This paper describes the protocol for a pragmatic cluster randomised controlled trial examining the preliminary feasibility, effectiveness, and acceptability of an educational intervention to train mental health clinicians to conduct brief sexual and reproductive health screening with adolescents attending a child and youth mental health service.
Adolescents living with mental illness are more likely than their peers to engage in risky sexual behaviours that can result in STIs, unplanned pregnancies, and sexual coercion or violence.
A lack of skills and confidence among mental health clinicians to discuss sexual and reproductive health (SRH) concerns is identified as a key barrier to SRH care for adolescents with mental illness.
The trial uses a pragmatic cluster randomised controlled trial design to test an educational intervention for mental health clinicians in a child and youth mental health service (CYMHS).
The educational intervention is complemented by a nurse-led SRH consultation referral pathway for adolescents identified through screening as needing further care.
The trial will assess acceptability of SRH screening and nurse-led consultations through qualitative interviews with three groups: clinicians, adolescents, and their parents.
The study identifies an unmet need for SRH care among adolescents living with mental illness and frames the trial as addressing a gap in service provision.
This research describes the design of a clinical trial testing whether training mental health workers to ask teenagers about their sexual and reproductive health can improve access to care for this vulnerable group. Young people with mental health conditions are more likely than their peers to engage in risky sexual behaviours, putting them at greater risk of sexually transmitted infections, unplanned pregnancies, and sexual coercion. Despite this elevated risk, they often do not receive appropriate sexual health care, partly because mental health clinicians feel they lack the skills and confidence to raise these topics. The trial will train some clinicians in a child and youth mental health service in Australia to conduct brief sexual and reproductive health screenings with patients aged 12 to 17, while other clinicians will not receive the training for comparison purposes. When screening identifies a need, teenagers can be referred to a nurse who specialises in sexual and reproductive health. The study will measure how often trained versus untrained clinicians make these referrals, and will also track whether training improves clinicians' knowledge and confidence. Interviews with clinicians, teenagers, and their parents will explore whether this approach is acceptable to everyone involved. This research suggests that embedding sexual and reproductive health screening directly into mental health services could help close a significant gap in care for young people with mental illness. If the approach proves feasible and acceptable, it could inform how mental health services are designed to better address the full range of health needs of the young people they serve. This paper describes the study protocol only; results have not yet been reported.
Blake J, Debattista J, Andersen I, Rao S, Hart E, Gorden N, et al.. (2025). Implementing routine sexual and reproductive health screening into an Australian child and youth mental health service: study protocol for a cluster randomised controlled trial.. Trials. https://doi.org/10.1186/s13063-025-09019-x