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27/03/2015
Primary Aim of Ripple project:
The Ripple Intervention – A Local Tertiary
Mental Health Service Collaboration to
Enhance the Mental Health of Young
People in Out of Home Care (OoHC)
• To demonstrate that a relatively small reallocation and redesign of existing
resources can improve the mental health
of young people in Out of Home Care.
Tony Glynn – The Royal Children’s Hospital – Mental Health
&
Steve Halperin – Orygen Youth Health - Clinical Program
We aim to achieve this by:
How the Research Developed
•Enhancing the therapeutic care roles and
capacities of carers and case managers in
OoHC.
•Improving the consistency and quality of
OoHC for 12-17 year olds
•Improving access to early intervention
mental health and alcohol and other drug
services.
Ripple Service Providers
(partnership):
•The Royal Children’s Hospital (RCH)
•Orygen Youth Health – Clinical Program
(Orygen)
•Youth Support & Advocacy Service (YSAS)
Community Service Organisations
(project partners) :
•Mackillop Family Services
•Westcare (Salvation Army)
•Anglicare
•Victorian Aboriginal Child Care Agency
(VACCA)
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27/03/2015
Ripple research design :
•5 year study (2 years completed)
•1 ½ years building partnerships & developing
intervention
•Pre-Intervention measures of: individual young
people, carers, CSO staff
•Intervention & comparison groups
•3 ½ years of intervention
•Repeat (Post) Intervention measures
Intervention: Guiding principles
•Working in Partnership
– Due to complex difficulties of young people in
OoHC
• Flexible & responsive to context
– Young people & carers have differing needs &
they change over time
• Multi dimensional
– Operate at multiple levels of organisational
systems
‘Practice elements’ approach :
•A practical approach to introducing
evidence based practice into a range of
staff and organisations.
• Key content related to adolescent
development, emotional & mental
wellbeing, and attachment & trauma
theory.
• Able to be delivered flexibly to small
groups / local work teams.
Consultation process
(2013/2014)
The development of the intervention involved an
extended period of consultation and co-design
via:
•Focus Groups
•Interviews with youth, carers, professional
stakeholders
•Working Group
•Meetings, phone calls, meetings, emails,
meetings!
Guiding principles (continued):
• Building on strengths
– Identify already existing abilities & enhance
them
• Sustainable post-research
– Cost effective & desireable
• Generalisable
– The ‘Ripple effect’ through the system
• Co-investment
– from stakeholders
Who are the Ripple Clinicians?
• Experienced tertiary youth mental health /
alcohol & drug service staff.
• Mixture of social workers, psychologists, nurses,
occupational therapists and youth workers.
• Working within YSAS, RCH & OYH.
• Provided with additional training about OoHC,
trauma and other topics.
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Modes of intervention :
•Regular visiting Ripple practitioner
•Secondary Consultation and Care Team
Consultation
•Professional Practice Groups
•Training Sessions
•Input from Bounce project peer leaders
•Accessing the YSAS toolbox
Why designed in this way:
• Reflects the practical challenges of the
work
• Allows flexible delivery over time
• Focused on meeting each staff group ‘at
the appropriate level’
• To be able to be responsive to the
changing needs of the sector
Challenges:
Content “menu”:
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Therapeutic Care & reflective practice
Challenging Behaviours
Motivational Interviewing
Emotion Regulation
Communication & Social Skills Training
Problem-Solving Skills Training
Family Focused Interventions
Anxiety & Depression
Self Injury / Self Harm
Suicide Prevention
Promoting Resilience
Findings to date :
•Intervention & Ripple clinicians universally
welcomed.
•Significant variation in readiness of staff to utilize
the range of modes on offer.
•High levels of mental health and alcohol and drug
problems within cohort.
•CSO staff are able to describe presenting MH &
AOD problems well & are keen to intervene
more effectively.
Thank You
• Researchers and practitioners can have different
priorities and languages.
• Maintaining the organisational support (staffing) across
RCH, Orygen, & YSAS across the five years of the
project.
• Staffing and structural changes within organisations.
• Acceptance from CSO partner’s that project is not
focused on working directly with Young People
• Organisational ‘buy in’ from CSO’s at appropriate levels.
• Not doubling up / competing with existing services
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