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Tobin, Margaret J. "Rural Psychiatric Services." Australian & New Zealand Journal of Psychiatry 30, no. 1 (February 1996): 114–23. http://dx.doi.org/10.3109/00048679609076079.
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Objective: The objective was to describe and evaluate a community mental health service developed during 1991–1992 in an attempt to meet the mental illness needs of an isolated rural community. The setting was the Grampians health region in Western Victoria: this region has an area of 45,000 square kilo-metres and a population of 182,000. Method: The method involved firstly describing the evolution of the service delivery model. This comprised a team of travelling psychiatrists and community psychiatric nurses which succeeded in providing a combined inpatient and outpatient service which was integrated with general practitioners. Secondly, diagnostic and case load descriptions of patients receiving service were compared for both the inpatient and outpatient settings. Results: The results were that reduced reliance on inpatient beds and increased consumer satisfaction were achieved. Conclusion: It was concluded that on initial evaluation of the service it was seen to be meeting its objective of treating the seriously mentally ill in an isolated rural community based setting.
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Ervin, Kaye, Jacqueline Phillips, and Jane Tomnay. "Establishing a clinic for young people in a rural setting: a community initiative to meet the needs of rural adolescents." Australian Journal of Primary Health 20, no. 2 (2014): 128. http://dx.doi.org/10.1071/py12157.
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This paper describes the establishment and evaluation of a rural clinic for young people. A conceptual approach to community development was used to establish the clinic in a small north Victorian rural health service, with qualitative methods used to evaluate services. Study participants were members of an operational committee and advisory committee for the establishment of the rural clinic for young people. The clinic was evaluated against the World Health Organization framework for the development of youth-friendly services. With robust community support, the clinic was established and is operational. Most consultations have been for sexual and mental health. Qualitative evaluation identifies that not all the World Health Organization benchmarks have been met, but this is hampered predominantly by financial constraints. In conclusion, establishing clinic for young people in a small rural setting can be achieved with community support and the development of referral pathways.
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Hall, Teresa, Sharon Goldfeld, Hayley Loftus, Suzy Honisett, Hueiming Liu, Denise De Souza, Cate Bailey, et al. "Integrated Child and Family Hub models for detecting and responding to family adversity: protocol for a mixed-methods evaluation in two sites." BMJ Open 12, no. 5 (May 2022): e055431. http://dx.doi.org/10.1136/bmjopen-2021-055431.
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IntroductionIntegrated community healthcare Hubs may offer a ‘one stop shop’ for service users with complex health and social needs, and more efficiently use service resources. Various policy imperatives exist to implement Hub models of care, however, there is a dearth of research specifically evaluating Hubs targeted at families experiencing adversity. To contribute to building this evidence, we propose to co-design, test and evaluate integrated Hub models of care in two Australian community health services in low socioeconomic areas that serve families experiencing adversity: Wyndham Vale in Victoria and Marrickville in New South Wales.Methods and analysisThis multisite convergent mixed-methods study will run over three phases to (1) develop the initial Hub programme theory through formative research; (2) test and, then, (3) refine the Hub theory using empirical data. Phase 1 involves co-design of each Hub with caregivers, community members and practitioners. Phase 2 uses caregiver and Hub practitioner surveys at baseline, and 6 and 12 months after Hub implementation, and in-depth interviews at 12 months. Two stakeholder groups will be recruited: caregivers (n=100–200 per site) and Hub practitioners (n=20–30 per site). The intervention is a co-located Hub providing health, social, legal and community services with no comparator. The primary outcomes are caregiver-reported: (i) identification of, (ii) interventions received and/or (iii) referrals received for adversity from Hub practitioners. The study also assesses child, caregiver, practitioner and system outcomes including mental health, parenting, quality of life, care experience and service linkages. Primary and secondary outcomes will be assessed by examining change in proportions/means from baseline to 6 months, from 6 to 12 months and from baseline to 12 months. Service linkages will be analysed using social network analysis. Costs of Hub implementation and a health economics analysis of unmet need will be conducted. Thematic analysis will be employed to analyse qualitative data.Ethics and disseminationRoyal Children’s Hospital and Sydney Local Health District ethics committees have approved the study (HREC/62866/RCHM-2020). Participants and stakeholders will receive results through meetings, presentations and publications.Trial registration numberISRCTN55495932.
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Gillard, Steve, Christine Edwards, Sarah Gibson, Jess Holley, and Katherine Owen. "New ways of working in mental health services: a qualitative, comparative case study assessing and informing the emergence of new peer worker roles in mental health services in England." Health Services and Delivery Research 2, no. 19 (July 2014): 1–218. http://dx.doi.org/10.3310/hsdr02190.
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BackgroundA variety of peer worker roles are being introduced into the mental health workforce in England, in a range of organisational contexts and service delivery settings. The evidence base demonstrating the effectiveness of peer worker-based interventions is inconclusive and largely from outside England. An emerging qualitative literature points to a range of benefits, as well as challenges to introducing the peer worker role.AimsIn this study we aimed to test the international evidence base, and what is known generally about role adoption in public services, in a range of mental health services in England. We also aimed to develop organisational learning supporting the introduction of peer worker roles, identifying learning that was generic across mental health services and that which was specific to organisational contexts or service delivery settings.TeamThe research was undertaken by a team that comprised researchers from a range of academic and clinical disciplines, service user researchers, a peer worker, and managers and service providers in the NHS and voluntary sector. Service user researchers undertook the majority of the data collection and analysis. We adopted a coproduction approach to research, integrating the range of perspectives in the team to shape the research process and interpret our findings.Study designThe study employed a qualitative, comparative case study design. We developed a framework, based on existing evidence and the experiential insight of the team, which conceptualised the challenges and facilitators of introducing peer worker roles into mental health services. The framework was used to inform data collection and to enable comparisons between different organisational contexts, service delivery settings and the perspectives of different stakeholders.SettingsThe study took place in 10 contrasting cases comprising mental health NHS trusts, voluntary sector service providers and partnerships between the NHS and voluntary sector or social care providers. Peer workers were employed in a variety of roles, paid and unpaid, in psychiatric inpatient settings, community mental health services and black and minority ethnic (BME)-specific services.ParticipantsParticipants were 89 people involved in services employing peer workers, recruited purposively in approximately equal proportion from the following stakeholder groups: service users; peer workers; (non-peer) coworkers; line managers; strategic managers; and commissioners.Data collectionAll participants completed an interview that comprised structured and open-ended questions. Structured questions addressed a number of domains identified in the existing evidence as barriers to, or facilitators of, peer worker role adoption. Open-ended questions elicited detailed data about participants’ views and experiences of peer worker roles.Data analysisStructured data were analysed using basic statistics to explore patterns in implementation across cases. Detailed data were analysed using a framework approach to produce a set of analytical categories. Patterns emerging in the structured analysis informed an in-depth interrogation of the detailed data set, using NVivo 9 qualitative software (QSR International Pty Ltd, Victoria, Australia) to compare data between organisational contexts, service delivery settings and stakeholder groups. Preliminary findings were refined through discussion with a range of stakeholders at feedback workshops.FindingsMany of the facilitators of peer worker role adoption identified in the existing evidence base were also evident in mental health services in England, although there were issues around pay, leadership, shared understanding of the role, training and management where good practice was uneven. A number of examples of good practice were evident in the voluntary sector, where peer worker roles had been established for longer and organisations were more flexible. In the NHS there were a range of challenges around introducing peer worker roles into existing structures and cultures of practice. Peer workers were able to engage people with services by building relationships based on shared lived experience – the language they used was particularly important in BME-specific services – but barriers to engagement could be created where roles were overformalised.ConclusionsKey barriers to, and facilitators of, peer worker role adoption were identified, including valuing the differential knowledge and practice that peer workers brought to the role (especially around maintaining personally, rather than professionally defined boundaries); maintaining peer identity in a role of work; changing organisational structures to support peer workers to remain well in their work; and challenging organisational cultures to empower peer workers to use their lived experience. Recommendations for future research include developing a theoretical framework articulating the change mechanisms underpinning ‘what peer workers do’, piloting and formally evaluating the effectiveness and cost-effectiveness of peer worker interventions, and mixed-method research to better understand the impact of working as a peer worker.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Castle, David J. "Letter from Australia: mental healthcare in Victoria." Advances in Psychiatric Treatment 17, no. 1 (January 2011): 2–4. http://dx.doi.org/10.1192/apt.bp.110.008375.
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SummaryMental health services in the state of Victoria, Australia, have undergone enormous change over the past 15 years, with the closure of all stand-alone psychiatric hospitals and a shift of resources and services into the community. Although successful overall, various areas cause concern, including pressure on acute beds, a paucity of alternative residential options, and suboptimal integration of government and non-government agencies concerned with the care of people with mental illnesses. Certain groups, notably those with complex symptom sets such as substance use and mental illness, intellectual disability and forensic problems, remain poorly catered for by the system. Finally, community stigma and lack of work inclusion for mentally ill individuals are ongoing challenges.
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Dedman, Paul. "Community Treatment Orders in Victoria, Australia." Psychiatric Bulletin 14, no. 8 (August 1990): 462–64. http://dx.doi.org/10.1192/pb.14.8.462.
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It is one of the failures of contemporary psychiatry that many patients who respond well to neuroleptic medication given to them when they are in-patients relapse after discharge due to not taking any further medication. Those working closely with the acute psychiatric patient in the community are often forced to stand by powerlessly as a patient deteriorates, causing damage to himself and his social milieu until such a point is reached when he is again ill enough to warrant compulsory admission and treatment. This process is, of course, devastating for a patient's family and also disheartening for professionals involved, and is perhaps partly responsible for the high turnover of staff involved in front line services. Even if assertive outreach methods are employed such as those involved in a number of comprehensive community-based programmes (Stein & Test, 1980; Borland et al, 1989) so that contact with the patient is not lost, it is not possible without the necessary legislation to enforce treatment in the community.
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Silburn, Kate, and Virginia Lewis. "Commissioning for health and community sector reform: perspectives on change from Victoria." Australian Journal of Primary Health 26, no. 4 (2020): 332. http://dx.doi.org/10.1071/py20011.
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Commissioning health and community services is a complex task involving planning, purchasing and monitoring services for a population. It is particularly difficult when attempting system-level reform, and many barriers to effective commissioning have been documented. In Victoria, the state government has operated as a commissioner of many services, including mental health community support and alcohol and other drug treatment services. This study investigated the perceived consequences of a reform process in these two sectors after recommissioning was used as a mechanism to achieve sector-wide redesign. Semi-structured interviews were conducted with 23 senior staff from community health, mental health and drug and alcohol services 6 months after implementation. The process was affected by restructuring in the commissioning department resulting in truncation of preparatory planning and technical work required for system design. Consequently, reform implementation was reportedly chaotic, costly to agencies and staff, and resulted in disillusionment of enthusiastic reform supporters. Negative service system impacts were produced, such as disruption of collaborative and/or comprehensive models of care and strategies for reaching marginalised groups. Without careful planning and development commissioning processes can become over-reliant on competitive tendering to produce results, create significant costs to service providers and engender system-level issues with the potential to disrupt innovative models focused on meeting client needs.
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Mullen, P., and J. Ogloff. "Providing mental health services to adult offenders in Victoria, Australia: Overcoming barriers." European Psychiatry 24, no. 6 (September 2009): 395–400. http://dx.doi.org/10.1016/j.eurpsy.2009.07.003.
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AbstractPurposeTo illustrate the development of the interface between general and forensic mental health services in Victoria, Australia.MethodDeveloping effective cooperation between the general and forensic mental health services requires overcoming a number of barriers. The attitude of general services that antisocial behaviour was none of their business was tackled through ongoing workshops and education days over several years. The resistance to providing care to those disabled by severe personality disorders or substance abuse was reduced by presenting and promoting models of care developed in forensic community and inpatient services which prioritised these areas. The reluctance of general services to accept offenders was reduced by involving general services in court liaison clinics and in prisoner release plans. Cooperation was enhanced by the provision of risk assessments, the sharing of responsibility for troublesome patients, and a problem behaviours clinic to support general services in coping with stalkers, sex offenders and threateners.ConclusionsActive engagement with general services was promoted at the level of providing education, specialised assessments and a referral source for difficult patients. This generated a positive interface between forensic and general mental health services, which improved the quality of care delivered to mentally abnormal offenders.
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Martin, Claudia J., Linda De Caestecker, Robert Hunter, Alan Gilloran, Daniel Allsobrook, and Lyn M. Jones. "Developing community mental health services: an evaluation of Glasgow’s mental health resource centres." Health & Social Care in the Community 7, no. 1 (January 1999): 51–60. http://dx.doi.org/10.1046/j.1365-2524.1999.00149.x.
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Ong, Kevin, Andrew Carroll, Shannon Reid, and Adam Deacon. "Community Outcomes of Mentally Disordered Homicide Offenders in Victoria." Australian & New Zealand Journal of Psychiatry 43, no. 8 (January 1, 2009): 775–80. http://dx.doi.org/10.1080/00048670903001976.
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Objective: The aim of the present study was to describe characteristics and post-release outcomes of Victorian homicide offenders under the Crimes (Mental Impairment and Unfitness to be Tried) Act 1997 (and/or its forerunner legislation) released from forensic inpatient psychiatric care since the development of specialist forensic services. Method: A legal database identified subjects meeting inclusion criteria: hospitalized in forensic psychiatric care due to finding of mental impairment or unfitness to stand trial for homicide in Victoria; released into the community; and released between 1 January 1991 and 30 April 2002. Using clinical records, demographics, index offence, progress in hospital, diagnosis, psychosocial and criminological data were obtained. Outcomes (offending or readmission into secure care) were obtained from the clinical records. Results: Of the 25 subjects, 19 (76%) were male. Primary diagnoses on admission to forensic hospital care were schizophrenia, n = 16 (64%); other psychotic disorder, n = 5 (20%); depression, n = 3 (12%); and personality disorder, n = 1 (4%). Mean time in custodial supervision was 11 years and 2 months, less for those whose offence occurred after the development of forensic rehabilitation services. In the first 3 years after release, there was a single episode of criminal recidivism, representing a recidivism rate of 1 in 25 (4%) over 3 years. Twelve subjects (48%) were readmitted at some point in the 3 year follow up. Conclusion: There was a very low rate of recidivism after discharge, but readmissions to hospital were common. Lengths of custodial care were reduced after the introduction of forensic rehabilitation facilities. Recidivism is low when there are well-designed and implemented forensic community treatment programmes, consistent with other data suggesting a reciprocal relationship between safe community care and a low threshold for readmission to hospital, lessening re-offending at times of crisis. Further research should be directed at timing of release decisions, based on reducing identified risk factors to acceptable levels.
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EZARD, NADINE, NICK LINTZERIS, PETA ODGERS, GLENDA KOUTROULIS, PETER MUHLEISEN, AARON STOWE, and AMANDA LANAGAN. "An evaluation of community methadone services in Victoria, Australia: results of a client survey." Drug and Alcohol Review 18, no. 4 (December 1999): 417–23. http://dx.doi.org/10.1080/09595239996284.
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Ronnau, Peggy, Arthur Papakotsias, and Glen Tobias. ""Not for" sector in community mental health care defines itself and strives for quality." Australian Journal of Primary Health 14, no. 2 (2008): 68. http://dx.doi.org/10.1071/py08025.
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This paper briefly describes the history and service context of the Psychiatric Disability Rehabilitation and Support sector (PDRSS) in Victoria, and, to a lesser extent, in New South Wales, South Australia and Western Australia. In describing the sector we will call upon the experience of a particular PDRSS - Neami - in operating and developing services, and the challenges it faced in establishing a culture of quality that directly improves consumer outcomes. Elements of this experience may serve as a guide in the development of mental health service policy at state and federal level.
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Teresa Dawson, Maria, Paul Grech, Brendan Hyland, Fiona Judd, John Lloyd, Anne M. Mijch, Jennifer Hoy, and Alan C Street. "A Qualitative Approach to the Mental Health Care Needs of People Living with HIV/AIDS in Victoria." Australian Journal of Primary Health 8, no. 3 (2002): 30. http://dx.doi.org/10.1071/py02041.
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This article reports on the findings of the qualitative stage of a larger project on the mental care needs of people with HIV/AIDS and mental illness (Tender T1176 Department of Human Services, Mental Health Branch, Victoria - Research on the Mental Health Care Needs of People with HIV/AIDS and Mental Illness). The purpose of the larger research was to evaluate the needs and treatment requirements of persons with HIV/AIDS, who also suffer from mental health problems, with a view to developing proposals for improving existing service delivery in Victoria, Australia. The qualitative stage was designed to complement and elucidate data obtained through the quantitative stages of the project. Thirty in-depth open-ended interviews were carried out with service providers including HIV physicians, general practitioners, psychiatrists, clinical and managerial staff of Area Mental Health Services, Contact Tracers and forensic mental health services staff, as well as representatives of community groups such as People Living with HIV/AIDS and Positive Women and carers. The interviews explored the perspective of both service providers and users of such services with respect to needs for psychiatric care and service delivery, ease of access or barriers to mental health services, and the perceived strengths and weaknesses in current service provision. This paper presents the main findings and recommendations submitted to the funding body.
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Griffiths, Daniel, Luke Sheehan, Dennis Petrie, Caryn van Vreden, Peter Whiteford, and Alex Collie. "The health impacts of a 4-month long community-wide COVID-19 lockdown: Findings from a prospective longitudinal study in the state of Victoria, Australia." PLOS ONE 17, no. 4 (April 7, 2022): e0266650. http://dx.doi.org/10.1371/journal.pone.0266650.
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Objectives To determine health impacts during, and following, an extended community lockdown and COVID-19 outbreak in the Australian state of Victoria, compared with the rest of Australia. Methods A national cohort of 898 working-age Australians enrolled in a longitudinal cohort study, completing surveys before, during, and after a 112-day community lockdown in Victoria (8 July– 27 October 2020). Outcomes included psychological distress, mental and physical health, work, social interactions and finances. Regression models examined health changes during and following lockdown. Results The Victorian lockdown led to increased psychological distress. Health impacts coincided with greater social isolation and work loss. Following the extended lockdown, mental health, work and social interactions recovered to an extent whereby no significant long-lasting effects were identified in Victoria compared to the rest of Australia. Conclusion The Victorian community lockdown had adverse health consequences, which reversed upon release from lockdown. Governments should weigh all potential health impacts of lockdown. Services and programs to reduce the negative impacts of lockdown may include increases in mental health care, encouraging safe social interactions and supports to maintain employment relationships.
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Williams, Ruth F. G. "Community Mental Health Services as a Process Innovation: Appropriate Economic Evaluation." Prometheus 25, no. 4 (December 2007): 393–414. http://dx.doi.org/10.1080/08109020701689243.
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McDonald, Paul. "Through the wall: An address to practitioners at a forum on the Working Together Strategy." Children Australia 25, no. 1 (2000): 27–32. http://dx.doi.org/10.1017/s1035077200009585.
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This address was given at a forum in November J999 for practitioners in the juvenile justice, alcohol and drug, mental health and child protection services in Victoria as part of the Department of Human Services’ Working Together Strategy’ (WTS). The WTS is a quality improvement initiative of the DHS in partnership with adolescent mental health and drug treatment service providers.WTS provides an organisational framework for the Community Care Division, the Aged, Community and Mental Health Division and the Public Health Division (specifically in reference to the mental health, child protection and care, juvenile justice and drug treatment services programs) to achieve better outcomes for shared clients. WTS is a response to perceived deficits in cross-program collaboration and communication in cases involving high need adolescent clients.
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Bigby, Christine. "A demographic analysis of older people with intellectual disability registered with Community Services Victoria." Australia and New Zealand Journal of Developmental Disabilities 19, no. 1 (January 1994): 1–10. http://dx.doi.org/10.1080/07263869400035061.
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Manning, Victoria, Nicki A. Dowling, Simone N. Rodda, Ali Cheetham, and Dan I. Lubman. "An Examination of Clinician Responses to Problem Gambling in Community Mental Health Services." Journal of Clinical Medicine 9, no. 7 (July 1, 2020): 2075. http://dx.doi.org/10.3390/jcm9072075.
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Gambling problems commonly co-occur with other mental health problems. However, screening for problem gambling (PG) rarely takes place within mental health treatment settings. The aim of the current study was to examine the way in which mental health clinicians respond to PG issues. Participants (n = 281) were recruited from a range of mental health services in Victoria, Australia. The majority of clinicians reported that at least some of their caseload was affected by gambling problems. Clinicians displayed moderate levels of knowledge about the reciprocal impact of gambling problems and mental health but had limited knowledge of screening tools to detect PG. Whilst 77% reported that they screened for PG, only 16% did so “often” or “always” and few expressed confidence in their ability to treat PG. However, only 12.5% reported receiving previous training in PG, and those that had, reported higher levels of knowledge about gambling in the context of mental illness, more positive attitudes about responding to gambling issues, and more confidence in detecting/screening for PG. In conclusion, the findings highlight the need to upskill mental health clinicians so they can better identify and manage PG and point towards opportunities for enhanced integrated working with gambling services.
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Lien, On. "Attitudes of the Vietnamese Community towards Mental Illness." Australasian Psychiatry 1, no. 3 (August 1993): 110–12. http://dx.doi.org/10.3109/10398569309081340.
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There are approximately 155,000 Vietnamese born people in Australia, with 46,000 in Victoria. The majority came to Australia as refugees. Many were subjected to the reality or threat of war, persecution, imprisonment, discrimination, economic deprivation, violence, the loss of family or other major stressors. These stressors have included the hazards of the escape, lengthy stays in refugee camps and, on arrival in Australia, lack of familiarity with English and with the culture. The Vietnamese Community in Australia was expected to have a high prevalence of mental illness, especially when newly arrived from refugee camps. In a study published in 1986 as “The Price of Freedom” [1] 32% of the young Vietnamese adult group was found to suffer from psychiatric disorder. At follow-up two years later, the prevalence of psychiatric disorder, without any major intervention, had dropped to 5–6%, a prevalence lower than that in the Australian-born community. In addition, the Vietnamese community's use of mental health services (inpatient and community-based) is lower than that of any other ethnic group.
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Loi, Samantha, and Anne Hassett. "Evolution of aged persons mental health services in Victoria: The history behind their development." Australasian Journal on Ageing 30, no. 4 (July 3, 2011): 226–30. http://dx.doi.org/10.1111/j.1741-6612.2011.00529.x.
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Hunter, David E. K., William P. Buick, Thomas Wellington, and Gloria Dzerovych. "Initial Evaluation of Reorganized Hospitalization Services in a Community Mental Health Center." Psychiatric Services 44, no. 3 (March 1993): 271–75. http://dx.doi.org/10.1176/ps.44.3.271.
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Allevi, Liliana, Giovanni Salvi, and Mirella Ruggeri. "Quality of mental health services: a self audit in the South Verona mental health service." Epidemiologia e Psichiatria Sociale 15, no. 2 (June 2006): 138–47. http://dx.doi.org/10.1017/s1121189x00004346.
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SUMMARYAims – To start a process of Continuous Quality Improvement (CQI) in an Italian Community Mental Health Service by using a quality assurance questionnaire in a self audit exercise. Methods – The questionnaire was administered to 14 key workers and clinical managers with different roles and seniority. One senior manager's evaluation was used as a benchmark for all the others. Changes were introduced in the service practice according to what emerged from the evaluation. Meetings were scheduled to monitor those changes and renew the CQI process. Results – There was a wide difference in the key workers' answers. Overall, the senior manager's evaluation was on the 60th percentile of the distribution of the other evaluations. Those areas that required prompt intervention were risk management, personnel development, and CQI. The CQI process was followed up for one year: some interventions were carried out to change the practice of the service. Conclusions – A self audit exercise in Community Mental Health Services was both feasible and useful. The CQI process was easier to start than to carry on over the long term.
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Byrne, Louise, Michael Wilson, Karena J. Burke, Cadeyrn J. Gaskin, and Brenda Happell. "Mental health service delivery: a profile of mental health non-government organisations in south-east Queensland, Australia." Australian Health Review 38, no. 2 (2014): 202. http://dx.doi.org/10.1071/ah13208.
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Objective Non-government organisations make a substantial contribution to the provision of mental health services; despite this, there has been little research and evaluation targeted at understanding the role played by these services within the community mental health sector. The aim of the present study was to examine the depth and breadth of services offered by these organisations in south-east Queensland, Australia, across five key aspects of reach and delivery. Methods Representatives from 52 purposively targeted non-government organisations providing mental health services to individuals with significant mental health challenges were interviewed regarding their approach to mental health service provision. Results The findings indicated a diverse pattern of service frameworks across the sector. The results also suggested a positive approach to the inclusion of consumer participation within the organisations, with most services reporting, at the very least, some form of consumer advocacy within their processes and as part of their services. Conclusions This paper offers an important first look at the nature of non-government service provision within the mental health sector and highlights the importance of these organisations within the community sector. What is known about the topic? Non-government organisations make a substantial contribution to the multisectorial provision of services to mental health consumers in community settings. Non-government organisations in Australia are well established, with 79.9% of them being in operation for over 10 years. There is an increasing expectation that consumers influence the development, delivery and evaluation of mental health services, especially in the community sector. What does this paper add? This paper provides a profile of non-government organisations in one state in Australia with respect to the services they provide, the consumers they target, the practice frameworks they use, the use of peer workers and consumer participation, the success they have had with obtaining funding and the extent to which they collaborate with other services. What are the implications for practitioners? This paper provides readers with an understanding of the non-government organisations and the services they provide to people with mental health conditions. In addition, the findings provide an opportunity to learn from the experience of non-government organisations in implementing consumer participation initiatives.
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Kantorski, Luciane Prado, Vanda Maria da Rosa Jardim, Carlos Alberto dos Santos Treichel, Daiane Aquino Demarco, Aline dos Santos Neutzling, Michele Mandagará de Oliveira, and Valéria Cristina Chirstello Coimbra. "Satisfaction with mental health community services among patients’ relatives." Revista Brasileira de Epidemiologia 20, no. 2 (June 2017): 237–46. http://dx.doi.org/10.1590/1980-5497201700020005.
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ABSTRACT: Objective: This study aims to assess the satisfaction of family members of patients of mental health community services through a tested, validated and previously applied scale in order to allow comparison of results. Methods: The results were obtained by applying the scale SATIS-BR to 1242 relatives of patients of 40 mental health community services in Brazil. The average scores of the three subscales of the SATIS-BR scale were compared using the Wilcoxon test. To measure statistical significance for each item of the scale, the Friedman test was applied, considering significant p-value < 0.05. Results: The average overall satisfaction score was 4.35 with a standard deviation (SD) of 0.44, with a range varying from 1 to 5. The subscale with the highest score refers to the “Results of Treatment”, what presents scores of 4.54 with SD of 0.66. As for the other subscales, which refer to “Reception and Staff Competence” and “Service Privacy and Confidentiality” had scores of 4.25 (SD: 0.51) and 4.17 (SD: 0.51). Conclusion: The high level of satisfaction with the service among families of patients highlights the potential of these services and their contribution to the advance of a model of mental health community care, as it seems to be the global trend. The different results between the scales further suggest that the family distinguishes different aspects of the service and evaluates separately, providing a good reference for evaluation studies.
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Gaddini, A., M. Ascoli, and L. Biscaglia. "Mental health care in Rome." European Psychiatry 20, S2 (October 2005): s294—s297. http://dx.doi.org/10.1016/s0924-9338(05)80177-4.
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AbstractAimTo describe principles and characteristics of mental health care in Rome.MethodBased on existing data, service provision, number of professionals working in services, funding arrangements, pathways tocare, user/carer involvement and specific issues are reported.ResultsAfter the Italian psychiatric reform of 1978, an extensive network of community-based services has been set up in Romeproviding prevention, care and rehabilitation in mental health. A number of small public acute/emergency inpatient units inside general hospitals was created (median length of stay in 2002 = 8 days) to accomplish the shift from a hospital-based to a community-based psychiatric system of care. Some private structures provide inpatient assistance for less acute conditions (median length of stay in 2002 = 28 days), whilst the large Roman psychiatric hospital was closed in 1999.DiscussionWhilst various issues of mental health care in Rome overlap with those in other European capitals, there also are some specific problems and features. During the last two decades, the mental health system in Rome has been successfully converted to a community-based one. Present issues concern a qualitative approach, with an increasing need to foresee adequate evaluation, especially considering mental health patients' satisfaction with services and economic outcomes.
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Jensen, Elsabeth, Patty Chapman, Amy Davis, Cheryl Forchuk, Bill Seymour, Penny Witcher, and Denise Armstrong. "An Evaluation of Community-Based Discharge Planning in Acute Mental Health Care." Canadian Journal of Community Mental Health 29, S5 (January 1, 2010): 111–24. http://dx.doi.org/10.7870/cjcmh-2010-0038.
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This study assessed the effectiveness of a discharge planning service that was remodelled and relocated from a hospital to community-based setting. The study used a single group program evaluation strategy. In this “in-reach” model, the discharge planner is based with the community service, and visits the hospital daily to meet with all admitted clients to offer discharge services. Through analyses of administrative data and interviews with clients, the study found that readmission rates were 40% lower in the year following the change in service delivery model. This change was statistically significant. Agency partners used the findings to modify their program during the course of the evaluation. Findings will be helpful for other acute care mental health services.
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Parkman, Sue, and Sara Bixby. "Community interviewing: experiences and recommendations." Psychiatric Bulletin 20, no. 2 (February 1996): 72–74. http://dx.doi.org/10.1192/pb.20.2.72.
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Evaluation studios of community mental health services require the research, often in the form of interviews, to be carried out in private homes which poses a particular set of issues relating to the interview environment and the organisation of the work. This paper describes the experiences of interviewing patients, staff and informal carers as part of an evaluation study of the mental health services in two psychiatric sectors in South London and makes recommendations for more effective community based research.
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Adams, Karen, Chris Halacas, Marion Cincotta, and Corina Pesich. "Mental health and Victorian Aboriginal people: what can data mining tell us?" Australian Journal of Primary Health 20, no. 4 (2014): 350. http://dx.doi.org/10.1071/py14036.
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Nationally, Aboriginal people experience high levels of psychological distress, primarily due to trauma from colonisation. In Victoria, Aboriginal Community Controlled Health Organisations (ACCHOs) provide many services to support mental health. The aim of the present study was to improve understanding about Victorian Aboriginal people and mental health service patterns. We located four mental health administrative datasets to analyse descriptively, including Practice Health Atlas, Alcohol and Other Drug Treatment Service (AODTS), Kids Helpline and Close The Gap Pharmaceutical Scheme data. A large proportion of the local Aboriginal population (70%) were regular ACCHO clients; of these, 21% had a mental health diagnosis and, of these, 23% had a Medicare Mental Health Care Plan (MHCP). There were higher rates of Medicare MHCP completion rates where general practitioners (GPs) had mental health training and the local Area Mental Health Service had a Koori Mental Health Liaison Officer. There was an over-representation of AODTS episodes, and referrals for these episodes were more likely to come through community, corrections and justice services than for non-Aboriginal people. Aboriginal episodes were less likely to have been referred by a GP or police and less likely to have been referrals to community-based or home-based treatment. There was an over-representation of Victorian Aboriginal calls to Kids Helpline, and these were frequently for suicide and self-harm reasons. We recommend primary care mental health programs include quality audits, GP training, non-pharmaceutical options and partnerships. Access to appropriate AODTS is needed, particularly given links to high incarcerations rates. To ensure access to mental health services, improved understanding of mental health service participation and outcomes, including suicide prevention services for young people, is needed.
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Hill, Shane, Niall Turner, Siobhan Barry, and Eadbhard O'Callaghan. "Client satisfaction among outpatients attending an Irish community mental health service." Irish Journal of Psychological Medicine 26, no. 3 (September 2009): 127–30. http://dx.doi.org/10.1017/s0790966700000422.
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AbstractObjectives: To assess patient satisfaction with mental health services. Client satisfaction with mental health services is attracting increasing attention and is now considered a key outcome variable in evaluating mental health services. The Quality Framework (Mental Health Commission (MHC)), and Vision for Change (VFC) support such evaluation. However, there are no published quantitative data from Irish users of a community mental health service.Method: We invited outpatients attending a Dublin community mental health service to complete a standardised self-report instrument (Client Satisfaction Questionnaire, CSQ-8) and provide qualitative feedback.Results: Of the seventy-nine respondents, 80% report they were ‘satisfied’ or ‘very satisfied’ with the service. However, they were critical of; access to, operation of, and communication with the mental health services.Conclusions: Although satisfied, when given the opportunity to comment, service users can be critical of aspects of the service they receive. Only using quantitative evaluation of outpatient client satisfaction levels may fail to capture important consumer suggestions for service development. Recent recommendations and upcoming changes would address a number of the criticisms of mental health services identified in this study.
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O'connor, Daniel, and Pamela Melding. "A Survey of Publicly Funded aged Psychiatry Services in Australia and New Zealand." Australian & New Zealand Journal of Psychiatry 40, no. 4 (April 2006): 368–73. http://dx.doi.org/10.1080/j.1440-1614.2006.01804.x.
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Objective: To map the size and distribution of publicly funded aged psychiatry (psychogeriatric) services in Australia and New Zealand in 2003. Method: Services were tracked exhaustively through personal, professional and academic contacts, electronic searches and word-of-mouth. Directors or managers of services were asked to complete a brief questionnaire concerning their locality, services, staff profile and patient contacts. Results: Services varied widely with respect to their numbers, size and community outreach. Victoria was the only Australian state to provide specialist, multidisciplinary aged psychiatry teams with community, acute inpatient and residential arms in all its major cities. New South Wales, the state with the largest aged population, performed relatively poorly on most indicators. New Zealand performed relatively well despite its small size and widely dispersed population. Conclusions: Publicly funded aged mental health services are effective and reach frail, multiply disabled old people who cannot access private psychiatrists and are often overlooked by services for younger adults. At the time of our survey, such services were distributed in Australia in a highly inequitable fashion.
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Ward, Max, and Pamela Attwell. "Evaluation of two community outreach forensic psychological services." Journal of Forensic Practice 16, no. 4 (November 4, 2014): 312–26. http://dx.doi.org/10.1108/jfp-04-2013-0027.
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Purpose – The purpose of this paper is to gauge service user’ perspectives on the effectiveness of two community outreach forensic psychological services in London for people with personality disorder and serious mental illness who pose a risk of sexual and violent offending. Both services are guided by principles of the Good Lives Model and circles of support and accountability. Design/methodology/approach – The research design was mixed qualitative and quantitative, incorporating thematic evaluation of semi-structured interviews with service users and a rating-scale constructed specifically for this purpose. Findings – Outcomes suggest both services are broadly successful in achieving their aims to: first, enhance psychological well-being and general quality of life; second, promote links with other agencies and broader social inclusion; and third, monitor and manage risk of re-offending. Research limitations/implications – However, there are limitations. Cause and effect cannot be inferred and outcomes are not generalizable to other contexts partly as a result of the small sample size. Another possible issue is that participants spoke favorably about their care through fear of being evaluated negatively or through fear of compromising the support they receive. To control for these and other possible confounding variables, further more rigorous research is required. Practical implications – The current findings can be used as a guide to help services engage and manage people with personality disorder and serious mental illness who are at risk of further serious offending. Originality/value – It is suggested here that the current findings contribute to the body of evidence supporting initiatives that aim to address recidivism by enabling offenders to develop a more positive identity through social and community inclusion and integration.
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Kapp, Marshall B. "Book Review: Community Mental Health Centers and the Courts: An Evaluation of Community-Based Forensic Services." Journal of Psychiatry & Law 15, no. 1 (March 1987): 133–35. http://dx.doi.org/10.1177/009318538701500109.
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Goldberg, D. "Cost-effectiveness studies in the evaluation of mental health services in the community." International Clinical Psychopharmacology 9 (January 1995): 29–34. http://dx.doi.org/10.1097/00004850-199501005-00006.
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Powell, Robin, Geraldine Strathdee, and Graham Thornicroft. "A short course in planning, development and evaluation of community mental health services." Psychiatric Bulletin 20, no. 4 (April 1996): 234–36. http://dx.doi.org/10.1192/pb.20.4.234.
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In response to the expressed needs of trainees for training in the planning development, and evaluation of mental health services, a short course was designed and is described here. The course was run several times and proved flexible enough to be presented to either multidisciplinary, inter-agency audiences or to a solely medical audience.
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Whiteford, Harvey, Bill Buckingham, and Ronald Manderscheid. "Australia's National Mental Health Strategy." British Journal of Psychiatry 180, no. 3 (March 2002): 210–15. http://dx.doi.org/10.1192/bjp.180.3.210.
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BackgroundAustralia commenced a 5-year reform of mental health services in 1993.AimsTo report on the changes to mental health services achieved by 1998.MethodAnalysis of data from the Australian National Mental Health Report 2000 and an independent evaluation of the National Mental Health Strategy.ResultsMental health expenditure increased 30% in real terms, with an 87% growth in community expenditures, a 38% increase in general hospitals and a 29% decrease in psychiatric hospitals. The growth in private psychiatry, averaging 6% annually prior to 1992, was reversed. Consumer and carer involvement in services increased.ConclusionsMajor structural reform was achieved but there was limited evidence that these changes had been accompanied by improved service quality. The National Mental Health Strategy was renewed for another 5 years.
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Spear, Jon, Andrew Cole, and Jan Scott. "A cross-sectional evaluation of a community-orientated mental health service." Psychiatric Bulletin 19, no. 3 (March 1995): 151–54. http://dx.doi.org/10.1192/pb.19.3.151.
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Community mental health services have been criticised for seeing those with minor psychiatric disorders at the expense of those with severe and long-term illness. We report a cross-sectional evaluation of a UK service based entirely within the community. Most patients in contact with the service (66%) had a psychotic disorder or an affective disorder. Patients with greater impairment were likely to receive more intensive treatment. Only 20% of the community psychiatric nurse (CPN) case load focused on acute distress and neurotic disorders. Within this service careful operational planning and maintaining CPNs within the secondary care system appear to be critical factors in achieving the goal of giving priority to the severely mentally ill.
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Barbato, Angelo. "Psychiatry in Transition: Outcomes of Mental Health Policy Shift in Italy." Australian & New Zealand Journal of Psychiatry 32, no. 5 (October 1998): 673–79. http://dx.doi.org/10.3109/00048679809113122.
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Objective: To assess the outcomes of changes in mental health policy introduced in Italy in 1978. Methods: Data on psychiatric services, before and after the policy change, are presented. Effects of change are evaluated through indicators related to four issues: transfer of care, criminalisation of the mentally ill, suicides, and homelessness. Results: Admissions of new patients to mental hospitals have been stopped and the size of the mental hospital population is now very low (26 per 100 000 population). Psychiatric care has been shifted to community services including general hospital psychiatric units. There has been an overall reduction of psychiatric hospitalisation. However, the provision of residential facilities is inadequate and community services are unevenly distributed across the country. Few negative effects of changing patterns of care have been reported, although the low quality of data limits the validity of such a conclusion. Outcome of care in areas where the full range of community services is available has been rated as satisfactory. Conclusions: Although care of the mentally ill has been shifted to community services, we lack hard data on the social and clinical outcome of communty care at the nation-wide level. Long-term monitoring and evaluation of community services is a high priority in Italy.
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Ross, Anna, Nicola Reavley, Lay San Too, and Jane Pirkis. "Evaluation of a novel approach to preventing railway suicides: the community stations project." Journal of Public Mental Health 17, no. 2 (June 18, 2018): 51–60. http://dx.doi.org/10.1108/jpmh-06-2017-0022.
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Purpose The purpose of this paper is to describe an evaluation of the Community Stations Project. The Community Stations Project was designed to address railway suicides in two ways: by improving the station environment in a manner that might improve community members’ feelings of wellbeing; and raising community members’ awareness of poor mental health and likelihood of reaching out to at-risk individuals. It involved four types of interventions (arts and culture, music, food and coffee, and “special events”) delivered at four stations in Victoria. Design/methodology/approach A short anonymous survey was administered to community members on iPads at the four participating railway stations during the implementation of the interventions (between October and December 2016). The survey included questions about respondents’ demographics, their awareness of the intervention(s), their views of the station, their attitudes towards people with poor mental health and their emotional wellbeing. Findings A total of 1,309 people took part in the survey. Of these, 48 per cent of community members surveyed reporting noticing an intervention at their station. Noticing the events was associated with positive views of the station, improved understanding of poor mental health, and a greater likelihood of reaching out to someone who might be at risk of poor mental health. Awareness of intervention events was not associated with respondents’ own emotional wellbeing. Practical implications Continuing to focus efforts on mental health awareness activities may further strengthen the impact of the Community Stations Project interventions and ultimately prevent suicides at railway stations. Originality/value This paper evaluates a novel approach to improving wellbeing and understanding of poor mental health in the train station environment.
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Magon, Rakesh, and Ruth White. "Specialist community perinatal screening clinic: service evaluation." Psychiatrist 34, no. 11 (November 2010): 492–95. http://dx.doi.org/10.1192/pb.bp.109.026625.
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Aims and methodTo identify the outcomes of patients in the obstetric screening clinic. In 2 years, 180 women were referred by midwives to a clinic run by specialist community perinatal team. ‘Ultra-high risk’ patients were identified. There were four outcome measures predicated on level of care.ResultsOf those referred, 69 women were managed in primary care/generic community mental health teams, 90 by specialist perinatal team and 21 did not attend; 23 women were ultra-high risk. The majority of the ultra-high risk patients required treatment with specialist teams.Clinical implicationsSpecialist community perinatal screening clinics are successful at identifying those at high risk of developing mental health problems. Ultra-high risk women needed a higher level of service. High morbidity in women who fail to attend the services demands more assertive follow-up. Cumulative personal and family history is an important risk factor.
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Anderson, Daniel, Howard Cattell, and Elaine Bentley. "Nurse-led liaison psychiatry service for older adults: service evaluation." Psychiatric Bulletin 32, no. 8 (August 2008): 298–302. http://dx.doi.org/10.1192/pb.bp.107.016725.
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Aims and MethodTo comprehensively describe a nurse-led consultation liaison service for older adults by retrospectively reviewing all referrals received in 2006 and comparing them against other services and benchmark reports.ResultsOf the 298 individuals referred to psychiatric services from other hospital wards, 120 were aged 85–94 years old (40%), 193 were male (65%) and 152 were referred from geriatrics (51%). A majority of 204 have not had previous contact with psychiatric services (69%). the most common diagnosis was dementia (33%, n=88), with 27% individuals (n=65) being referred onwards to secondary care.Clinical ImplicationsThis nurse-led service, using a novel approach of a support worker providing further community support, functions well compared with traditional consultation models. It helps identify many individuals with dementia and engages them into community psychiatric services.
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Santhanam, Radhika, Ernest Hunter, Yvonne Wilkinson, Harvey Whiteford, and Alexandra McEwan. "Care, Community Capacity: Rethinking Mental Health Services in Remote Indigenous Settings." Australian Journal of Primary Health 12, no. 2 (2006): 51. http://dx.doi.org/10.1071/py06022.
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In 2002 a project was initiated to evaluate and restructure the Child and Youth Mental Health (CYMH) services in three health Service Districts: Cape York, the Torres Strait and Northern Peninsula Area and remote Cairns. The objective was to develop, establish and evaluate models of best practice for remote area CYMH services for Indigenous families living in far north Queensland. For the purposes of the project, an action research framework was adopted to guide the project design, methodology, implementation and evaluation. The first phase involved mapping of needs, the second phase focused on service restructure and outcomes were measured in the third phase. The planning/implementation/planning cycle was an ongoing part of the project and raised five significant themes: service equity, service quality, service sufficiency, Indigenous workforce, and service structure/ infrastructure. The principal project outcome was the establishment of a defined model of service delivery that incorporates the identified themes and sits within a community development framework. Other significant outcomes include the implementation of regular supervision and professional development activities and improvements in service data collection. This paper is a descriptive account of the process of service restructure and discusses the key project outcomes.
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Renshaw, Judy. "Good Practices in Mental Health." Psychiatric Bulletin 13, no. 4 (April 1989): 191–92. http://dx.doi.org/10.1192/pb.13.4.191.
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Good Practices in Mental Health (GPMH) is a national charity set up to disseminate information about local mental health services which are found to work well. Its general aim is to promote and assist the development of good mental health services. By providing an exchange of information about effective services in both hospitals and the community, GPMH encourages others to build on what is already proving successful. GPMH developed from a survey of mental health in big cities carried out by the International Hospital Federation (IHF) and was set up in 1977 with the support of the IHF, MIND and the King's Fund. It has the backing of all the major professional organisations concerned with mental health in the United Kingdom, the World Health Organization and the World Federation for Mental Health internationally. It is now funded mainly by the DHSS; some funding comes from the London Boroughs Grants Committee and charitable sources. There are three units within the organisation: information, development and evaluation.
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Hobbs, Coletta, Lesley Newton, Christopher Tennant, Alan Rosen, and Kate Tribe. "Deinstitutionalization for Long-Term Mental Illness: A 6-Year Evaluation." Australian & New Zealand Journal of Psychiatry 36, no. 1 (February 2002): 60–66. http://dx.doi.org/10.1046/j.1440-1614.2002.00984.x.
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Objective: Forty-seven patients with long-term mental illness were transferred to the community following the closure of a psychiatric hospital in Sydney. This 6-year evaluation is an extension of a detailed clinical, ethnographic and economic study of the initial 2-years of community transition. Method: Quantitative evaluation was conducted using the Brief Psychiatric Rating Scale, Life Skills Profile, Social Behaviour Scale, Montgomery Asberg Depression Rating Scale and Quality Of Life measures. Assessments were completed prior to discharge and at two- and 6-year intervals following community transfer. Repeated measures analysis was utilized to determine changes in outcome variables over time. The residents' perception of 6-years of community living was explored in qualitative semistructured interviews. Details of accommodation, level of care, readmissions, incidents and medication were also documented. Results: During the 6 years following community relocation a total of seven residents returned to hospital for long-term care, three residents died from medical causes and one resident required detention in a corrective services facility. The 36 residents who remained in the community at the 6-year follow-up no longer required intensive 24-h supervision. Living semi-independently, 23 residents resided in two to three person accommodation with either daily or weekly case manager visits. Clinically, community residents remained stable over the 6 years without significant changes in psychiatric symptoms, depression, living skills or social behaviour problems. Clinical stability was achieved with significant reduction in medication levels over the 6 years. Community-based residents continued to experience improved quality of life and reported their marked preference for living in the community. Conclusion: The residents maintained community tenure with significant improvement in quality of life and a reduction in medication, supported by a mental health system with adequate community resources. Issues regarding continuing rehabilitation and social integration need to be addressed. Further deinstitutionalization will require 24-h supervision for most initially and for some on a continuing basis. An ageing population will require specific age related medical and psychiatric services.
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MacDonald, L. D., J. Orhera, J. A. Leibowitz, and E. K. McLean. "Community Mental Health Services from the User's Perspective: an Evaluation of the Doddington Edward Wilson (Dew) Mental Health Service." International Journal of Social Psychiatry 36, no. 3 (September 1990): 183–93. http://dx.doi.org/10.1177/002076409003600303.
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Goldberg, David. "Community psychiatry in Europe: assessment and evaluation." Epidemiologia e psichiatria sociale. Monograph Supplement 6, S1 (April 1997): 217–27. http://dx.doi.org/10.1017/s1827433100000976.
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It is tempting to suppose that changes in the mental illness service in one's own part of Europe are taking place elsewhere as well. The asylum era is drawing to a close, and politicians everywhere are closing mental illness beds in order to re-distribute health costs in order to pay for new treatments needing expensive technology, as well as to allow for the needs of a population that is now living longer.In an attempt to become independent of official figures, key figures with a reputation for epidemiological psychiatry were approached in each European country, and asked to complete a brief questionnaire describing the mental health services in their country. Whether this method produces figures that are more or less accurate than official government figures is a question that cannot be addressed at present.
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Marraccini, Marisa E., Juliana L. Vanderburg, Robert R. Martinez, Steven E. Knotek, Cari Pittleman, and Rebecca Neshkes. "Development and Psychometric Evaluation of a Brief Measure of School and Community Mental Health Supports and Services." Professional School Counseling 26, no. 1 (January 2022): 2156759X2210876. http://dx.doi.org/10.1177/2156759x221087653.
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This study evaluated a self-report survey assessing school professionals’ perceptions of school and community mental health supports and services. Based on responses from 560 school professionals, findings provide support for the measure’s internal structure and ability to distinguish low-poverty and high-poverty schools. Practitioners and researchers may consider using this survey to understand perceptions of the quality and availability of mental health services, informing the selection and adaptation of school-based mental health supports and services.
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Rosen, Alan, Vivienne Miller, and Gordon Parker. "Standards of Care for Area Mental Health Services." Australian & New Zealand Journal of Psychiatry 23, no. 3 (September 1989): 379–95. http://dx.doi.org/10.3109/00048678909068296.
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A provisional set of standards of care was derived from a quality assurance strand of a wider research project, which reported the development of evaluation strategies for area integrated mental health services (AIMHS). In contrast to most published standards, they apply to all facets of care in a comprehensive catchment area mental health service, whether clinical or functional, community or hospital based, urban or rural, or managed by the public, private or voluntary sectors. We review briefly existing sets of standards of mental health services and report the process of development of standards of care, each with sub-sets of performance indicators and examples. While the AIMHS standards and a companion quality assurance manual are still undergoing refinement, they offer a guide for mental health professionals to the provision of services, and a checklist to service-users of services that should be available to them at every stage of care in a mental health system.
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Rosen, Alan, Vivienne Miller, and Gordon Parker. "Standards of Care for Area Mental Health Services." Australian & New Zealand Journal of Psychiatry 23, no. 3 (September 1989): 379–95. http://dx.doi.org/10.1177/000486748902300325.
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A provisional set of standards of care was derived from a quality assurance strand of a wider research project, which reported the development of evaluation strategies for area integrated mental health services (AIMHS). In contrast to most published standards, they apply to all facets of care in a comprehensive catchment area mental health service, whether clinical or functional, community or hospital based, urban or rural, or managed by the public, private or voluntary sectors. We review briefly existing sets of standards of mental health services and report the process of development of standards of care, each with sub-sets of performance indicators and examples. While the AIMHS standards and a companion quality assurance manual are still undergoing refinement, they offer a guide for mental health professionals to the provision of services, and a checklist to service-users of services that should be available to them at every stage of care in a mental health system.
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Dodd, Karen, Vicky Laute, and Selven Daniel. "The development and evaluation of an integrated intensive support service." Advances in Mental Health and Intellectual Disabilities 16, no. 1 (November 30, 2021): 1–17. http://dx.doi.org/10.1108/amhid-04-2021-0021.
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Purpose This paper aims to describe the development and evaluation of integrated intensive support service (ISS) for adults with learning disabilities who have complex needs and are at risk of admission to an inpatient unit. Design/methodology/approach Existing services were remodelled. The service explored external service models and established an integrated ISS comprising intensive community support and intensive support beds. Findings Data indicates that the majority of people referred to the service avoid both admission to an inpatient unit and placement breakdown. Most people admitted to the inpatient unit are not known to community services. Length of stay has significantly reduced. Practical implications Other services can use the information to remodel how to provide intensive support and avoid admission to an inpatient unit. Originality/value It demonstrates how remodelling can drive improvements to reduce placement breakdown and risk of admission.
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Kennedy, Craig, and Peter Yellowlees. "A community-based approach to evaluation of health outcomes and costs for telepsychiatry in a rural population: Preliminary results." Journal of Telemedicine and Telecare 6, no. 1_suppl (February 2000): 155–57. http://dx.doi.org/10.1258/1357633001934492.
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A pilot trial was established to support visiting psychiatric services and local public and private practitioners through the use of videoconferencing. The purpose of the trial was to determine whether people in the community received better health-care with telemedicine. A community-based approach was used to evaluate health outcomes, costs, utilization, accessibility, quality and needs for such services in a rural community in Queensland. Over a two-year period data were collected from 124 subjects who met the criteria of having a mental health problem or mental disorder. Nine further subjects refused to participate in the study. Only 32 subjects used videoconferencing to receive mental health services. Preliminary results did not show any significant improvements in wellbeing or quality of life, although the time span was relatively short. However, the results confirmed that the people were no worse off from a consumer or a practitioner perspective from using videoconferencing. Most consumers found that videoconferencing with a psychiatrist moderately or greatly helped them in managing their treatment, with 98% of them preferring to be offered videoconferencing in combination with local services. Overall, videoconferencing is a crucial part of enhancing psychiatry services in rural areas. However, it is not necessarily cost-effective for all consumers, general practitioners, psychiatrists, or the public mental health service.