S15: LEAD & PANEL PRESENTATIONS: Evidence into Practice (Service Delivery)

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By November 25, 2022 No Comments

Authors: Ellen McNaught, Michael Shartrand, Minjoo Kwon, Sharon Lawn, Naomi Laauli, Thea Prasad, Euan Macleay

Year: 2022

Event: 2022 TheMHS Conference

Subject: services, integration, men,

Type of resource: Conference Presentations and Papers

Abstract: LEAD PRESENTATION: Making sense of service integration
Ellen McNaught

Integration is a key theme of the current Victorian mental health reform agenda, though this pursuit of integration is not new. System fragmentation and resulting poor outcomes are cited across multiple sectors, and the need for integrated services remains a repetitive call from commission and senate inquiries for more than ten years. While seemingly straightforward and compelling, service integration has proved challenging to define and implement. Challenged by a multitude of descriptors (wrap-around, multidisciplinary, inter-organisational, one-stop-shop) it is often thought of as a service, or a model rather than a system. 25 years ago Hasse & Austin (1997) suggested that integration must be viewed as ongoing system reform, however, integration continues to be described in dichotomous ways (top/down or horizontal/vertical). What happens when we think of integration as an ecological system centred around consumers, consisting of levels, people, interactions and levers? What does this lens help us see or understand differently? What does it confirm about our current practice?
This presentation will provide a brief overview of integration literature through an ecosystem lens, and present preliminary data from a current research project ‘mapping an actor-based logic of service integration’ to support making sense of and implementing service integration.

PANEL PRESENTATION: IPS Employment Model: The future for “tens of thousands” of Australians? Let us hope so!
Michael Shartrand

Navigating the employment landscape with the experience of an enduring mental health condition can challenge the basic notion of what’s possible for someone. IPS is an evidence-based employment program designed to support people experiencing sever and persistent mental illness into meaningful and preferred employment. IPS is directly embedded into existing mental health and homelessness services to enhance recovery and sustain long-term, positive wellbeing.
IPS delivery in Australia has been a stepping-stone proposition. Nurtured at the grassroots level within NGO’s and Health Organisations, to an emerging broader national level, that is now positioning IPS to arrive as the standard for how job supports are delivered across Australia. However, embedding IPS into existing structures or newly created programs, such as the Adult Mental Health Centres, will be a complex conversation between IPS model integrity and funder requirements.
This presentation will reflect on six years of IPS delivery and growth at Neami National and how concurrent Federal IPS program growth has been maturing across the sector. This growth is leading to wider IPS adoption and creating a distinction of a more human-centered employment delivery practice.

PANEL PRESENTATION: Understanding Men's Engagement and Disengagement when seeking support for mental health
Minjoo Kwon, Sharon Lawn

Research over several decades has found that men are less likely to utilise health care services compared to women. When it comes to mental health, men have been found to hold more reluctant attitudes towards engaging with mental health services. Current studies have predominantly been quantitative and focused on understanding effective strategies to promote men’s engagement and why men disengage. Much of this research has been undertaken from the services’ perspective. This research attempts to gain better insight into men’s disengagement from mental health services and what it will take to re-engage them back into the system by hearing men’s qualitative comments about their experiences.
This research was a secondary analysis of data collected by a national survey conducted by Lived Experience Australia (LEA). Responses of 53 male consumers were gathered and analysed.
Analysis of the responses was split into two themes: (1) Why men disengage and (2) What will help men re-engage. Four sub-themes arose from responses reflecting on (1) why men disengage: (1.1) Autonomy; (1.2) Professionalism; (1.3) Authenticity; (1.4) Systemic Barriers. Three sub-themes were found for (2) What can help men re-engage; (2.1) Clinician-driven reconciliation, (2.2) Community and Peer Workers; (2.3) Ease of re-entry.

PANEL PRESENTATION: Embedding integration – how integrated mental health hubs make a difference in Brisbane North.
Naomi Laauli, Thea Prasad

Brisbane North PHN’s innovative model of integrated services for people experiencing complex and severe mental ill health via local Hubs has made a positive difference. Over the first two years of operation a comprehensive evaluation of the Integrated Mental Health Hubs identified:
• Over 2,200 referrals which resulted in 1651 episodes of care and more than 38,000 service contacts.
• People accessing the hubs reported positive experience and improved recovery outcomes, including positive group-level changes in psychological distress and recovery over time.
• Service user rated experience scores exceeded the 85% satisfaction target set.
• The pooling of resources enables integration of clinical and non-clinical supports in one place.

This presentation will detail how the PHN, service providers and consumers overcame common challenges and share the extensive co-design model and funding approach which has seen services delivered in a comprehensive, integrated manner since 2019.

Attendees will understand how the PHN has commissioned, supported, and worked with service providers and services users to embed integration with the aim of supporting people with severe mental illness to:
- live well in the community
- access integrated clinical and non-clinical services, matched to their level of need; and
- achieve their recovery goals

PANEL PRESENTATION: Navigating complexity through person-centred care planning and review in inpatient mental health
Euan Macleay

Person-centred care is an essential part of modern healthcare systems and the foundation of recovery-oriented practice. However, authentic involvement of consumers and carers in the care planning and review process has been difficult to achieve in mental health services.

This presentation will focus on results from a before and after study evaluating a multi-faceted intervention that introduced person-centred, goal directed, care planning and review on two inpatient units.

To measure the quality of care plans, and consumer and carer involvement in the care planning process before, and after the intervention.

A medical record audit of care planning and review, and a consumer survey of involvement in the care planning process, before and after the intervention.

The audit showed significant changes in the overall quality and person-centred nature of care plans - this was strongly linked to the occurrence of a collaborative meeting to develop the care plan. There was no significant change in the survey measure of consumer involvement in the care planning process.

Conclusion and significance
Practice regarding collaborative care planning improved with a structured intervention based on a behaviour change model. Further work needs to concentrate on improving review of the care plan.

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