S23: Clinical Services & Recovery

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By October 19, 2023 No Comments

Authors: Melissa Savaglio, Ashley Vincent, Danny Mcculloch, Shaun McNamara, Helen Searle & Rachel Barbara-May

Year: 2023

Event: 2023 The MHS conference - Adelaide

Subject: Clinical Services & Recovery

Type of resource: Conference Presentations and Papers

Presentation 1: Enhancing the psychosocial functioning of adults with severe mental illness: A controlled evaluation of Foundations.
Authors: Melissa Savaglio & Ashley Vincent
Severe mental illness (SMI) adversely impacts functioning, yet limited evidence for psychosocial programs in Australia exists. This presentation describes the controlled evaluation of Foundations, a nationally accredited, recovery-oriented, person-centred, goal-focused and community-based psychosocial service. We examined Foundation’s effect on the clinical mental health symptomology and psychosocial functioning of adults with SMI, compared to clinical mental health support only. Clients engaged in Foundations were allocated to the intervention group (n=103). Implemented in Tasmania by Baptcare, Foundations provides 18-months of holistic wrap-around psychosocial support to enhance clients’ mental health recovery. Clients engaged with State-wide Mental Health Services were allocated to the control group and received clinical mental health support only (n=101). The HoNOS and BASIS measures were completed at intake, every 3 months during program engagement, and closure. Foundations clients experienced a greater reduction in the severity of their mental health symptomology and larger improvement in psychosocial functioning (p<.05). Specific improvements were observed in daily functioning, social functioning, and reduced impairment associated with mental health symptoms. This is the first controlled study to demonstrate the efficacy of a community-based psychosocial recovery program, which empowers and supports the humanity and rights of adults with SMI in Tasmania.
Learning Objective
1. This presentation demonstrates how psychosocial support can enhance the quality of life and broader functioning of adults with severe mental illness, and their carers/families. 2. The provision of psychosocial support could become part of standard community mental health care to empower all adults experiencing SMI.
1. O’Donnell, R., Savaglio, M., Fast, D., Vincent, A., Vicary, D., & Skouteris, H. (2020). The Mycare study: protocol for a controlled trial evaluating the effect of a community-based intervention on psychosocial and clinical outcomes and hospital admission rates for adults with severe mental illness. BMJ Open, 10, e040610. doi: 10.1136/bmjopen-2020-040610
2. O’Donnell, R., Ayton, D., Pizzirani, B., Savaglio, M., Fast, D., Vicary, D., & Skouteris, H. (2020). MyCare – enhancing community mental health care in Tasmania, Australia: Program description and implementation findings. Australian Journal of Primary Health. doi: 10.1071/PY20046

Presentation 2: Uptake and experience of mental health crisis support at Adelaide's Urgent Mental Health Centre.
Authors: Danny Mcculloch & Shaun McNamara
The Urgent Mental Health Care Centre aims to provide a welcoming, person-focused alternative for people seeking support in distress or mental health crisis. People can walk-in or be referred by first responders and receive intensive supports for up to 24 hours from a combined clinical and lived experience workforce. This first-of-its-kind service has been operating since March 2021, and as a 24 hour service since mid 2022.
This presentation will share data from the most recent year of service operation, demonstrating how community members and the local sector are utilising the Urgent Mental Health Care Centre. This will include demographics of people using supports, their level of need, and pathways into the service, along with service activity data. Deidentified feedback on people’s experience of the service will highlight what people are valuing and finding challenging about the service. These findings will show the service as a welcome alternative to the emergency department for people in mental health crisis and a valued part of a reforming mental health sector in South Australia.
Learning Objective
1. Understanding of the service model, uptake and experience of this new service model providing an alternative to the emergency department for people in mental health crisis.
2. New service models are critical to driving reform and improving outcomes for people in mental health crisis.

Presentation 3: Holding Heart-Design and Implementation of Statewide Women's Mental Health Service utilising dialogically informed practices.
Authors: Helen Searle & Rachel Barbara-May
The Statewide Women’s Mental Health Service (SWMHS) is an innovative response to the Royal Commission Victorian Mental Health Service recommendation on public-private partnerships, established by the Alfred Health, Ramsay Health, and Goulburn Valley Health Partnership. It aims to provide a statewide trauma- and violence-informed service for women, or those who identify as women, who present with severe mental illness and trauma. A dialogical approach recognises the rights and roles that individuals (‘persons at the centre of concern’) have to make decisions about their care-‘no decision about me, without me’.
1. Open Dialogue has two fundamental features: an integrated treatment system that engages families and social networks as a standard part of treatment and a dialogic practice where treatment meetings involve the individual’s network in a collaborative, democratic space to plan, organise and talk about how best to work together.
2. ‘Taking the team with, and on the journey’…Embedding dialogic practice within the first public private consortium for inpatient mental health treatment for those who identify as women required a flattening of hierarchy, lived experience leadership and a flexible approach to learning. This included fortnightly multidisciplinary team ‘intervision’ and a flexible needs adapted approach. Vulnerability, curiosity, safety, and the honouring of team and individual expertise within and across stakeholder groups
Learnings from ongoing implementation will be shared.
Learning Objective
1. Dialogic practice provides much greater person centred, compassionate care which in turn creates a strong culture of teamwork and shared responsibility. Implementation requires a commitment to ongoing team and systems training.
2. Innovation in care of women in mental health distress and lived experience embedded in treating team
The Key Elements of Dialogic Practice In Open Dialogue: Fidelity Criteria. Olson, M., Seikkula, J., Ziedonis, D. Version 1: August 20, 2014
2. Open Dialogue-Key Markers and Their Context. Eitera, A et al 2014

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