Time to invest in developing community mental health services

Abstract

Objectives:

To report on the evaluation of publicly funded community mental health services in two New South Wales health districts.

Methods:

Qualitative and quantitative data from 28 publicly funded adult community mental health teams in two NSW health districts were gathered using structured interviews, benchmarking surveys, focus groups and online questionnaires.

Results:

The community mental health services studied lacked a coherent strategic and recovery oriented framework or model of care for service delivery. There was evidence of poor role definition at the team level, resulting in duplication and inefficiency. There were inadequate staffing levels for stated objectives, a lack of training and continuing education in evidence based intervention, poor consumer and family participation in service design, and no development and monitoring of meaningful outcome measures.

Conclusions:

This review and benchmarking study highlights the need for mental health policy implementation to be further supported with: development of a service delivery framework outlining essential components of a specialist community mental health system; operational guidance to enable effective team specialisation in accordance with research; investment in practitioner training to support the development of evidence based practice; and processes to ensure effective consumer and carer participation in developing recovery oriented services.

Keywords

community mental health services service framework

Get full access to this article

View all access options for this article.

References

Whiteford

Buckingham

. Ten years of mental health services reform in Australia. Are we getting it right? Med J Aust 2005; 182: 396-400.

Department of Health and Ageing. National mental health report 2010: summary of 15 years of reform in Australia’s mental health services under the National Mental Health Strategy 1993–2008. Canberra: Commonwealth of Australia, 2010.

NSW Mental Health Commission. Living well: a strategic plan for mental health in NSW. Sydney: NSW Mental Health Commission, 2014.

National Mental Health Commission. The national review of mental health programmes and services. Sydney: NMHC, 2014.

Hoult

Reynolds

Charbonneau-Powis

. Psychiatric hospital versus community treatment: the results of a randomised trial. J Aust NZ Coll Psychiatrists 1983; 17: 160–167.

Hoult

. Community care of the acutely mentally ill. Br J Psychiatry 1986; 149: 137–144.

Department of Health NIMHE. The mental health policy implementation guidance: crisis resolution & home treatment teams. London: UK Department of Health, 1999.

NSW Health. NSW community mental health strategy 2007–2012: from prevention torecovery, 2008. http://www.health.nsw.gov.au/mhdao/publications/Documents/070214_cmhs_summary.pdf (2008, accessed 27 September 2015).

Mental Health Commission. Blueprint for mental health services in New Zealand: how things need to be. Wellington: New Zealand Government, 1998.

10.

Department of Health. National service framework for mental health: modern standards and service models. London: UK Department of Health, 1999.

11.

Flannery

Adams

O’Connor

. A community mental health service delivery model: integrating the evidence base within existing clinical models. Australas Psychiatry 2011; 19: 49-55.

12.

Hickie

. A new model for delivering selected mental health services in Australia. Sydney: Brain and Mind Research Institute, 2010, pp.1–12.

13.

Department of Health. Policy Implementation Guidance: Community Mental Health Teams. London: UK Department of Health, 2002.

14.

The Cochrane Collaboration. Assertive community treatment for people with severe mental disorders (review). London: The Cochrane Collaboration, 2010.

15.

The Cochrane Collaboration, Crisis intervention for people with severe mental illnesses (review). London: The Cochrane Collaboration, 2012.

16.

Department of Health and Ageing. Principles of recovery oriented mental healthpractice. In: National standards for mental health services. Canberra: Commonwealth Government of Australia, 2010.