Future directions for mental health services in Australia

Whiteford, Harvey

doi:10.1111/j.1753-6405.1992.tb00080.x

Cited by 11 publications

(3 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…From the outset of the National Mental Health Strategy in Australia in 1992, the need for linkages between the mental health sector and other government and non-government services was considered critical to the provision of effective community-based treatment and support (Australian Health Ministers, 1992; Whiteford, 1994). The first National Mental Health Policy and plan required: the mainstreaming of mental health services to bring them under the same administrative umbrella as other health services (Singh, 1992; Whiteford et al, 1993); the integration of hospital (inpatient) mental health services with community mental health services (Whiteford et al, 1993); and intersectoral linkages requiring access to housing and community services (mostly operated outside of health departments) for individuals with mental illness and psychiatric disability living in the community (Whiteford, 1992a; Whiteford, 1992b). Following deinstitutionalization, with most people with severe and persistent mental illness now cared for in the community, poor linkages between the health, housing, employment and income support sectors became evident (Behan et al, 1994; HREOC [Human Rights and Equal Opportunity Commission], 1993).…”

Section: Introductionmentioning

confidence: 99%

System-level intersectoral linkages between the mental health and non-clinical support sectors: a qualitative systematic review

Whiteford

McKeon

Harris

et al. 2014

Aust N Z J Psychiatry

Self Cite

View full text Add to dashboard Cite

ObjectivesConcerns about fragmented mental health service delivery persist, particularly for people with severe and persistent mental illness. The objective was to review evidence regarding outcomes attributed to system-level intersectoral linkages involving mental health services and non-clinical support services, and to identify barriers and facilitators to the intersectoral linkage process. MethodsA systematic, qualitative, review of studies describing attempts to coordinate the activities of multiple service agencies at the policy, program or organisational level.Electronic databases Medline, PsycINFO and EMBASE were searched via OVID from inception to July 2012. ResultsOf 1,593 studies identified, 40 were included in the review -26 in adult and 14 in vulnerable youth populations. Identified mechanisms to promote positive system-level outcomes included: interagency coordinating committees or intersectoral/interface workers engaged in joint service planning; formalised interagency collaborative agreements; a single care plan in which the responsibilities of all agencies are described; cross-training of staff to ensure staff culture, attitudes, knowledge and skills are complementary; service co-location; and blended funding initiatives to ensure funding aligns with program integration. Identified barriers included: adequacy of funding and 3 technology; ensuring realistic workloads; overcoming 'turf issues' between service providers and disagreements regarding areas of responsibility; ensuring integration strategies are implemented as planned; and maintaining stakeholder enthusiasm. ConclusionsSystem-level intersectoral linkages can be achieved various ways and are associated with positive clinical and non-clinical outcomes for services and clients. Some linkage mechanisms present greater implement challenges than others (e.g., major technology upgrades or co-location in geographically remote areas). In some instances (e.g., colocation) alternative options may achieve equivalent benefits. Publication bias could not be discounted, and studies using high-quality research designs are scarce. The limited information base applicable to system-level integration argues strongly for evaluation of the models that evolve in the rollout of the national Partners in Recovery initiative.

show abstract

Section: Introductionmentioning

confidence: 99%

System-level intersectoral linkages between the mental health and non-clinical support sectors: a qualitative systematic review

Whiteford

McKeon

Harris

et al. 2014

Aust N Z J Psychiatry

Self Cite

View full text Add to dashboard Cite

show abstract

“…The integration of mental health services into primary care, was designed to allow people with mental health problems to access quality mental health services close to their homes, families and daily activities 44. Using growth mixture models our study showed that treatment use was varied and treatment patterns were diverse for the women born 1973–1978 over time.…”

Section: Discussionmentioning

confidence: 93%

Transitions in health service use among women with poor mental health: a 7-year follow-up

et al. 2022

View full text Add to dashboard Cite

ObjectiveWomen suffering from mental health problems require varied needs of mental health service utilisation. Transition between general practitioner and mental health services use are available through the Better Access Scheme initiative, for those in need of treatment. The study’s aim was to identify trajectories of mental health service utilisation by Australian women.DesignThe Australian Longitudinal Study on Women’s Health data linked to the administrative medical claims dataset were used to identify subgroups of women profiled by their mental health service use from 2006 to 2013. Latent growth mixture model is a statistical method to profile subgroups of individuals based on their responses to a set of observed variables allowing for changes over time. Latent class groups were identified, and used to examine predisposing factors associated with patterns of mental health service use change over time.SettingThis study was conducted in Australia.ParticipantsNational representative sample of women of born in 1973–1978, who were aged between 28 and 33 years at the start of our study period.ResultsSix latent class trajectories of women’s mental health service use were identified over the period 2006–2013. Approximately, one-quarter of the sample were classified as the most recent users, while approximate equal proportions were identified as either early users, late/low user or late-high users. Additional, subgroups were defined as the consistent-reduced user and the late-high users, over time. Only 7.2% of the sample was classified as consistent high users who potentially used the services each year.ConclusionThese findings suggest that use of the Better Access Scheme mental health services through primary care was varied over time and may be tailored to each individual’s needs for the treatment of depressive symptoms.

show abstract

“…The inception of a National Mental Health Strategy (NMHS) and the first five-year National Mental Health Plan in 1992 marked an important turning point for mental health in Australia [ 8 , 9 ]. The subsequent 20 years of mental health reform saw the publication of further five-yearly Government Plans, each of which outlined priority areas for investment and reform.…”

Section: Introductionmentioning

confidence: 99%

An analysis of policy levers used to implement mental health reform in Australia 1992-2012

Grace

Head

Hall

et al. 2015

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundOver the past two decades, mental health reform in Australia has received unprecedented government attention. This study explored how five policy levers (organisation, regulation, community education, finance and payment) were used by the Australian Federal Government to implement mental health reforms.MethodsAustralian Government publications, including the four mental health plans (published in 1992, 1998, 2003 and 2008) were analysed according to policy levers used to drive reform across five priority areas: [1] human rights and community attitudes; [2] responding to community need; [3] service structures; [4] service quality and effectiveness; and [5] resources and service access.ResultsPolicy levers were applied in varying ways; with two or three levers often concurrently used to implement a single initiative or strategy. For example, changes to service structures were achieved using various combinations of all five levers. Attempts to improve service quality and effectiveness were instead made through a single lever-regulation. The use of some levers changed over time, including a move away from prescriptive, legislative use of regulation, towards a greater focus on monitoring service standards and consumer outcomes.ConclusionsPatterns in the application of policy levers across the National Mental Health Strategy, as identified in this analysis, represent a novel way of conceptualising the history of mental health reform in Australia. An improved understanding of the strategic targeting and appropriate utilisation of policy levers may assist in the delivery and evaluation of evidence-based mental health reform in the future.

show abstract

Future directions for mental health services in Australia

Cited by 11 publications

References 19 publications

System-level intersectoral linkages between the mental health and non-clinical support sectors: a qualitative systematic review

System-level intersectoral linkages between the mental health and non-clinical support sectors: a qualitative systematic review

Transitions in health service use among women with poor mental health: a 7-year follow-up

An analysis of policy levers used to implement mental health reform in Australia 1992-2012

Contact Info

Product

Resources

About