Mental Health

Reform

What is the mental health reform?

• Federal Government engaged the National Mental Health Commission (NMHC) to review mental health programs

• NMHC released report in November 2014

• Australian Government response to report released in November 2015

Reform is about …. localised services delivered through Primary Health Networks

• Identify needs and challenges that are specific to communities that do not always fit the one-size-fits-all model of service delivery run from Canberra.

• PHNs will lead the procuring of mental health services they consider necessary and appropriate to the needs of their local communities, rather than them being contracted at a fragmented national level in Canberra.

Stepped Care Approach

Well Population

At risk groups (early

symptoms, previous illness)

Mild mental illness

(self help psychological)

Moderate mental illness and access to psychological

services

Severe and complex

mental illness (packaged

care)

• What do we need to achieve?• What services are relevant?• What are the typical workforce requirements?

Six Focus Areas:

• Youth, including children

• Indigenous (mental health and suicide)

• Suicide prevention

• Low intensity services

• Hard to reach groups (under serviced)

• Severe and complex

GCPHN Consultation

• Community Advisory Council and Clinical Council meetings

• 20 Deep Dive Service Visits

• HHS consultations

• Indigenous specific consultation

• A community briefing which attracted 96 attendees

• MHN service visits x 14 with 17 staff

• MHN service provider forum

• ATAPS Forum

• Suicide prevention breakfast with service providers

• Consumer journey mapping to include the documenting the lived experience of 6 individuals

• Human Voice Connections – Consumer group consultations

• GP Advisory Group meetings x 2

• Mental Health Working Group 22 July 2016

• AoD working Group 22 July 2016

• GP Forum with 40 General Practice staff

Mental health for GC

• Gold Coast has a slightly higher rate of people with mental health and behavioural problems compared to Queensland

• Gold Coast Health data indicates increase in demand for mental health services in the Emergency department, community and inpatient mental health services. The increase in the amount of drug and alcohol related presentations have increased complexity of mental health presentations

• Gold Coast Medicare data indicates females are more likely to access services for mental health 61.4% and only 38.6% for males

• Indicative data suggests that treatment varied considerably according to severity of illness (94% for people with severe, 64% for people with moderate, and 26% for those with mild mental illness)

• People with a current mental health issue are the fastest growing client group for specialist homelessness services, growing at an average rate of 12% each year since 2011–12

Mental health for GC

Alcohol and Drug

Additional funding to address the under-investment in alcohol and drug services

Alcohol and other Drugs

• Increasing service delivery capacity of drug and

alcohol treatment sector

- Improved regional coordination

- Commissioning additional drug and alcohol

treatment services

- Focus on methamphetamine use

Alcohol and other Drugs

In scope treatment services for AoD funding:

• Early intervention targeting less problematic drug use,

including brief intervention

• Counselling

• Withdrawal management with pathways to post acute-

withdrawal support and relapse prevention

• Residential rehabilitation with pathways to post

rehabilitation support and relapse prevention

• Day stay rehabilitation and other intensive non-

residential programmes

• Post rehabilitation support and relapse prevention

• Case management, care planning and coordination

• Supporting the workforce undertaking these service

types through activities that promote joined up

assessment processes and referral pathways and

support continuous quality improvement, evidence

based treatment and service integration and

coordination

Alcohol and other Drugs

GCPHN Response

Service Mapping

Service data validation

Consumer Mapping

Data Validation

Needs Assessment

Service Design and

Sector Profile Development

Completed

Completed

Completed

Completed

To be completed in August

Service Mapping• Services/programs

• Accessibility

• Availability

• Eligibility criteria

• Funding etc

• An understanding of services on the Gold Coast across mental health, alcohol and drug, disability, youth, Indigenous, housing, child, employment, suicide, homelessness, finance, legal etc.

• 20 Deep Dive service visits – based on Harvard Business School methodology

• HHS consult with relevant staff

• Indigenous specific consultation

• Community Briefing – 28th June – 96 attendees

• Mental Health Nurse Incentive Program (MHNIP) service visits – 14

• MHNIP Forum x 1

• ATAPS Forum x 1

• Suicide Prevention Breakfast x 1

• GP Forum – June - 52 attendees

• Consumer Journey Mapping – 7 in total

• Human Voice Connections- consumer group consultation

• GP Advisory Group meetings – 2

Consultation

Service data validation

• Undertake a deep dive process to examine more closely the outcomes of the service mapping

• Includes gathering information on:o Client satisfaction and organisational effectiveness

o Workforce issues eg: recruitment, retention, staff satisfaction

o Continuity of care – referral pathways, service integration

o Unfunded services provided based on identified need

o Identified need but cannot provide services

Service data validation (Deep Dive)

• As well as mapping services, service and population data needs to be analysed

• Data sources:o Hospital and Health Service

o MBS

o PBS

o Australian Institute of Health and Welfare (AIHW)

o … and many others

Service and population data

• Following the completion of the needs assessment, a sector profile will be developed from:

o Data analysed

o Service mapping

o Deep dive process

o Community consultation

o GP engagement

o Consumer journey mapping

o Validation process

Sector Profile September 2016

Gaps and Barriers

• From the needs assessment, gaps and barriers

across the priority areas for mental health will be

identified

• Co-design process to identify what services are

needed to address the gaps and barriers

Co-Design

• We cannot do it alone …..

• Working groups to assist GCPHN in the co-design

process

• Online community validation

Service Reviews

• Service reviews of existing programs are also

necessary:

o ATAPS Program

o Mental Health Nurse program

• Undertaking a service review will include:

o Determining clinical effectiveness

o Measuring program outcomes

o Efficiency of service models

Investment in mental

health and AoD

services

Dataanalysis

Service mapping

Service validation

Program specific input

Sector input

Needs assessment

Consumer Journey Mapping

Gaps andbarriers

Co-Design

Service reviews

Group Activity

some important things to consider……

• The data analysis is not complete as there are a number of data sets

• You may have told us information that is not written down …..it will be

included

• The areas we have selected today are the ones we need your help with

most

• We want to be as inclusive as possible – we need your help with that

too

• Some data and information we have been provided is not included for

the reason that it is out of scope in relation to our funding

requirements.

Aim of the group activity

• To start to make sense of some of the data we have

• To “unpack” a selection of outcome recommendations from the Community Briefing

• We will then apply the high level thematic analysis from Griffith University Business School to themes from the Community briefing

Group Activity instructions • There are 3 stations set up and you will stay in

your place – the facilitators will move

• There will be an A3 sheet in front of you

• There are 2 questions to answer related to the A3 sheet – you will have 10 minutes to answer

• What are the gaps you are aware of for this group ?

• How do you know it is a gap ?