Balancing our focus: The development of a collaborative approach between child development and children’s mental health services

Abstract

Child development and children’s mental health services are currently not an integrated service in Brisbane (and many other regions around the world). Children with social-emotional, behavioural and developmental issues present to both child development and children’s mental health services.Without joint collaboration, it is difficult for either team to independently gain a thorough understanding of both the child’s developmental profile and the environmental context in which the development occurs. This can prevent the adequate meeting of the child and family’s needs and can reduce the appropriateness of interventions.Clinicians in Zero to Four Child and Youth Mental Health and the Child Development Service in northern Brisbane have recently begun to work more closely when families require the involvement of both services. A joint formulation, developed collaboratively from the initial assessments of both teams, focusing on identifying need and responding to need, can be an innovative solution to lengthy waiting times and may contribute to earlier intervention.1 The collaboration has been motivated by a biopsychosocial framework and systems theory which emphasise that you cannot separate a child from the family and environment in which they live. Current research highlights the interlinking of developmental and psychological processes and the relational context of development.Balancing both a developmental and mental health focus is important in order to fully meet the needs of the children and families. In order to integrate emotional and developmental schools of thought in clinical formulation and therapy, it is necessary to maintain a reflective stance within teams. This prevents clinicians from merely “seeing what we know” and to consider the most effective treatments.Collaboration during the assessment process has led to greater accuracy in formulating the child’s difficulties while also reassuring parents and carers that the health professionals are “on the same page.” In addition, it has enabled the opportunity for early intervention related to mental health concerns for the child. When a child’s mental health needs are addressed within the family context, this creates a setting which will optimise the progress of the child with developmental challenges, enabling them to be the best that they can be. This presentation will include a discussion of how the child development and children’s mental health services inspire to work together with the family’s best interest in mind. Cases which involved collaboration between the two services will be presented, including a case where there was uncertainty as to whether a diagnosis of autistic spectrum disorder or trauma was more appropriate. Methods used to sensitively gather a detailed history and support the family through the assessment process will be described. We will also consider what the collaboration between services has meant for the families and clinicians involved.