Evaluation of a Mental Health Service for Young Children: Development, Outcome and Satisfaction

Area of Science:

• Child and Adolescent Mental Health
• Community Health Services
• Healthcare Management

Background:

• A child guidance clinic evolved a community service for parents of young children with mental health issues between 1984-1996.
• The service included primary care staff support and training, with clinical input shifting from a clinic-based model to a community nurse-led service.
• Nurses increasingly managed cases independently, referring only complex situations to specialists.

Purpose of the Study:

• To compare the effectiveness and cost of a specialist under-five clinic (1990-91) with a community nurse-led service (1994-95).
• To evaluate parental satisfaction with both service models.
• To assess the validity and reliability of a parental satisfaction questionnaire.

Main Methods:

• Comparative analysis of clinical work between 1990-91 and 1994-95.
• Outcome measurement using 5-point Likert scales for problem severity, completed by families and clinicians pre- and post-treatment.
• Cost analysis of both service models and development of a satisfaction questionnaire for the 1994-95 evaluation.

Main Results:

• The community nurse-led service (1994-95) showed a slight decrease in effect size but was two-thirds less costly than the previous clinic.
• Parental satisfaction was high for both service models.
• The developed parental satisfaction questionnaire demonstrated face validity, construct validity, and internal consistency.

Conclusions:

• Community-based services delivered by nurses are a cost-effective approach for families with young children's mental health problems.
• A subset of families requires referral to specialist teams; further research is needed to define appropriate referral criteria and timing.
• The parental satisfaction questionnaire is a valid and reliable tool for assessing family experiences with mental health services.