The Impact of Treatment as Usual on School and Vocational Attendance Problems in a Child and Youth Mental Health Service

Abstract

Background

This study investigated changes in school and vocational attendance problems (SVAP) among young people receiving treatment as usual (TAU) at Child and Youth Mental Health Services (CYMHS) in Australia. Although CYMHS primarily addresses severe psychiatric disorders, SVAP frequently co-occurs in this population, impacting overall wellbeing.

Method

A random sample of 210 patients who completed treatment in the year prior to the COVID-19 pandemic was selected. SVAP was assessed using the Health of the Nations Outcome Scales for Children and Adolescents (HoNOSCA), a routinely collected measure of symptoms and functioning, with ratings recorded at Assessment, 91-day Review, and Discharge.

Results

At Assessment, 48.6% of patients presented with SVAP. This reduced to 44.8% at Review and significantly dropped to 24.3% by Discharge (p < 0.001). While no significant change was observed from Assessment to Review, a substantial reduction in SVAP was noted from both Assessment to Discharge and Review to Discharge (p < 0.001).

Conclusion

These findings suggest that CYMHS TAU, though not specifically focused on attendance issues, can positively impact SVAP in young people with complex psychiatric needs.

Plain Language Summary

Young people with mental health challenges often struggle with school or work attendance, impacting their education, social connections, and wellbeing. This study explored whether regular mental health care, provided as part of routine services, could improve attendance for young people with complex mental health needs. The research involved 210 young people treated at a Child and Youth Mental Health Service (CYMHS) in Melbourne, Australia. Their school or work attendance was assessed at three points: when treatment began, around three months later, and at discharge. At the start, almost half (49%) had serious attendance problems. After three months, this number improved only slightly. By the end of treatment, attendance problems had reduced significantly to 24%. This suggests that even though regular mental healthcare does not directly target attendance, it can have a positive impact over time. It also highlights the need for extra strategies or specialised programs for the 24% who do not respond to standard mental health care alone. This research shows that mental health services can improve young people’s participation in education and work. However, for some young people, additional support may be needed to ensure they stay engaged in school or vocational activities. The findings may help mental health professionals identify which young people might benefit from extra help earlier in their treatment.