Implementing evidence-based care for paediatric obsessive-compulsive disorder in public mental health services: clinician perspectives of barriers and enablers

Objective: To evaluate the feasibility and acceptability of a model of care for paediatric obsessive-compulsive disorder (OCD), by outlining the barriers and enablers experienced by clinicians implementing the model in routine public health settings. Method: Six child and adolescent public mental health services participated in a Type 2 implementation and effectiveness trial of an OCD model of care. Clinicians were trained in screening, assessment, psychoeducation and group-based exposure with response prevention. Focus group interviews were conducted at the conclusion of the trial with clinicians from each service. Interview responses were guided by a logic model to elucidate enablers and barriers to implementation, considering resources, moderators, mediators and outcomes. Results: Implementation varied across services. Three key themes emerged. Firstly, existing resources were directly and inversely linked to implementation. Secondly, OCD training and specialised clinical support increased clinicians' knowledge and skills, benefitting both clinicians and clients. Finally, case complexity influenced how and when implementation occurred. Conclusions: The model of care was feasible and acceptable. Adjuncts to clinical service delivery (e.g. attending training) were easier to implement than changes to existing procedures (e.g. introducing screening). Aligned with the UK NICE guidelines, this model of care may be suitable for public Australian services to improve OCD detection and treatment for young people.