Health needs and timeliness of assessment of Victorian children entering out‐of‐home care: An audit of a multidisciplinary assessment clinic

Abstract

Aim To describe the health needs identified in children attending a comprehensive health assessment at a tertiary hospital, multidisciplinary clinic for children following entry to out‐of‐home care and timeliness of referral and assessment compared with national recommendations. Methods This was a retrospective audit of all the children who attended the Pathway to Good Health clinic at The Royal Children's Hospital, Melbourne from May 2013 until 31 August 2016. Results A total of 119 children aged 0–12 years attended the clinic during the audit period. Of these children, 17% (including more than 30% of 0–2‐year‐olds) were not up‐to‐date with immunisations, and 87% had physical health concerns that were addressed on the day or needed further management. Over 50% had mental health concerns identified (76% of 7–12‐year‐olds). In children aged 3–6 years, 64% had behavioural problems and 77% had developmental problems identified. Only a third of the children was referred to the Pathway to Good Health clinic within the national standard of 30 days post‐entry to care, and 24% of children attended within 3 months of entry to care. Conclusion Children in out‐of‐home care within Victoria have high rates of physical, mental and developmental health concerns, consistent with previous studies. Timeliness of attendance at the clinic was low compared with national recommendations, even within a programme designed to facilitate timely health checks. This is the second and largest Australian study exploring timeliness of health checks. Further research would establish whether these results are more systemic.

Foster and kinship carer survey: Accessing health services for children in out‐of‐home care

“…The largest gap between carer‐perceived need and service use was in mental health, and mental health services were the hardest to access. We know from previous studies that rates of mental health problems and the need for appropriate care are very high 2,4,14 . The limited demographic data about the children described in this study showed that 42% of those in foster care had at least three previous placements, increasing their likelihood of behavioural and mental health problems 27 .…”

“…We know from previous studies that rates of mental health problems and the need for appropriate care are very high. 2,4,14 The limited demographic data about the children described in this study showed that 42% of those in foster care had at least three previous placements, increasing their likelihood of behavioural and mental health problems. 27 The difficulties accessing mental health services existed across metropolitan and regional areas, regardless of carer education level or socio-economic status.…”

“…Studies within Australia and internationally have demonstrated that these children and young people have higher prevalence of health needs across all domains of health: physical, developmental and mental health 2–4 . Due to these high rates of need, Australian and international peak health bodies and state and federal guidelines recommend routine assessment of health needs upon entry to OOHC (including dental, hearing and vision assessments), followed by the appropriate services or treatments as required 5–7 .…”