Integrating healthcare into education settings represents a promising model to address complex health problems in disadvantaged communities through improving access to health and social services. One such example of an effective school-based health hub is the Our Mia Mia (OMM) Wellbeing Hub, located in a primary school in Nowra and servicing a community experiencing significant socioeconomic disadvantage. The efficacy of OMM rests on its success in facilitating access to services by removing the barriers of cost and transport and establishing connection to community. The OMM fosters collaborations between health professionals and educators to coordinate holistic treatment and implement appropriate student supports in a timely manner. The support of key individuals and groups, in addition to the flexibility of the model, has allowed the hub to pivot and adapt to meet the changing needs of its community, particularly as challenges pertaining to bureaucracy, financial sustainability and community mistrust have presented themselves. Future directions for the OMM hub, and the possibility of adapting and translating school-based healthcare delivery models in other disadvantaged communities, is discussed.

Young people in Out of Home Care (OoHC) have complex mental health and psychosocial needs due to a range of individual, systemic and intergenerational factors that may limit the effectiveness of usual clinic-based services. To address this, in 2017 an assertive-integrated service (AIS) model of care was adopted by the Child and Adolescent Mental Health Service (CAMHS) in South Western Sydney Local Health District (SWSLHD), Australia, through outreach to the young person in the community. This paper outlines the study protocol comparing AIS with clinic-based CAMHS usual care to meet the physical, mental health and wellbeing needs of young people in OoHC. Using routinely collected outcome data, the AIS model will be compared to clinic-based CAMHS treatment as usual care. Measures of overall functioning (e.g. Global Assessment Scale [CGAS]), psychological functioning (e.g. Strength and Difficulties Questionnaire [SDQ]), general health and social functioning (e.g. Health of the Nation Outcome Scales for Children and Adolescents [HoNOSCA]) and other relevant socio-demographic and clinical variables will be collected at intake and at 3-month intervals until discharge from the respective services. Semi-structured interviews will also be conducted with young people, their carers, and service providers, to examine qualitative themes about the suitability of service provision. It is expected that a better understanding of the key indicators of functioning for young people accessing AIS and clinic-based services will help inform what works for these young people so that they can receive targeted and tailored support from the start of service engagement.

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Issues AddressedIntegrated school‐based health services have the potential to address the unmet health needs of children experiencing disadvantage, yet these models remain poorly evaluated. The current article examines an integrated social and health care hub located on the grounds of a regional Australian public primary school, the Our Mia Mia Wellbeing Hub, to identify critical success factors for this service and others like it.MethodsSemi‐structured qualitative interviews were conducted with N = 55 multi‐sector stakeholders comprising parents, students, school staff, social and health care providers, and local Aboriginal community members. Interview transcripts were analysed according to a grounded theory approach.ResultsSix themes emerged from the analysis, reflecting important success factors for the model: service accessibility; service coordination; integration of education and health systems; trust; community partnerships; and perceptions of health.ConclusionsFindings highlighted Our Mia Mia as a promising model of care, yet also revealed important challenges for the service as it responds to the varied priorities of the stakeholders it serves.So What?Through capturing the perspectives of a large number of stakeholders, the current study provides valuable insight into key challenges and success factors for Our Mia Mia; these learnings can guide the development of other emerging school‐based health services and integrated care hubs.