Stepped care in child and youth mental health services: Current developments and challenges of adapting IAPT for Australia

The delivery of child and youth mental health (CYMH) services in Australia is fragmented across various government, charity, and private organisations. Only a minority of children and youth access and receive the appropriate evidence-based mental health support, and current service models are largely inadequate to resolve this. There is urgent need to adopt evidence-based models of service delivery in Australia to optimise use of resources in providing support to children and young people with mental health treatment needs. Here we present the IMPACT model, an adaptation of the UK’s IAPT model for the Australian context, that attempts to address some of these problems through 3 mechanisms of change to mental health service delivery: immediate engagement in online psychological interventions through stepped care; measurement-based care; and practitioner training in stepped care. We describe our early experiences of implementing the IMPACT model at one pilot trial site within the Western Australia Child and Adolescent Mental Health Service. The current work highlights the salience of engaging stakeholders at all levels of the mental health care system, to ensure integration and sustainability of the IMPACT model in a way that addresses the current problems of the Australian CYMH system.