Prevention and Recovery Care Services in Australia: Describing the Role and Function of Sub-Acute Recovery-Based Residential Mental Health Services in Victoria

Abstract

Background: Prevention and Recovery Care (PARC) services are relatively new sub-acute residential services that have supported people with mental ill-health in Victoria since 2003. Operated from a partnership model between non-governmental agencies and clinical mental health services, PARC services integrate intensive recovery-focused psychosocial input with clinical mental health care. Aim: To describe and contrast the 19 PARC services operating in Victoria at the time of the study, in terms of structures and function, resources, and content and quality of care. Method: Nineteen participants, one representing each PARC, completed two surveys: the first, a purpose-designed survey relating to the government guidelines for PARC services, and the second, the Quality Indicator for Rehabilitative Care. Results: Descriptive analyses highlighted that PARC services have operated in inner-city, urban, and regional areas of Victoria, from between 1 and 14 years. Participants reported that a recovery approach was at the core of service delivery, with a vast array of group and individual programs on offer. Across the state, there was variation in the quality of services according to the Quality Indicator for Rehabilitative Care domains. Conclusions: This study has identified that there is variation in the structure and function, resourcing, and content and quality of care offered across Victoria’s PARC services even though, in the main, they are guided by government guidelines. Hence it appears that the services adapt to local needs and changes in service systems occurring over time. The findings indicate emerging evidence that PARCs are providing recovery-oriented services, which offer consumers autonomy and social inclusion, and therefore likely enable a positive consumer experience. The range of individual and group programs is in line with the Victorian guidelines, offering practical assistance, therapeutic activities, and socialization opportunities consistent with consumer preferences. Further research into implementation processes and their impacts on quality of care is warranted concerning this and similar service models.

Outcomes of Victorian Prevention and Recovery Care Services: A matched pairs comparison

“…The current study was designed to respond to the clear need for a large-scale comparison of a range of outcomes for appropriately matched groups of PARCS consumers and inpatients. As noted, it was part of a broader evaluation of Victorian PARCS by our group that involved multiple studies (Fletcher et al, 2019a;Harvey et al, 2019;Sutherland et al, 2020…”

“…This study was designed to respond to the clear need for a large-scale comparison of a range of outcomes for appropriately matched groups of PARCS consumers and inpatients. As noted, it was part of a broader evaluation of Victorian PARCS by our group that involved multiple studies (Fletcher et al, 2019a;Harvey et al, 2019;Sutherland et al, 2020). It aimed to determine whether Victorian PARCS are achieving their objectives in relation to delivering services to people who might otherwise have required acute inpatient care.…”

Similarities and differences in people accessing prevention and recovery care services and inpatient units in Victoria, Australia

“…All PARC services have a system to assess suitability and prioritise referrals for admission. This process is not standardised across PARC services and there is variation in the process of entry [7]. Acceptance to a PARC service is determined jointly by the clinical and MHCCS provider following referral from the inpatient or community mental health team.…”

“…6 Southern Synergy, Faculty of Medicine, Nursing and Health Science, Monash University, Clayton, VIC, Australia. 7 Dept of Psychiatry, Monash University, Peninsula Mental Health Service, Frankston, VIC, Australia. 8 School of Allied Health, Human Services and Sport, La Trobe University , Bundoora, VIC, Australia.…”

“…The clinical services provide assessment and treatment interventions, while the MHCCS provide 24-h residential services as well as assessment, treatment, psychosocial support to individuals and group activities. The service delivery model, informed by a personal recovery framework, is guided by the state government's adult PARC services framework and operational guidelines [1,7], described more fully elsewhere [7].…”