Melbourne Children's Campus Mental Health Strategy 2021-2026

Overview

Lifetime mental health problems begin in childhood and are among the most common and serious health issues affecting children and young people. Half of all mental health disorders begin before the age of 14, yet many families struggle to access timely, appropriate care. 

At The Royal Children’s Hospital (RCH), mental health presentations to the Emergency Department have surged by 400 per cent in recent years. Children living with chronic physical illness are at even greater risk, and stigma and fragmented systems often leave families without the support they need.

Coupled with the findings from the 2020 Royal Commission into Victoria's Mental Health System, this growing crisis demanded a bold and coordinated response across the Melbourne Children’s Campus.

The strategy

Launched in 2021, the Melbourne Children’s Campus Mental Health Strategy set out to make mental health everyone’s business. 

It brought together The Royal Children’s Hospital ( RCH), Murdoch Children’s Research Institute (MCRI), and the University of Melbourne Department of Paediatrics to create integrated, evidence-based approaches to mental health research, education, and care.

Proudly funded by The Royal Children’s Hospital Foundation and the Good Friday Appeal, the strategy aimed to:

• Amplify the voices of children, young people, and families, ensuring lived experience shapes all outputs.
• Integrate clinical and academic mental health research.
• Develop evidence-based mental health education and resources for campus staff.
• Enable consistent, quality child and family centred care, inclusive of parents, carers, and siblings.
• Advocate for the integration of mental health care with physical health care as part of usual practice.
• Increase awareness and develop a shared understanding of trauma-informed care with a focus on preventing trauma and re-traumatisation of children, young people, families, and staff.

Over five years, the strategy delivered significant developments across mental health research, education, care, and advocacy, improving experiences and outcomes for thousands of children, young people, and their families.

The development and implementation of the strategy was supported by many passionate people from across the campus, as well as Lived Experience Advisors.

Lived experience engagement

Our Lived Experience Advisor Network provided the strategy and campus with access to over 1,200 people of diverse ages (over 15 years) and backgrounds who identified with having lived experiences of mental health concerns and recovery as patients and carers.  

We engaged over 840 Lived Experience Advisors (LEA) for consultation, co-design, and co-development in all our deliverables, making sure the needs of children, young people, and their families informed the work.  

Consistent quality care

Clinical practice guidelines capture the available evidence and outline the gold standard of care for supporting children and young people.  

After a rigorous initial systematic review, we identified existing gaps in evidence-based clinical practice guidance for common paediatric mental health problems and set about developing guidelines to address them.

In 2023, we developed Australia’s first Evidence-based Clinical Practice Guideline for Anxiety in Children and Young People.   

With the help of LEAs, the guideline was translated into a family-facing resource to help parents, carers, and supporters in navigating care for their young person.  

In 2024, the guideline was endorsed by the Royal Australian College of General Practitioners (RACGP). It was adapted to several external clinical platforms, including RCH Clinical Practice Guidelines: Anxiety Identification and Management (endorsed by the Paediatric Improvement Collaborative), Melbourne HealthPathways, and Guideline Central (based in the US). 

In 2026, we published another nation-first, Suicide and Non-suicidal Self-injury in Children and Adolescents: Evidence-based Clinical Practice Guideline. This guideline was then adapted to Guideline Central in the US.

Medically unexplained symptoms

Around 30 per cent of young people seen by health practitioners like GPs experience physical symptoms that don’t have a clear medical cause or explanation. These are known as medically unexplained symptoms (MUS), physical symptoms that are not caused by a medical illness.

We have developed a useful guide to help parents, carers, and family members understand and support their young person experiencing MUS.

Other MUS resources:

• eLearn module for RCH staff
• The Education Hub's Conversation with the experts podcast, Medically Unexplained Symptoms (MUS) in young people
• Kids Health Info fact sheet: Somatising and medically unexplained symptoms
• Kids Health Info fact sheet: Somatic symptom and related disorders (SSRDs)

Trauma-informed preventative care (TIPC)

TIPC is a framework for the delivery of care that involves realising the high prevalence of psychological trauma, recognising and addressing its impact on patients, their families, and staff, and preventing re-traumatisation that occurs during care.   
We set about enabling a trauma-informed campus by upskilling staff and developing resources that support a universal approach to TIPC. 
 
Policy summary

In 2024, we developed a policy summary, Paving the Way: Trauma-Informed Preventative Care at The Royal Children’s Hospital, that outlines the RCH's role in recognising, addressing, and preventing the impact of psychological and emotional trauma at the RCH. It positions the RCH’s potential as a leader in paediatric trauma-informed care and advocates for the sustainable implementation of TIPC to improve outcomes for children, families, and staff. 

TIPC foundational training

After a successful pilot, the TIPC Foundational eLearn was launched in 2025 on LearningHERO. Co-designed and developed with RCH staff and Lived Experience Advisors, the module covers:

• the prevalence and impact of psychological trauma
• paediatric medical traumatic stress
• how we can respond to signs of overwhelm
• the impact of secondary trauma and staff wellbeing.

The Behaviour Support Profile (BSP)

The BSP is a trauma-informed digital tool in the Electronic Medical Record (EMR). It documents the psychosocial needs of children and young people visiting the RCH, including their communication preferences, sensory sensitivities, and coping strategies. The BSP helps staff tailor care to each patient, reducing distress and enhancing their sense of safety and wellbeing. 

In 2024, the strategy evaluated the BSP's effectiveness, usability, and impact on improving hospital experiences. Our findings, documented in the evaluation report, highlighted the BSP’s potential for broader application and the need for improved accessibility, awareness, and training to maximise its benefits across the hospital.    

In 2025, we upgraded the BSP in the EMR and released a suite of resources to educate staff, including an EMR tipsheet, eLearn, and nursing guideline.

Family centred care

Families were at the heart of our work. We developed the Family Wellbeing Model with Lived Experience Advisors (LEAs) and clinicians to support staff in recognising and responding to the needs of parents, carers, and siblings during a child’s care journey at the RCH., To assist staff in using the model, we developed an eLearn that provides education on how to start a conversation with family members, direct them to the right services, and follow up to ensure they are supported.

Research

The strategy was committed to integrating and growing mental health research across campus. Along with coordinating our own research initiatives, the Strategy funded seven clinically led research projects. 

Feasibility of a single question: Mental health surveillance in chronic disease 

The objective was to determine the feasibility and acceptability of a single mental health surveillance question to parents and carers of children with chronic disease whilst admitted as inpatients to detect children “at risk”.  

 Publications: 

• Feasibility of single question mental health surveillance in chronic disease; White et al 2022 

Improving mental health among transgender, gender diverse and non-binary adolescents 

The project co-designed and trialled a group mental health program to support transgender and non-binary young people attending The RCH Gender Service (RCHGS), based on a model of cognitive behavioural therapy (CBT) and peer support. 

Publications:

• Evaluation of a codesigned group cognitive–behavioural therapy intervention for trans young people (TAG TEAM): protocol for a feasibility trial and a subsequent pilot RCT; Chinsen et al
• “There’s hope and there’s a future for all of us”: Co-design of a group cognitive behavioral therapy (CBT) intervention for trans young people (TAG TEAM); Chinsen et al
• “I could be one of those people that’s alive and happy”: a qualitative exploration of a co-designed group therapy program targeting gender minority stress for trans young people (TAG TEAM); Chinsen et al 

Evaluating an intervention for psychological distress for children with chronic medical conditions 

Children and young people with chronic medical conditions are 30 per cent more likely to develop an anxiety disorder than children and young people without chronic illness. The project aimed to tailor a manualised, modular and flexible, evidence-based transdiagnostic intervention to meet this population’s needs.  

A randomised controlled trial to provide the best evidence for this therapy is being completed. 

Publications: 

• A waitlist randomised control trial of the unified protocol for the treatment of emotional disorders in children and adolescents with chronic medical conditions (The UP-CAM Study): protocol paper; Botchway-Commey et al

Clinical implementation study of the “Take a Breath” parent program  

The Take a Breath (TAB) group program is an online, group mental health intervention for parents of very sick children. It provides parents with skills to manage distress and psychological challenges presented by their child’s illness, to prevent more serious long-term mental health difficulties. 

A randomised controlled trial was conducted with RCH parents, and it found that TAB effectively reduced symptoms of post-traumatic stress and improved their management of the illness (Muscara et al., 2020). 

The project completed an implementation study where 30 RCH staff were trained to use TAB. Many of these clinicians are now used TAB as part of their usual care, and it is also used by several groups internationally.  

Publications:  

• Traumatic Stress in Parents of Children With Life-threatening Illness: A Randomized Clinical Trial; Muscara et al 

Reducing aggression and irritability in children attending mental health services 

The study aimed to explore the associations between irritability in children accessing mental health care, parent functioning (parental distress and parental irritability), and family dysfunction. 

Publications: 

• The Associations between Child Irritability, Parental Distress, Parental Irritability and Family Functioning in Children Accessing Mental Health Services; Zendarski et al 

COVID Resilience study  

This project worked to understand and respond to the impacts that the COVID-19 pandemic restrictions had on vulnerable RCH children and families. 

Publications: 

• The impact of COVID‐19 on the well‐being of Victorian children born with cleft lip and/or palate; Branson et al 

• Parent-Reported Child and Parent Quality of Life during COVID-19 Testing at an Australian Paediatric Hospital Outpatient Clinic: A Cross-Sectional Study; Brusco et al 

• Characterising the Educational Experiences and Mental Health of Children with Pre-Existing Learning Difficulty or Specific Learning Disorder (SLD) during the COVID-19 Pandemic; Catroppa et al 

• Mental Health Impacts of the COVID-19 Pandemic on Australian Children and Adolescents with a Medical Condition: Longitudinal Findings; Crowe et al 

• Mental health impacts of the COVID-19 pandemic on children and adolescents with chronic health conditions; Crowe et al 

• The indirect impacts of the COVID-19 pandemic on children and adolescents; MCRI 

• Exploring the lived experience of families with a COVID-19 positive child: The journey from a critical grounded theory approach; Kaufam et al 

• Effect of a videoconference-based online group intervention for traumatic stress in parents of children with life-threatening illness: a randomized clinical trial; Muscara et al 
• The impact of the COVID-19 pandemic on children in Australian early childhood education and care; CCCH 

We also funded two large-scale mental health studies, completed in 2026:  

• Interactions that hurt or heal: Patient and parent perceptions of healthcare conflict, mental health impacts and preferences for intervention (interHEAL):;Maria McCarthy 

• “Mighty Minds” - Co-design of an evidence-informed approach to promote the mental health of children living with disabilities and chronic health conditions on the Melbourne Children’s Campus; Rebecca Giallo  

Education  

Evidence-based education is a key driver in delivering great paediatric care across the campus. Throughout the Strategy, we aimed to enhance staff knowledge, skills, and confidence in supporting the mental health and wellbeing needs of children, young people, and their families.  

We delivered a range of accessible education resources for clinical and non-clinical staff, which were integrated into existing programs, including our Mental Health and Wellbeing Learning Hub on LearningHERO.  

We launched digital material such as eLearns, podcasts, and webinars; hosted in-person education sessions such as workshops and Grand Rounds; and produced reference materials such as a policy summary, clinical practice guidelines, and educator resources. 

Some of the education topics we covered included: 

• mental health and wellbeing for young people, families, and staff 
• trauma-Informed Preventative Care 
• the Behaviour Support Profile 
• medically unexplained symptoms 
• childhood anxiety 
• suicide and non-suicidal self-injury 

Mental health advocacy

We aimed to be a strong voice advocating for the mental health needs of children, young people, and families and creating purposeful change across the mental health sector.  

Our advocacy agenda focused on improving outcomes by prioritising workforce mental health literacy, access to evidence-based clinical care, and amplifying lived experience to inform decision-makers. 

Advocacy toolkit 

In 2025, we developed an evidence-informed Advocacy Toolkit f[CD1] or researchers, policymakers, and clinician scientists. The toolkit is a practical step-by-step resource that offers guidance and educational support for planning and delivering impactful public health advocacy. It includes information on timing advocacy, managing risk, integrating lived experience, and tailoring messaging for different audiences, using real case studies. 

Where to next?

The strategy concluded in April 2026 with a focus on sustainability and scale. You can view our Executive Summary Report 2026 on Mental Health Central. 

Our priorities included:

• Investing in the continued integration of mental health research, education, and clinical care to improve outcomes for children, young people, and their families.
• Embedding evidence-based clinical practice guidelines into routine care across the campus and beyond.
• Expanding trauma-informed preventative care education and culture across campus to ensure it becomes a universal approach.
• Progressing research into mental health amongst chronically ill and gender-diverse populations.
• Strengthening workforce mental health education for all campus staff, no matter their role or department.