equally well - together we can make a difference€¦ · equally well - together we can make a...
TRANSCRIPT
Level Health
Presenters Tanya Ewart
Elida Meadows
Russell Roberts
Equally Well - together we can make a difference
#EquallyWell
www.equallywell.org.au
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The Facts:People who experience mental health conditions have:
Cunningham et al. NZMJ 2014 127:1394 www.equallywell.org.au
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Physical health of people living with SMI
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Comorbidities
• 80% of people living with a mental illness have a chronic physical illness (ABS,2017)
• 55% have two or more co-existing conditions(AIHW, 2017)
• 20% of people with a physical illness have a co-existing mental illness (ABS, 2015)
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Number of premature deaths is high in Australia for peopleliving with mental illnessABS 2017
0 500 1000 1500 2000 2500 3000 3500 4000 4500 5000
Trachea, bronchus and lung cancer
Ischaemic heart diseases
Chronic lower respiratory diseases
Colon, sigmoid, rectum and anus cancer
Breast cancer
Intentional self-harm
Blood and lymph cancer
Cerebrovascular diseases
Diabetes
Annual number of premature deaths of persons with mental illness in Australiaby cause
Mental illness Rest of the population
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The risk of premature death is high in Australia for peoplewith mental illnessAbs 2017
51
51
52
52
55
56
56
61
64
13
0% 20% 40% 60% 80% 100%
Blood and lymph cancer
Colon, sigmoid, rectum and anus cancer
Diseases of the urinary system
Intentional self-harm
Diabetes
Trachea, bronchus and lung cancer
Breast cancer
Prostate cancer
Chronic lower respiratory diseases
Persons accessing MBS/PBS mental health related treatment
mental illness
rest of pop'n
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Relative risk of early deathABS, September, 2017
7
0
1
2
3
4
5
6
7
8
9
10
Stan
dar
dis
ed d
eath
rat
e
General Population
Mental Illness
MI and disadvantage
MI and rural
MI and male
MI and not in workforce
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Relative risk of early deathABS, September, 2017
8
0
1
2
3
4
5
6
7
8
9
10
Stan
dar
dis
ed d
eath
rat
e
General Population
Mental Illness
MI and disadvantage
MI and rural
MI and male
MI and not in workforce
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The Paradox - Dying for a Life Worth Living…
“Many people are spending years living with undetected
but treatable physical health problems and people are losing their lives because
things have been picked up too late”
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The Drivers of Inequities
Health systems
Workforce issues
Exposure to known risk
factors
Psychotropic Medication
Socio-economic
status
Adverse childhood
experiences
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Taking Action
Health Systems >
Integrate practice
Address Stigma & discrimination
Workforce Issues >
Address diagnostic overshadowing
Exposure to known risk factors >
Support healthy lifestyles
Psychotropic Medication >
Prescribe for wellbeing
Socio-economic status >
Support employment aspirations
Adverse Childhood Experiences >
Trauma informed care
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2014: A Call to Action
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WE are here
Stakeholder interviews
Grey Literature
Review
Published literature Review
Draft
Workshop Materials
Consensus Building Workshop
AdditionalStakeholder interviews
Grey Literature
ReviewCont.Broad Consultation
Draft
Background Paper
DraftConsensusStatement
FinalConsensus
Statement and Background Paper
Endorsement by OrganisationsMental Health Drug and Alcohol
Principal Committee
EWIC
ExpertAdvisory
Group
Implementationand
collaboration
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Building on a strong base
• 6 focused reports (Australian)
• 10 state and territory mental health plans
• 6 national mental health plans
• 7 Australian consensus statements
• 41 state and territories mental health/physical health clinical guidelines and related policy documents
• 8 international ph-mh statements/plans/platforms
• 125 reviews, reports, research papers.
15https://equallywell.org.au/
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Working in partnership
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Av All Items
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P
o
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t
R
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g
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c
a
l
e
COMPARISON RATINGS OF 80 CONSENSUS ITEMS FOR 8 WORKSHOP GROUPINGS AND TOTAL SAMPLE
Av Total sample Psychiatrist -clinician (3) Service Provider (10) National Organisation (7) Other - misc (4)
Academic Researcher (3) Professional Colleges (8) State Terrritory MH (11) Carer -Consumer (8)
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EW
Promote
Awareness
• Stakeholder database
• Communication strategy
• Website
• Social media campaigns
• Newsletters
• Symposium
Facilitate Collaboration
• Virtual communities
• Social and digital media
• Connecting initiatives
• Symposium
Set Targets & Measure Progress
• National snapshots
• MHISSC data/targets
• ABS monitoring
• Self evaluation
• Web-based analytics
• Stakeholder consultation
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EW
Measure Progress
• Audit tool. Test-retest
• MHISSC data/targets
• ABS monitoring
• Self evaluation
• Web based analytics
• Stakeholder consultation Promote
Awareness
• Stakeholder database
• Communication strategy
• Website
• Social media campaigns
• Newsletters
• Symposium
Facilitate Collaboration
• Audit of activities
• Symposium
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A health system…?
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in the universe of Australian health and human services
Shared vision
Pro
mo
te awaren
ess
SQPSCNT
SA
WA
QldNSW
Vic
Tas
ACTCom
MHISSC
NT
SA
WA
QldNSW
Vic
Tas
ACTCom
NMHCCFNT
SA
WA
QldNSW
Vic
Tas
ACT
MHPCNT
SA
WA
QldNSW
Vic
Tas
ACTCom
Com
AMSs
GPs
ANMF
APS
PHNs
Faci
litat
e co
llab
ora
tio
n
HeAL
Measure progress
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A Growing Movement
Since November 2014,
it has grown from 8
organisations to more than 200
in ANZ
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Aust
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Te Pou o te Whakaaro Nui
• 2014 Evidence review
• 2017 Evidence update
National Mental Health Commission
• 2018 Narrative review
Evidence Informed
www.equallywell.org.au
1981 2013
Over 20,000research publications
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Increasing access to primary care: Canterbury’s Equally Well extended GP consults
Four extended consultations per year for everyone who has been, or is expected to be, on antipsychotics for more than 3 months
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Diabetes strategy (p.21)
• By 2020 there should be routine diabetes screening for all people who experience mental health and addiction issues.
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Current policy directions
• National Consensus Statement
• National Mental Health Commission Report Card
• ACSQHC – Health care standards – Health service standards
• ABS tracking and reporting (Sept 2017)
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Involve patients in co-
designing service or practice solutions
Offer “stepped” solutions –
alternative and complementary
medicine, not just pharmacological
Empower Patients to
Self-research solutions and bring
them to you
Screen for deficiencies
(i.e. B12) and Inflammatory Conditions/
Autoimmunity
Connect people with
formal or informal Peer
Support
Offer longer appointments,
employ nursing or admin for
holistic/root cause screening questions
What can YOU do to improve people’s wellbeing?
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WHO Multilevel ModelLiu et al. (2017) Roberts, Locket, Bagnall, Maylea, Hopwood (2018)
Individual-focused interventionsMental health disorder management•Early detection and appropriate treatment•Interventions delivered at critical time points (e.g., within first year of discharge from hospital)•Recovery-oriented treatment (e.g., service-user involvement, informed choice)Physical health treatment•Early detection and appropriate treatmentLifestyle behaviour interventions•Tobacco cessation•Behavioural weight management programmes, including healthy diet, physical activity•Interventions addressing substance abuse and risky sexual behaviour
Health system-focused interventionsService delivery•Screening for medical conditions•Care coordination or collaborative care strategies (e.g., nurse care manager)•Guidelines for integrated delivery of mental and physical health care
Community level and policy-focused interventionsSocial support•Peer support programmes•Family support programmes•Mental health and consumer advocacy groupsSigma reduction interventions•Directed toward communities with SMD and general publicLifestyle behaviour interventions•Comprehensive health care packages, insurance parity and quality•Public health programmes(tobacco cessation, HIV prevention, suicide prevention)•Employment, housing, and social welfare sector involvement
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Get your organisation and/or professional body to endorse the consensus position paper
Sign up to receive the Equally Well e-news
Be part of the discussions on the Equally Well online
Spend some time today thinking about one or two actions you can start tomorrow…
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Join the conversation
Equally Well Symposium
Melbourne,
28, 29 March 2019
Supported by RMIT, CSU, NMHC
www.equallywell.org.au