The COVID pandemic required significant changes in the provision of youth mental health services during the period of lockdown/stay at home orders. Things which were identified as changing significantly during this period included: service via telehealth; working from home, split teams (to reduce infection risk), and social (physical) distancing. An online survey of clinicians was conducted involving both closed and open ended questions. Service staff identified significant benefits from the changes to the way services were delivered as well as some impediments and challenges. Advantages in the new way of working revolved around the flexibility of the virtual service, with appointments online enabling families to more easily overcome issues of transport, work commitments, childcare and disruption to routines and timing. The online platforms also enabled some family members to participate who otherwise might not have been able to come to appointments in person. Disadvantages included where there were issues with availability and access to appropriate technology or private spaces, or when the young person was very young, very unwell, unstable, isolated or at higher risk. This study suggests that telehealth and flexible working arrangements have become an essential new element in the clinicians' toolkit to be offered either alone or as a supplement to in person interventions.

Purpose The purpose of this study was to identify and understand the barriers and enablers to the implementation of youth peer support in a clinical mental health service. The development of a lived experience workforce in mental health is a key component of policy at both the state and the federal level in Australia. Implementing a peer workforce within existing clinical services, however, can be a challenging task. Furthermore, implementing peer support in a youth mental health setting involves a further degree of complexity, involving a degree of care for young people being invited to provide peer support when they may be still early in their own recovery journey. Design/methodology/approach This paper reports on a formative evaluation of the beginning stages of implementation of a youth peer workforce within an existing clinical mental health service in Melbourne. Findings The project found that it was feasible and beneficial to implement youth peer support; however, significant challenges remain, including lack of appropriate training for young people, uncertainty amongst clinical staff about the boundaries of the peer role and the potential for “tokenism” in the face of slow cultural change across the whole service. Originality/value Very little evaluation has yet been undertaken into the effectiveness of implementing peer support in youth mental health services. This paper offers an opportunity to investigate where services may need to identify strengths and address difficulties when undertaking future implementation efforts.

Objective To examine the evidence for best practice in educational support to hospitalised students and describe the existing supports available across each Australian state and territory. Methods A descriptive approach to the diversity of current practice and a review of the published evidence for best practice. Results We have constructed a model of best-practice in education support to hospitalised students. We found that education support services in each state met some of the criteria for best practice, but no one state service met all of the criteria. Conclusions All Australian states and territories make provision for hospitalised students to continue with their education, however the services in some states are closer to the best-practice model than others. What is known about the topic? It is well known that children and young people living with health conditions are at higher risk of educational underachievement and premature disengagement from school than their healthy peers. Although each state and territory across Australia offers some form of educational support to students during periods of hospitalisation, this support differs widely in each jurisdiction in fundamentals such as which students are eligible for support, where the support is delivered, how it is delivered and who coordinates the support. Published evidence in the literature suggests that the elements of good practice in education support have been well identified but, in practice, lack of policy direction can hinder the implementation of coordinated support. What does this paper add? This paper draws together the different models in place to support students in hospital in each state and territory and identifies the common issues that are faced by hospital education support services, as well as identifying areas where practice differs across settings. It also identifies the elements of good practice from the literature and links the elements of theory and practice to present a model of education support that addresses the needs of students with health conditions in an integrated and child-centred way. What are the implications for practitioners? Education support has developed over many decades in a variety of different forms across the states and territories of Australia. This paper brings together for the first time the published evidence for good practice in this area with existing models of practice to identify ways in which both healthcare professionals and education professionals can work together to improve the health, well being and education of children and young people living with health conditions.

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