Introduction

Conduct disorder is the most common childhood mental health disorder with the greatest long-term costs to the individual, families and society. The NSW Ministry of Health, through MH-Children and Young People (MH-CYP), provides leadership and management of the Got It! (Getting On Track In Time!) program which delivers specialist mental health early intervention services for children in Kindergarten to Year 2 (K-2) of 5-8 years of age who display emerging conduct problems. Got It! is delivered in schools by NSW Child and Adolescent Mental Health Services (CAMHS) in partnership with the Department of Education (DoE).

Extensive Australian and international research provides evidence for the effectiveness of clinical interventions for children in this age group with emerging conduct problems. Economic evaluation has indicated that targeted programs deliver significant economic benefits to the individuals through health, education and employment benefits and to society in the form of savings to social welfare and criminal justice systems (Knapp M. et al, 2011).

Got It! is modelled on the successful CASEA (CAMHS and Schools: Early Action) program in Victoria designed to assist schools and families to support primary school-aged children with their social, emotional and behavioural development (Brann, Corby, Costin, McDonald, Hayes, & Turner, 2007). The Got It! program is conducted in schools across two school terms by child mental health clinicians as a multilevel intervention. A targeted clinical program is supported by a universal wholeof-school intervention designed to enhance parenting skills and to build capacities for school staff to respond effectively to emerging conduct problems. Got It! pilot teams were established in Dubbo, Newcastle and Mt Druitt in 2011.

The Got It! pilot demonstrated the successful implementation in the NSW context of a clinical mental health service for conduct disorder provided in schools. Key findings of the independent evaluation of Got It! include significant positive behaviour shift for children completing the targeted intervention, significant improvements in parenting with the majority of parents continuing to improve at the 6-8 month follow-up and economic benefits projected in the long term (Plath, Croce, Crofts & Stuart, 2016). Delivering the program in the school context was found to be effective in engaging families to take part in the targeted intervention. Findings also demonstrated additional benefits including increased connection between parents, the school and local community and improved appropriate help-seeking by parents for assistance with other health and social needs (Plath, Crofts & Stuart, 2015).

The Got It! model has been refined in response to evaluation findings and an extension of the independent Got It! evaluation focused on the effectiveness of Got It! interventions two years post intervention. For the children with sustained improvement, parents reported positively about their child’s behaviour and attributed improvements to the Got It! program and the support and strategies provided by the school. It also highlighted the important role that Got It! has in linking children with more significant physiological and psychological issues and families facing social/ environmental stressors with specialist services.

These guidelines have been commissioned by NSW Ministry of Health and prepared by Debbie Plath Consulting in consultation with the Got It! pilot teams in Hunter New England, Western NSW and Western Sydney Local Health Districts (LHDs) and MH-CYP. The purpose of the guidelines is to provide a reference, framework and resources to assist managers and clinicians in LHDs in establishing Got It! programs in schools in their local district. Collaboration with regional DoE staff is fundamental to launching a local Got It! initiative. Program fidelity in implementing this evidence-based model is important to maintain confidence in the effectiveness of outcomes. For this reason, it is important that all components of the Got It! model are included when implementing the program.

The guidelines comprise three parts: n Part 1: provides an overview of the program components, principles and evidence for effectiveness. n Part 2: includes detailed information on the procedures for program implementation. n Part 3: contains resources developed by the existing Got It! teams and MH-CYP to support program delivery.