{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T20:49:47Z","timestamp":1768423787216,"version":"3.49.0"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T00:00:00Z","timestamp":1727049600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nBackground<\/jats:title>\nThe COVID-19 pandemic was associated with an increase in child and adolescent mental health disorders, with subsequent worsening of patient access to specialist mental health care. Clinicians working in the community were faced with increased demands to diagnose and manage pediatric mental health disorders, without always having the confidence and knowledge to do so. We therefore developed COnnecting Mental-health PAediatric Specialists and community Services (COMPASS)\u2014a collaborative model designed to upskill community clinicians in child and adolescent mental health care and provide them with better access to child and adolescent psychiatry expertise. COMPASS comprises (1) an online Community of Practice (CoP) with fortnightly one-hour sessions covering: anxiety; aggression and challenging behaviours; depression; self-harm and suicidality; eating disorders; and autism spectrum disorder\/complex cases and (2) primary and secondary consultations for general practitioners and paediatricians with an experienced child psychiatrist. We aimed to assess the impact of COMPASS on community clinician self-reported confidence in: managing common child and adolescent mental health disorders (Objective 1, primary outcome); navigating the mental health care system (i.e. knowing how services are organised, accessed, and how to refer patients, Objective 2); diagnosing conditions (Objective 3); prescribing psychotropic medications (Objective 4) as well as the impact on, clinician practice and wellbeing (Objective 5) and outcomes of patients referred by COMPASS clinicians to the child psychiatrist (Objective 6).<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nWe evaluated COMPASS in its first year, with COMPASS running from March to July 2021. Participating clinicians completed pre-post surveys evaluating change in Objectives 1 to 4 above, using study-designed measures. A purposive sample of clinicians was then invited to a semi-structured interview to understand their experience of COMPASS and its impacts on practice and wellbeing (Objective 5). We adopted an inductive approach to the qualitative analysis using the Framework Method. This involved selecting five random transcripts which were double coded and categorized, to generate an initial framework against which all subsequent transcripts were analysed. Themes and subthemes were generated from the data set, by reviewing the matrix and making connections within and between clinicians, codes and categories One child psychiatrist completed a 2-week logbook of the nature and outcomes of primary and secondary consultations (Objective 6).<\/jats:p>\n<\/jats:sec>\n\nFindings<\/jats:title>\n51 (86%) clinicians attended CoP sessions and completed pre-post surveys, with 92% recommending COMPASS to peers. Clinicians reported increased confidence in the pharmacological and non-pharmacological management of all conditions, most notably for management of self-harm. They also reported increased knowledge of how to navigate the mental health system and prescribe medications. Qualitative analysis (n = 27 interviews) found that COMPASS increased clinician wellbeing and reduced feelings of professional isolation and burnout. Over the 2-week snapshot, the child psychiatrist consulted on 22 patients and referred all back to the community clinician.<\/jats:p>\n<\/jats:sec>\n\nConclusions<\/jats:title>\nCOMPASS is associated with improved clinician confidence to manage child and adolescent mental health concerns, navigate the mental health system, improved clinician wellbeing, and reduced need for ongoing mental health care by specialists.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0310377","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T17:28:39Z","timestamp":1727112519000},"page":"e0310377","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of a collaborative model on community clinician confidence in child and adolescent mental health care, wellbeing, and access to child psychiatry expertise"],"prefix":"10.1371","volume":"19","author":[{"given":"Elise","family":"D\u2019Abaco","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Khano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Al","family":"Giles-Kaye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jag","family":"Dhaliwal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3598-775X","authenticated-orcid":true,"given":"Ric","family":"Haslam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chidambaram","family":"Prakash","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3017-2770","authenticated-orcid":true,"given":"Harriet","family":"Hiscock","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,9,23]]},"reference":[{"key":"pone.0310377.ref001","author":"WHO","year":"2021","journal-title":"Adolescent Mental Health"},{"key":"pone.0310377.ref002","author":"D Lawrence","year":"2015","journal-title":"The mental health of children and adolescents: Report on the second Australian child and adolescent survey of mental health and wellbeing"},{"key":"pone.0310377.ref003","article-title":"An analysis of educational outcomes from Young Minds Matter: the second Australian Child and Adolescent Survey of Mental Health and Wellbeing.","author":"LD Goodsell B","year":"2017","journal-title":"Perth: Graduate School of Education, The University of Western Australia.;"},{"key":"pone.0310377.ref004","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1007\/s10802-007-9099-2","article-title":"Social anxiety and peer relations in early adolescence: Behavioral and cognitive factors","volume":"35","author":"SA Erath","year":"2007","journal-title":"Journal of abnormal child psychology"},{"issue":"1","key":"pone.0310377.ref005","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1177\/0004944118823576","article-title":"Impact of mental disorders on attendance at school","volume":"63","author":"D Lawrence","year":"2019","journal-title":"Australian Journal of Education"},{"key":"pone.0310377.ref006","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1007\/s00787-018-1139-7","article-title":"Developmental course of anxiety and depression from adolescence to young adulthood in a prospective Norwegian clinical cohort.","volume":"27","author":"I Ran\u00f8yen","year":"2018","journal-title":"European child & adolescent psychiatry."},{"issue":"9","key":"pone.0310377.ref007","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1097\/00004583-200109000-00018","article-title":"Life course outcomes of young people with anxiety disorders in adolescence.","volume":"40","author":"LJ Woodward","year":"2001","journal-title":"Journal of the American Academy of Child & Adolescent Psychiatry."},{"key":"pone.0310377.ref008","author":"Royal Commission into Victoria\u2019s Mental Health System","year":"2021","journal-title":"Final Report, Summary and recommendations, Parl Paper No. 202, Session 2018\u201321 (document 1 of 6)."},{"key":"pone.0310377.ref009","author":"NHMRC","year":"2021","journal-title":"National Mental Health Commission: Monitoring mental health and suicide prevention reform: National Report 2020"},{"issue":"1","key":"pone.0310377.ref010","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1192\/bjp.2019.32","article-title":"Mental health difficulties across childhood and mental health service use: findings from a longitudinal population-based study","volume":"217","author":"M Mulraney","year":"2020","journal-title":"The British Journal of Psychiatry"},{"issue":"5","key":"pone.0310377.ref011","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1111\/1742-6723.13598","article-title":"Emergency department utilisation by vulnerable paediatric populations during the COVID-19 pandemic.","volume":"32","author":"JA Cheek","year":"2020","journal-title":"Emergency Medicine Australasia"},{"issue":"5","key":"pone.0310377.ref012","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1071\/AH22015","article-title":"Association between COVID-19 restrictions and emergency department presentations for paediatric mental health in Victoria, Australia.","volume":"46","author":"H Hiscock","year":"2022","journal-title":"Australian Health Review"},{"key":"pone.0310377.ref013","first-page":"0004867420984242","article-title":"Clinicians\u2019 perceptions of the Australian Paediatric Mental Health Service System: Problems and solutions.","author":"K Paton","year":"2021","journal-title":"Australian & New Zealand Journal of Psychiatry"},{"key":"pone.0310377.ref014","unstructured":"Wenger E. Communities of practice: A brief introduction University of Oregon Scholars\u2019 Bank2011 [Available from: https:\/\/scholarsbank.uoregon.edu\/xmlui\/handle\/1794\/11736."},{"issue":"1","key":"pone.0310377.ref015","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/1748-5908-4-11","article-title":"Evolution of Wenger\u2019s concept of community of practice","volume":"4","author":"LC Li","year":"2009","journal-title":"Implementation Science"},{"issue":"2","key":"pone.0310377.ref016","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/nuf.12065","article-title":"The Meaning of a Healthcare Community of Practice","volume":"50","author":"S. Seibert","year":"2015","journal-title":"Nursing Forum."},{"issue":"1","key":"pone.0310377.ref017","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1186\/1472-6963-11-273","article-title":"How and why are communities of practice established in the healthcare sector? A systematic review of the literature.","volume":"11","author":"G Ranmuthugala","year":"2011","journal-title":"BMC Health Services Research."},{"issue":"1","key":"pone.0310377.ref018","first-page":"16","article-title":"Getting to uptake: do communities of practice support the implementation of evidence-based practice?","volume":"18","author":"MA Barwick","year":"2009","journal-title":"J Can Acad Child Adolesc Psychiatry"},{"issue":"7495","key":"pone.0310377.ref019","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1136\/bmj.330.7495.839","article-title":"Managing common mental health disorders in primary care: conceptual models and evidence base","volume":"330","author":"P Bower","year":"2005","journal-title":"Bmj"},{"issue":"6","key":"pone.0310377.ref020","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1192\/bjp.bp.106.023655","article-title":"Collaborative care for depression in primary care: making sense of a complex intervention: systematic review and meta-regression","volume":"189","author":"P Bower","year":"2006","journal-title":"The British Journal of Psychiatry"},{"issue":"7235","key":"pone.0310377.ref021","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1136\/bmj.320.7235.614","article-title":"Systematic review of the effect of on-site mental health professionals on the clinical behaviour of general practitioners","volume":"320","author":"P Bower","year":"2000","journal-title":"Bmj"},{"issue":"6","key":"pone.0310377.ref022","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1542\/peds.2009-1340","article-title":"Improving Access to Mental Health Care for Children: The Massachusetts Child Psychiatry Access Project","volume":"126","author":"B Sarvet","year":"2010","journal-title":"Pediatrics"},{"issue":"2","key":"pone.0310377.ref023","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"A metadata-driven methodology and workflow process for providing translational research informatics support.","volume":"42","author":"PA Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"pone.0310377.ref024","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","author":"PA Harris","year":"2019","journal-title":"Journal of biomedical informatics"},{"issue":"4","key":"pone.0310377.ref025","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1071\/AH19177","article-title":"Strengthening care for children: pilot of an integrated general practitioner\u2013paediatrician model of primary care in Victoria, Australia.","volume":"44","author":"H Hiscock","year":"2020","journal-title":"Australian Health Review"},{"issue":"1","key":"pone.0310377.ref026","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/1471-2288-13-117","article-title":"Using the framework method for the analysis of qualitative data in multi-disciplinary health research.","volume":"13","author":"NK Gale","year":"2013","journal-title":"BMC Medical Research Methodology"},{"key":"pone.0310377.ref027","article-title":"Successful Qualitative Research: A Practical Guide for Beginners: SAGE Publications; 2013.","author":"V Braun"},{"issue":"12","key":"pone.0310377.ref028","doi-asserted-by":"crossref","first-page":"2153","DOI":"10.1377\/hlthaff.2014.0896","article-title":"Behavioral health care for children: the Massachusetts child psychiatry access project.","volume":"33","author":"JH Straus","year":"2014","journal-title":"Health Affairs"},{"issue":"6","key":"pone.0310377.ref029","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.genhosppsych.2014.05.013","article-title":"Encouraging and sustaining integration of child mental health into primary care: interviews with primary care providers participating in Project TEACH (CAPES and CAP PC) in NY.","volume":"36","author":"AM Gadomski","year":"2014","journal-title":"General Hospital Psychiatry"},{"issue":"8","key":"pone.0310377.ref030","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1177\/0009922817738330","article-title":"Enhancing Pediatricians\u2019 Behavioral Health Competencies Through Child Psychiatry Consultation and Education.","volume":"57","author":"HJ Walter","year":"2018","journal-title":"Clinical Pediatrics"},{"issue":"1","key":"pone.0310377.ref031","doi-asserted-by":"crossref","first-page":"07","DOI":"10.1542\/peds.2018-3243","article-title":"Five-Year Outcomes of Behavioral Health Integration in Pediatric Primary Care","volume":"144","author":"HJ Walter","year":"2019","journal-title":"Pediatrics"},{"key":"pone.0310377.ref032","unstructured":"The National Children\u2019s Mental Health and Wellbeing Strategy: Australian Government 2020 [1\u2013109]. Available from: https:\/\/www.mentalhealthcommission.gov.au\/mental-health-reform\/childrens-mental-health-and-wellbeing-strategy."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0310377","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T17:28:52Z","timestamp":1727112532000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0310377"}},"subtitle":[],"editor":[{"given":"Saiendhra Vasudevan","family":"Moodley","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,9,23]]},"references-count":32,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,9,23]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0310377","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,23]]}}}