role of an interagency forum.
OBJECTIVE
To review the origins, processes, clientele and outcomes of a child and youth interagency forum, a collaborative response to children and youth with severe and complex presentations.


METHODS
After a description of the Forum origins, membership and processes, both qualitative and quantitative information is provided on the Forum clientele. The Forum's effectiveness is considered in terms of changes in services provided to this group, as well as changes in agency and interagency work practices.


RESULTS
Forum clients were predominantly boys aged 12 years, with an overrepresentation of indigenous and intellectually disabled children. Few lived with biological parents, and on average had experienced five schools, 11 or more residential placements and were involved with six agencies. Disruptive behaviour symptoms were common, as were suicidal thoughts or actions (43%), history of physical (50%) or sexual abuse (21%), alcohol (29%) and drug use (14%). On average Forum clients were taking three psychotropic medications. Forum client impairment ranged from major impairment to gross impairment across several domains.


CONCLUSIONS
While this is not a formal outcome study, evidence suggesting Forum usefulness included qualitative feedback from agencies, altered clinical and interagency practices, and decreased client impairment. Practical interventions for clients with chronic, complex multidomain impairments are discussed in the context of current Australian child and adolescent mental health services.
Lee
Erica
E
Mater Child and Youth Mental Health Service, Mater Children's Hospital, South Brisbane, Qld, Australia. erlee@mater.org.au
Dillon
Alana
A
Dorries
Valda
V
Beech
Michael
M
McDermott
Brett
B
D000124:Achievement; D000293:Adolescent; D002648:Child; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D007373:Interinstitutional Relations; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D012017:Referral and Consultation; D012307:Risk Factors