title: A controlled trial of implementing a complex mental health intervention for carers of vulnerable young people living in out-of-home care: the ripple project.
abstract: BACKGROUND
  Out-of-home care (OoHC) refers to young people removed from their families by the state because of abuse, neglect or other adversities. Many of the young people experience poor mental health and social function before, during and after leaving care. Rigorously evaluated interventions are urgently required. This publication describes the protocol for the Ripple project and notes early findings from a controlled trial demonstrating the feasibility of the work. The Ripple project is implementing and evaluating a complex mental health intervention that aims to strengthen the therapeutic capacities of carers and case managers of young people (12-17 years) in OoHC.
  
  
  METHODS
  The study is conducted in partnership with mental health, substance abuse and social services in Melbourne, with young people as participants. It has three parts: 1. Needs assessment and implementation of a complex mental health intervention; 2. A 3-year controlled trial of the mental health, social and economic outcomes; and 3. Nested process evaluation of the intervention.
  
  
  RESULTS
  Early findings characterising the young people, their carers and case managers and implementing the intervention are available. The trial Wave 1 includes interviews with 176 young people, 52% of those eligible in the study population, 104 carers and 79 case managers.
  
  
  CONCLUSIONS
  Implementing and researching an affordable service system intervention appears feasible and likely to be applicable in other places and countries. Success of the intervention will potentially contribute to reducing mental ill-health among these young people, including suicide attempts, self-harm and substance abuse, as well as reducing homelessness, social isolation and contact with the criminal justice system.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12615000501549 . Retrospectively registered 19 May 2015.
authors.affiliation: Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.|Orygen The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Herrman
authors.affiliation: Department of Social Work, University of Melbourne, Parkville, VIC, 3010, Australia.
authors.forename: Cathy
authors.initials: C
authors.lastname: Humphreys
authors.affiliation: Orygen Youth Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Halperin
authors.affiliation: Orygen Youth Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.
authors.forename: Katherine
authors.initials: K
authors.lastname: Monson
authors.affiliation: Psychosocial Research Centre Department of Psychiatry, University of Melbourne, 130 Bell Street, Coburg, VIC, 3058, Australia.|North Western Mental Health, Melbourne, Australia.
authors.forename: Carol
authors.initials: C
authors.lastname: Harvey
authors.affiliation: Centre for Population Health Research, Faculty of Health, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia.
authors.forename: Cathrine
authors.initials: C
authors.lastname: Mihalopoulos
authors.affiliation: Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.|Orygen The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Cotton
authors.affiliation: Youth Support and Advocacy Service (YSAS), 131 Johnston Street, Abbotsford, VIC, 3065, Australia.
authors.forename: Penelope
authors.initials: P
authors.lastname: Mitchell
authors.affiliation: Integrated Mental Health Program, Royal Children's Hospital, 117-129 Warringa Cres, Hoppers Crossing, VIC, 3029, Australia.
authors.forename: Tony
authors.initials: T
authors.lastname: Glynn
authors.affiliation: Centre for Population Health Research, Faculty of Health, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Magnus
authors.affiliation: Orygen Youth Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.
authors.forename: Lenice
authors.initials: L
authors.lastname: Murray
authors.affiliation: Foundation House - Victorian Foundation for the Survivors of Torture Inc, 4 Gardiner Street, Brunswick, VIC, 3056, Australia.
authors.forename: Josef
authors.initials: J
authors.lastname: Szwarc
authors.affiliation: The Jack Brockhoff Child Health and Wellbeing Program, Centre for Health Equity, The Melbourne School of Population and Global Health, The University of Melbourne, Level 5, 207 Bouverie St, Melbourne, VIC, 3010, Australia.
authors.forename: Elise
authors.initials: E
authors.lastname: Davis
authors.affiliation: Department of Psychiatry, Mindful, Centre for Training and Research in Developmental Health, University of Melbourne, Building C, 50 Flemington Street, Flemington, 3031, Australia.
authors.forename: Sophie
authors.initials: S
authors.lastname: Havighurst
authors.affiliation: Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.|Orygen The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: McGorry
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
authors.forename: Sam
authors.initials: S
authors.lastname: Tyano
authors.affiliation: Foundation House - Victorian Foundation for the Survivors of Torture Inc, 4 Gardiner Street, Brunswick, VIC, 3056, Australia.
authors.forename: Ida
authors.initials: I
authors.lastname: Kaplan
authors.affiliation: Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia.|Orygen The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Rice
authors.affiliation: Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC, 3052, Australia. Kristen.moeller@orygen.org.au.|Orygen The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC, 3052, Australia. Kristen.moeller@orygen.org.au.
authors.forename: Kristen
authors.initials: K
authors.lastname: Moeller-Saxone
mesh_terms: D000293:Adolescent; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002985:Clinical Protocols; D005240:Feasibility Studies; D005260:Female; D005581:Foster Home Care / Q000379:methods*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008603:Mental Health; D008605:Mental Health Services / Q000458:organization & administration*; D020380:Needs Assessment; D015397:Program Evaluation; D016728:Self-Injurious Behavior / Q000517:prevention & control; D013406:Suicide, Attempted / Q000517:prevention & control; D014739:Victoria; D035862:Vulnerable Populations / Q000523:psychology
keywords: Complex intervention; Implementation; Looked after children; Out-of-home care; Prevention; Youth mental health