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To implement and evaluate strategies suggested by general nurses to improve management of children and adolescents with mental health problems admitted to a paediatric unit of a general hospital.The first phase of a study using a Participatory Action Research approach identified several concerns associated with general nurses providing care to young people with mental disorders in paediatric units of general hospitals, together with suggestions for strategies to address these issues. This paper describes the second and third phase of the Participatory Action Research study, involving the implementation and evaluation of these strategies.Participatory Action Research.Actions that occurred during phase two of the Participatory Action Research study included revision and introduction of policies and procedures for mental health care in the unit, education and training sessions for paediatric nursing staff and opportunities to strengthen communication between existing mental health services. In phase three, two focus groups were conducted to explore current perceptions of mental health care delivery in the unit and evaluate change, following phase two.Changes in clinical practice for paediatric mental health care were acknowledged by participants. Reflection has assisted nurses to better understand their strengths and weaknesses and to acknowledge and challenge the assumptions on which their ideas, feelings and actions about patients with mental health issues are based. Participants also recognised the existing skills and expertise they possess that are relevant to the management of young people with a mental health problem, although they continue to seek ongoing education and support in this field.This study demonstrates that through Participatory Action Research it is possible to enhance mental health nursing care in a rural paediatric unit.Such changes have the potential to improve the experience of young people and their families whilst receiving treatment for mental health conditions in a general paediatric unit.