S52: Stepped-care: A need to embrace change with innovative and pragmatic person-led mechanisms.

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By September 26, 2017 No Comments

Authors: Grant Macphail

Year: 2017

Event: 2017 TheMHS Conference

Subject: Service Systems, Delivery, Implementation,Change, Innovation, Reform,Research & Evaluation Informing Practice

Type of resource: Conference Presentations and Papers

Abstract: This presentation seeks to generate further innovative thinking, discussion, and action that embraces and enables adaptive processes for Australia’s changing mental health landscape and the provision of person-led support in a stepped-care environment. In doing so, this presentation calls for mental health system stakeholders to embrace and promote truly flexible, mutualistic, cross-sectorial, multi-level, adaptive responses to stepped-care reform within and between currently disjointed mental health system stakeholder groups. If stakeholders can embrace reformative change in innovative ways, stepped-care reform will ensure a more integrated system with greater capacity and equitable opportunities to access appropriate person-led supports. Therefore, innovative translations of stepped-care policy and research must be fostered within supportive environments, driven by the needs and voices of families, carers, and individuals with lived experience of mental ill-health, and actioned in a timely, effective, integrated, and holistic manner. As such, this presentation further calls for ecologically valid research methodologies to inform innovative and effective approaches to person-led service provision within changing contextual realities. We require evidence that enables a pragmatic understanding of the needs and perspectives of individuals with lived-experience, of which, is also appropriate for informing the continual improvement of our mental health system within a reformative environment.

Learning Objectives
Learning Objective 1: Audience will gain and learn:
- An increased, critical understanding of the complex practicalities likely to emerge from forthcoming Australian stepped-care reform and how these changes may impact provision of integrated and person-led services and supports.
- Stronger appreciation and understanding of the importance of developing an appropriate evidence-base to inform continual improvement through change, and innovative translations of stepped-care research evidence into practice.
- Critical, innovative, and pragmatic approach to thinking related to stepped care’s utility for building system capacity and diversity to promote a resilient and sustainable system.

Learning Objective 2: Stepped-care reform is an integral component in the sweep of recent policy reforms impacting the Australian mental health system. Therefore, it is essential to build a strong applied understanding of how stepped-care may impact individual access and engagement with services and supports of varying intensity. Further, in order for stepped-care reform to be effective and efficient it is also essential that system stakeholders embrace appropriate research methodologies which yield valid and reliable evidence that may inform and integrate a pragmatic understanding of lived-experience perspectives into appropriate policy development whilst enabling flexible translations of policy and research into practice.

Reich, M. R., Yazbeck, A. S., Berman, P., Bitran, R., Bossert, T., Escobar, M. L., ... & Yip, W. (2016). Lessons from 20 Years of Capacity Building for Health Systems Thinking. Health Systems & Reform, 2(3), 213-221.
Hickie, I. B. (2015). Time to implement national mental health reform. The Medical Journal of Australia, 202(10), 515-517.

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