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Children with disruptive behaviours II: clinical and community service needs
P L Hazell1, M Tarren-Sweeney, G V Vimpani
1Discipline of Psychiatry, Faculty of Medicine and Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia. hazell@mail.newcastle.edu.au
Insights
Families caring for children with disruptive behavior need expanded community counseling services. Some disadvantaged families also require intensive out-of-home care options.
Area of Science:
- Child and Adolescent Psychiatry
- Health Services Research
- Community Health
Background:
- Families with children exhibiting disruptive behaviors face significant challenges.
- Accurate assessment of service needs is crucial for effective health service planning.
Purpose of the Study:
- To identify the clinical and community service needs of families in the Hunter region caring for children with disruptive behaviors.
- To inform health service planning and resource allocation.
Main Methods:
- A survey was conducted with 1412 families of children diagnosed with disruptive behavior disorders or significant behavioral problems.
- Parents prioritized needs for clinical services and cost reduction strategies.
Main Results:
- Expansion of mainstream community treatment and counseling services was the highest priority for most families.
- Respite and in-patient services were ranked lower by the general sample.
- Disadvantaged and stressed families prioritized out-of-home care options like respite and in-patient services.
Conclusions:
- Enhancing community-based counseling services will address the needs of the majority of families.
- A subset of disadvantaged and highly stressed families requires intensive residential services.
Objective:
To assist in health service planning by determining the perceived clinical and community service needs of families resident in the Hunter region who care for a child manifesting disruptive behaviour.
Methodology:
Families were eligible to participate in the survey if they had at least one child known to have one of the DSM-IV disruptive behaviour disorders, autistic spectrum disorders, behaviour problems associated with rarer forms of brain disease, brain injury or mild intellectual disability or were identified by school personnel as having significant behaviour problems. Families were recruited to the survey via schools, early education centres and clinical services. Parents completed a questionnaire, mailed to them by educational and/or clinical services. Parents were asked to prioritize options for improving or expanding clinical services and for reducing their treatment costs.
Results:
A total of 1412 families responded to the survey. The highest-ranked clinical service options involved the expansion of mainstream community treatment services for children with disruptive behaviour problems and their families, with a particular emphasis on counselling services. Respite care and in-patient services were given relatively low priority. Subgroup analyses showed that disadvantaged and stressed families gave higher rankings to out of home options, such as respite care, in-patient care and subsidised holiday camps, than the aggregate sample.
Conclusions:
Enhancement of community based counselling services would meet the needs of the greatest number of participating families. Resource-intense residential services are required by a small but important group of families who experience disadvantage and high levels of stress.