Retrospective audit of a school‐based integrated health‐care model in a specialised school for children with externalising behaviour

• Published in: Journal of paediatrics and child health Vol. 59; no. 12; pp. 1311 - 1318
• Main Authors: Rungan, Santuri, Montgomery, Alicia, Smith‐Merry, Jennifer, Liu, Huei Ming, Eastwood, John
• Format: Journal Article
• Language: English
• Published: Australia John Wiley & Sons Australia, Ltd 01-12-2023; Blackwell Publishing Ltd
• Subjects: conduct disorder; externalising behaviour; integrated care; Medical screening; multidisciplinary; oppositional defiant disorder; Pediatrics; school health; Students; externalising behaviour; oppositional defiant disorder; multidisciplinary; integrated care; conduct disorder; school health
• ISSN: 1034-4810; 1440-1754; 1440-1754
• DOI: 10.1111/jpc.16515

Aim
Problematic externalising behaviours in adolescents are associated with high individual and societal burden. A school‐based multidisciplinary health clinic, Ngaramadhi Space (NS), was developed at Yudi Gunyi School, a specialised behavioural school in Sydney, Australia, to improve access to holistic health‐care and behavioural support. This evaluation aimed to describe the demographics, clinic attendance, health screening, recommendations made, and changes in Strengths and Difficulties Questionnaire (SDQ) scores of students attending the clinic.
Methods
Retrospective evaluation of students including changes in SDQ scores using descriptive statistics (26 July 2016 to 14 May 2019; n = 79).
Results
Prior to the assessment, few students engaged with a paediatrician or mental health professional (22.8%; 27.8%, respectively). Child protection services were involved with 76%. NS attendance was high (failure‐to‐attend = 7.6%; cancellations = 8.9%). New issues found at the assessment included: parental separation (31.6%); trauma history (27.8%); substance use (19%); emotional wellbeing concerns (16.5%), learning difficulties (12.7%), domestic violence (12.7%) and medical conditions (10.1%). SDQ teacher reports showed a significant decrease in total difficulties scores (M = 6.2, SD = 6.165, P < 0.05, eta squared = 1.013 (large effect)) and all subsets. No significant differences in parent and self‐reported SDQ.
Conclusions
Students with problematic externalising behaviour have unmet health and social needs. The NS school‐based integrated health‐care model offers a novel, convenient and innovative way to engage these students. This approach has high initial attendance rates with teacher‐reported SDQ results showing some behavioural improvement. Further qualitative studies are required.