The National Psychosocial Support Measure 8-17 Years

About the program:

Accoras was funded by the Brisbane South PHN to develop and pilot a developmentally appropriate adaption of the National Psychosocial Support Measure (NPSM) for children and adolescents 8 - 17 years who have, or are at risk of, severe mental illness but are not eligible for support through the NDIS. The NPSM pilot delivered developmentally-tailored, trauma informed, non-clinical mental health support tailored to the individual needs of younger clients and their families/caregivers. The evolution of the NPSM pilot, the services it delivered, and the outcomes for clients were captured through an independent evaluation.

Support Approach:

Two distinct client journeys were developed – one for children 8 – 12 yrs, one for adolescents 13 – 17 yrs. 

• Exclusively outreach model sees services delivered at home, in schools and at any other location important to the child / family.
• The Strengths and Difficulties Questionnaire, the Social and Occupational Assessment of Functioning, and the Kessler Psychological Distress Scale (K10) were used as assessment and outcome measures along with a comprehensive and holistic semi-structured conversational assessment.
• Strong focus on family / caregivers, with intervention designed to enhance family functioning and build caregiver skill, in addition to reducing psychosocial dysfunction in the client.  
• Initial service modelling envisioned psychosocial skill building to be the primary intervention delivered, but die to high unmet need and very limited service availability, case management and health service navigation and advocacy were also key service delivery activities.  
• Fortnightly meetings with the commissioning body and evaluators, and monthly meeting with service system stakeholders, assisted the pilot to rabidly adapt to local needs and feedback. This process also assisted collaboration and information-sharing between local mental health programs.
• 162 children and adolescents received 1881 service contacts in the 6 month pilot period.

A Case Study:

Carlos, 8 years

Background and goals of intervention

Carlos was referred to the NPSM pilot with concerns related to damaging property, family difficulties, deliberate self-harm and harm to others. Secondary concerns related to low self-esteem, stealing and difficulties with peer relationships. Carlos lives with his two brothers, sister, mother and father. Carlos’s father has been diagnosed with Bipolar and has been hospitalised three times. Carlos’s mother has concerns that the father’s deteriorating mental health is greatly impacting the children and the family unit. Carlos’s older brother is also engaged with the NPSM program and Carlos’s mother had concerns that Carlos was displaying similar behaviours as his brother.

Carlos has never been engaged with any services prior to NPSM engagement.

Carlos was open to engaging with the program and developed certain goals with the practitioner and his mother.

1. Reduce self-harm and harm towards others
2. Boundary setting / healthy relationships
3. Confidence building / identity
4. Perspective building
5. Coping strategies for anger and frustration

Action Plan:

A Lifeskills Action Plan was developed that spoke to the goals Carlos had agreed to work towards. Actions collaboratively undertaken by the NPSM Practitioner, Carlos, and his family were multifaceted and included:

• Confidence and identity building through identifying positive characteristics and achievements.
• Perspective building through the use of identifying values, role play and perspective taking through the use of comic strip characters.
• Workshop on anger mapping/identification and strategies to manage anger and frustration.
• Safety planning with the family through the use of an application to reduce self-harm.
• Coaching to equip Carlos with the confidence to engage with some of his friends.
• Carlos has reached out to one of the young people he plays with at school, and organised times to play online together on the weekends.
• Carlos has developed strategies with bullying at school. Carlos was able to speak to one of the young people at school who had bullied him previously and he has since requested to be his friend online.

Outcomes to date

Carlos self-reported and mother-reported mood has improved. Carlos is now able to regulate his emotions and use strategies to manage this. Carlos reports he is better able to listen to instructions.

Mother reports Carlos is no longer stealing, no longer self-harming or harming others. Mother reports she is pleased with Carlos’s improved mental wellbeing. Mother reports Carlos’s confidence has increased and this was an initial concern for her.

Carlos’s mother completed the Strengths and Difficulties Questionnaire (SDQ) as one of his outcome measures. His pre score was 21 (abnormal range); his review score was reduced to 7 (normal range) four months later.  

Learn more about NPSM at the Child and Adolescent Mental Health Conference.

Suzie Lewis will presenting on Tuesday breaking down a case study from this pilot program.

*NPSM has recently been renamed by the department, it is now also known as the Commonwealth Psychosocial Support Program (CPSP).