Article Text

Download PDFPDF

Protocol for a prospective, longitudinal mixed-methods case study: supporting a Model of Care for Healthier Adolescents (The MoCHA study)
  1. Claire Hayes1,2,
  2. Victoria J Palmer3,
  3. Magenta Simmons4,
  4. Bridget Hamilton5,
  5. Christine Simons1,2,
  6. Malcolm Hopwood1,2
  1. 1 The Albert Road Clinic, Melbourne, Victoria, Australia
  2. 2 Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
  3. 3 Department of General Practice, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
  4. 4 Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
  5. 5 Centre for Psychiatric Nursing, The University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to Ms Claire Hayes; c.hayes3{at}


Introduction Improving mental healthcare for adolescents is a global policy priority. Despite demands for community-based services, many adolescents require more intensive interventions, such as an inpatient admission. This is typically at a point of crisis, often accompanied by intense emotional dysregulation, impairment of coping function and impulsivity. However, limited evidence exists on how best to support this group while they are in inpatient care, aside from pharmacological treatments which have a limited role in adolescents. Little is known about the models of care (MoC) offered in inpatient units, whether adolescents perceive these as helpful and the perspectives of caregivers and clinicians. Here, we describe a protocol which aims to explore and evaluate an inpatient MoC.

Methods and analysis We designed a longitudinal, mixed-methods, case study. The population consists of adolescents, caregivers and clinicians at a single inpatient unit in Melbourne, Australia. Standardised outcome measures, including semi- structured interviews, will be administered to adolescents at three time-points, T1 (admission), T2 (discharge) and T3 (6 months post discharge). Caregivers will also be interviewed at T1, T2 and T3. Clinicians will be interviewed once. The measures include: Life Problems Inventory, Quick Inventory of Depressive Symptomatology, Kessler Psychological Distress Scale and the Youth Self-Report. Health of the Nation Outcome Scales for Children and Adolescents will be collected at T1 and T2. Quantitative analysis will include descriptive statistics and paired t-tests summarising adolescents admitted to the unit, clinical characteristics and longitudinal data on symptomatology. Qualitative data will be analysed using both thematic and trajectory analysis. Data collection began in May 2017 and will cease with T3 interviews by October 2018.

  • inpatient care
  • adolescents
  • model of care
  • longitudinal research
  • mixed method design

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

Statistics from


  • Contributors CH, VJP, MS, BH, CS and MH designed the protocol for this study. All authors supervised the design and revised the manuscript. All authors read and approved the final version of the manuscript.

  • Funding This research was supported by the Ramsay Health Care Ella Lowe Scholarship.

  • Disclaimer The study was partially funded by Ramsay Health Care. However, the funders had no role in the design of the study, data collection and analysis. Furthermore, funders were not involved in the decision to publish or preparation of the manuscript.

  • Competing interests None declared.

  • Ethics approval Ethical approval was sought and granted by the Ramsay Health Care Ethics Committee (protocol number EC00242). Once approval was granted, the study was registered with the University of Melbourne’s ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.