S75: SYMPOSIUM: Building the evidence base of Prevention and Recovery Care Services (PARCS).

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By September 27, 2017 No Comments

Authors: Lisa Brophy, Serhat Turut, Ella Svensson, Jia-Wern Toh, Carol Harvey, Justine Fletcher

Year: 2017

Event: 2017 TheMHS Conference

Subject: symposium, services, recovery, prevention,

Type of resource: Conference Presentations and Papers

Abstract: Paper one: An overview of Prevention and Recovery Care Services (PARCS). PARCS are a relatively new service option that is rapidly expanding across Australia. PARCS generally involve a partnership between mental health community support services (i.e. non-government agencies) and clinical mental health services. They are residential services that support people with severe mental disorders to either avoid hospital admission (step up) or leave hospital early (step down), with a strong emphasis on integrating clinical mental health care with intensive recovery-focused psychosocial input. Most PARCS provide sub-acute, short term care (maximum 28 days) for adults, but there are also Youth PARCS are an emerging model. This symposium will enable presentations about research and evaluation activities focused on PARCS in Victoria and it will enable discussion about emerging evidence about the impact of this important new model of care. We will also present the challenges associated with PARCS research and the contribution of peer researchers to these projects.

Paper Two: Evaluation the effectiveness of the Northern and Arion Prevention and Recovery Care (PARC) services. Neami National, cohealth and North Western Mental Health collaborated to evaluate the effectiveness of the Northern and Arion Prevention and Recovery Care (PARC) services in Victoria from 2011 to 2013. We investigated consumer satisfaction, and psychological wellbeing on entry, exit and 3 months post-exit, using the RAS, STORI-30, CANSAS and K10. Hospital usage data was compared for each person, comparing number of admissions, and days in hospital, in the 12 months before and 12 months after the PARC stay. Consumers were satisfied with their time at PARC and measures of psychological wellbeing moved in a positive direction, suggesting a positive impact on consumer recovery. Both number of hospitalisations and days in hospital reduced significantly, indicating PARCs may be achieving their desired impact of reducing acute inpatient hospital admissions

Paper Three: Youth Prevention and Recovery Care – monitoring the performance of an innovative service for young people with complex needs. The Peninsula Youth Prevention and Recovery Care (Y-PARC) is a sub-acute residential service based on a developmental and holistic approach to the young person’s recovery conducted as a partnership model between clinical and mental health support services. We will present the findings from an evaluation that aimed to assess whether the Y-PARC is meeting its objectives and to identify ways of improving the quality and effectiveness of the program. The evaluation was initially informed by the development of a logic model and the collaborative development of key research questions. A mixed methods design included interviews with YPARC residents and formers residents, their carers, focus groups with staff, a file audit and analysis of secondary data. The evaluation was enhanced by the involvement of two young people engaged as research team members. This new service initiative provides an important contribution to the care of young people experiencing complex mental health needs. There are high levels of satisfaction with the service but also opportunities for service improvement.

Paper four: Investigating the appropriateness, effectiveness and efficiency of PARCS. We will present preliminary findings from a state-wide project investigating the appropriateness, effectiveness and efficiency of PARCS. In our first of seven interconnected studies we aimed to assess the extent to which PARCS are providing the intended service option according to government guidelines; and, describe PARC services, including treatments and recovery-informed practices. We conducted a service mapping exercise for each of the nineteen adult PARCS in Victoria, using the Quality Indicator for Rehabilitative Care (QuIRC), an internationally validated tool designed to assess the quality of care in longer term inpatient and community-based mental health residential facilities. Mapping the services is an important step in understanding similarities and differences between PARCS, allowing for identification of possible PARCS subtypes. This will also assist in understanding data collected in the other studies in this large mixed methods project. More broadly, these findings will help identify where PARCS fit on the spectrum of community-based residential mental health facilities world-wide.

Learning Objectives
Learning Objective 1: The audience will better understand the service model of step-up/step-down services and what impact these services may have on the recovery of consumers and changes in hospital admissions.

Learning Objective 2: The step-up/step-down service model is still relatively new. Exploring the effectiveness of these services is important to not only understand what impact these service may have on the recovery of consumers but also how these services may interact with other mental health services.

Siskind, D., Harris, M., Kisely, S., Brogan, J., Pirkis, J., Crompton, D., & Whiteford, H. (2013). A retrospective quasi-experimental study of a community crisis house for patients with severe and persistent mental illness. Australian and New Zealand Journal of Psychiatry, 47: 667-75.
Turut, S. (2015) Prevention and Recovery Care (PARC) Service
Research Project Update. Neami National. http://neaminational1kyqws7klnr.devcloud.acquia-sites.com/sites/default/files/2015_parc_research_project_update_report.pdf

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