An Australian-first paediatric public health service is helping to bridge the gap and advance treatment for young people living with obsessive-compulsive disorder (OCD).
Based at Sydney Children’s Hospitals Network (SCHN), the OCD BOUNCE clinical service provides wrap-around clinical care and intensive treatment in community settings. It also offers specialised training and support for clinicians to enable them to better detect and treat OCD in community mental health care.
It was born out of a broader national research collective, also called OCD BOUNCE, which brings together internationally recognised experts from SCHN, University of New South Wales and Griffith University to advocate for, improve understanding and treatment of OCD.
Dr Iain Perkes, a Clinical Academic Child and Adolescent Psychiatrist at SCHN, leads the national of OCD BOUNCE together with Professor Jessica Grisham (UNSW) and Professor Lara Farrell (Griffith University). They recognised the need for a clinical service to address a significant gap between research and implementation.
An OCD BOUNCE-led study found children and young people with OCD had the second-highest psychiatric hospital admission length of stay and the highest readmission rates.
“The analyses in this paper show how severe and complex OCD can be, and that services need to better respond to this need,” Dr Perkes said.
"SCHN has invested in developing world’s best clinical care and advancing treatment through the establishment of OCD BOUNCE clinical service. It provides capacity to treat patients in the community and keep them at home with their family, friends, and classmates.”
In considering a community alternative to an inpatient admission for those with severe to extreme cases, Dr Perkes and the OCD BOUNCE team developed a service that aims to prevent admissions and ensure wrap-around care to reduce re-admissions
Since the OCD BOUNCE clinical service was established in January 2023, there have been 70 referrals from Sydney, and an additional 12 patients from regional NSW and interstate seen via Telehealth.
Dr Katelyn Dyason, Psychologist and Research Lead, said she is seeing the impact it is having for these children firsthand.
“OCD affects one in 50 children and young people in Australia. Fortunately, most people can achieve full recovery from symptoms if they are able to access the right treatment which is our primary purpose,” Dr Dyason said.
“Seeing patients make such big changes in their lives in a relatively short period of time is something I cherish in my work at OCD BOUNCE. When they’re able to use public transport, go out for coffee, eat dinner with their family again, or leave the house and shut the door behind them – I love sharing all these wins with them.”
OCD BOUNCE is working to increase the number of clinicians within existing mental health services in South-Eastern Sydney LHD (SESLHD) who are trained to deliver specialised cognitive-behavioural treatment, including exposure and response prevention (CBT-ERP) for OCD. So far, 18 clinicians have been trained across six services at SCHN and SESLHD.
Dr Perkes said by supporting and training clinicians to better detect and assess OCD, and deliver ERP, more children and young people can receive treatment earlier in their diagnosis.
“We are proud to be leading the nation in this field, having trained one of the Australia’s first ERP-trained Clinical Nurse Consultants, Seona Wilson,” Dr Perkes said.
“Our vision at OCD BOUNCE is to see mental health clinicians feeling confident and competent at detecting, assessing, and treating OCD using evidence-based practices.
"We know this vision is coming to light in working closely with clinicians at SCHN and SESLHD, as we have received positive feedback from them that the training has been useful and improved their knowledge and competence.”
In addition to expanding the availability of ERP services in the community, OCD BOUNCE is helping to refine the model of care so it can be delivered across NSW in the future.
“Through innovation in service delivery and capacity building within mental health services, OCD Bounce is translating clinical research into practice transforming care for children and young people with OCD,” Dr Perkes said.
The OCD BOUNCE team was invited to the inaugural Youth Mental Health Summit at Parliament House in September to present their innovative work, including the advancement of treatment through the new evidence-based model of care.
Find out more about OCD BOUNCE.