integrated service centres...personality disorder post natal depression primary diagnosis...
TRANSCRIPT
Integrated Service Centres
Leading Reform Conference
21 November 2018
Integration: A strategy or Quality Improvement?
Health services that are managed and delivered in a way that ensures people receive a continuum of health promotion, disease prevention, diagnosis, treatment, disease management, rehabilitation and palliative care services, at the different levels and sites of care within the health system, and according to their needs throughout their life course (WHO 2015)
Integration is a coherent set of methods and models on the funding, administrative, organisational, service delivery and clinical levels designed to create connectivity, alignment and collaboration within and between the cure and care sectors. The goal is to enhance quality of care and quality of life, consumer satisfaction and system efficiency for patients.
(Kodner and Spreeuwenberg 2002)
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4
‘Integrating mental health services into primary
care is the most viable way of closing the
treatment gap and ensuring that people get the
mental care they need’
(World Health Organisation 2008)
Aftercare: Integrated Service Centres
• The Poppy Centre – 0 to 11 years inc Infant MH program
• headspace Nundah – 12- 25 years
• headspace Woolloongabba
• headspace Ipswich
• headspace Meadowbrook
• headspace Capalaba
• headspace Hurstville
• headspace Miranda
• LikeMind Wagga Wagga – 18 – 65 years
• LikeMind Orange
• Floresco Ipswich
• Floresco Toowoomba
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What are we trying to achieve?
Development model of Integrated Care (Minkman 2012)8
What are we trying to achieve?
• Improved experience of care for the consumer
• Improved rates of ‘personal’ recovery
• Reduce acute hospital admissions
• Reduce the number of times Consumers and Carers have to tell
their story
• Reduction in the number of Care Plans that Consumers have
• Reduction in the number of people falling through service gaps
• Improved Carer and family health/mental health
How?
• Facility: accessible, ‘one stop shop’
• Governance: Consortium of partners and stakeholders
• Service delivery streams: Primary care, MH, AOD, vocational, housing, plus others targeting local needs
• Clinical Governance: Integrated clinical systems, including shared medical record and one care plan
• Clinical outcomes: pre & post measures
• Staffing profile: matched to client pathway and service streams
• Consumer participation
• Family & Friends/Carer Inclusive Practice
• Community engagement/ Health Promotion
• Hybrid funding model: State or PHN, Medicare, NDIS, Brokered etc
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Integration Partners
NGOs (psychosocial support; peer and group support)
Alcohol & other drugs service provider/s (NGO; public; private)
Employment provider
Housing provider (community/public)
Primary Health Care Providers (GP and Allied Health) - MBS
Private Psychiatrist - MBS
Public Mental Health Service Providers
Floresco Ipswich
3 year evaluation
Monday Tuesday Wednesday Thursday Friday1 Art Perspective 9.30am – 12pmHearing Voices Group 2pm - 4pmGrow Group 6.30pm – 8.30pm
2Women’s Managing Emotions 9.30am – 12pm (8 weeks finishing 22/03/2016)
3Carer’s Support Group 9.45am -12pmMorning Tea 10.30am (Drop in)New Story of You 12.30pm –2.30pm(10 weeks finishing 06/04/2016) YOGA 4.30pm - 5.30pm
4Buried in Treasures 10am to 12pm(20 weeks finishing 2/06/2016)Photography Group 10am – 12pmYarn Group 1pm – 3pm Grief and Loss Group 1pm – 3pm(8 weeks finishing 24/03/2016)
5Meditation 9am – 10amPoppy Play Group 10am – 12pm Trauma Support Group 10am –12pmBoxing 10.30am – 11.15amSMART Recovery 12.30pm – 2pmSignificant Others 2.30pm – 4pm
8Art Perspective 9.30am – 12pmHearing Voices Group 2pm - 4pmGrow Group 6.30pm – 8.30pm
9Women’s Managing Emotions 9.30am – 12pm (8 weeks finishing 22/03/2016)
10Carer’s Support Group 9.45am -12pmMorning Tea 10.30am (Drop in)New Story of You 12.30pm –2.30pm(10 weeks finishing 06/04/2016) YOGA 4.30pm - 5.30pm
11Buried in Treasures 10am to 12pm(20 weeks finishing 2/06/2016)Photography Group 10am – 12pmYarn Group 1pm – 3pm Grief and Loss Group 1pm – 3pm(8 weeks finishing 24/03/2016)
12Meditation 9am – 10amPoppy Play Group 10am – 12pm Trauma Support Group 10am –12pmBoxing 10.30am – 11.15am
15Art Perspective 9.30am – 12pmWRAP 9am – 12pm (8 weeks finishing 11/04/2016)Men’s RAGE 1pm to 3pm (6 weeks finishing 21 March)Hearing Voices Group 2pm - 4pmGrow Group 6.30pm – 8.30pm
16Women’s Managing Emotions 9.30am – 12pm (8 weeks finishing 22/03/2016)
17Carer’s Support Group 9.45am-12pmMorning Tea 10.30am (Drop in)New Story of You 12.30pm –2.30pm(10 weeks finishing 06/04/2016) YOGA 4.30pm - 5.30pm
18Buried in Treasures 10am to 12pm(20 weeks finishing 2/06/2016)Photography Group 10am – 12pmYarn Group 1pm – 3pm Grief and Loss Group 1pm – 3pm (8 weeks finishing 24/03/2016)
19Meditation 9am – 10amPoppy Play Group 10am – 12pm Trauma Support Group 10am –12pmBoxing 10.30am – 11.15amSMART Recovery 12.30pm – 2pmSignificant Others 2.30pm – 4pm
22Art Perspective 9.30am – 12pmWRAP 9am – 12pm (8 weeks finishing 11/04/2016) Men’s RAGE 1pm to 3pm (6 weeks finishing 21 March)Hearing Voices Group 2pm - 4pmGrow Group 6.30pm – 8.30pm
23Women’s Managing Emotions 9.30am – 12pm (8 weeks finishing 22/03/2016)
24Carer’s Support Group 9.45am-12pmMorning Tea 10.30am (Drop in)New Story of You 12.30pm –2.30pm(10 weeks finishing 06/04/2016) YOGA 4.30pm - 5.30pm
25Buried in Treasures 10am to 12pm(20 weeks finishing 2/06/2016)Photography Group 10am – 12pmYarn Group 1pm – 3pm Grief and Loss Group 1pm – 3pm (8 weeks finishing 24/03/2016)
26Meditation 9am – 10amPoppy Play Group 10am – 12pm Trauma Support Group 10am –12pmBoxing 10.30am – 11.15am
29Art Perspective 9.30am – 12pmWRAP 9am – 12pm (8 weeks finishing 11/04/2016)Men’s RAGE 1pm to 3pm (6 weeks finishing 21 March)Hearing Voices Group 2pm - 4pm
1 2 3For more information on any groups please turn over or call FLORESCO on
3280 5670
18-2516%
26-3526%
36-4526%
46-5521%
56-6510%
66-751%
Age Groups
18-25
26-35
36-45
46-55
56-65
66-75
Jan 2015 – Feb 2016
Floresco Ipswich evaluation
Anxiety24%
Aspergers1%
Bipolar8%
Borderline Personality Disorder3%
Carer Stress3%
Depression40%
DID1%
Gender Dysphoria0%
OCD0%
Personality Disorder0%
Post Natal Depression 0%
Psychosis0%
PTSD10%
Schizophrenia10%
Anxiety
Aspergers
Bipolar
Borderline PersonalityDisorderCarer Stress
Depression
DID
Gender Dysphoria
OCD
Personality Disorder
Post Natal Depression
Primary Diagnosis
Suicidality in the Past 12 Months
29%
16%
55%
Suicide Attempt
Self Harm
Suicidal Ideation
3
39
68
2 3
15
41
55
3
32
18
116
165
3 2
9385
1
1827
90
46
113 5
149
5 2 210
1 3 2
7781
51
211
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Additional Factors Impacting Participants
194
1 2 3 111 4 8 4 3 4
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Number of Referrals from Source (1120)
Queensland Health Referrals (400 received)
49%
14%
9%
28%
ACT
Emergency Department
Hospital Ward
IMHS
Evaluation by QCMHR - UQ
Consumer Outcomes Achieved based on RAS-DS:
Statistically significant improvements in self reported mental
health outcomes by consumers
Significant increases in recovery across all four domains of the
RAS-DS:
o Functional recovery – doing things I value
oPersonal recovery – looking forward
oClinical recovery – mastering my illness
oSocial recovery – connecting and belonging
Consumer Outcomes Achieved based on RAS-DS (continued):
High rates of suicidal ideation in the previous 12 months prior to
engagement with Floresco
▪ Dropped dramatically after engagement - almost two-thirds of
participants reported no suicidal ideation during the 6 months between
their base line and follow up interview.
80% of (N=34) respondents to the YES survey indicated that the
Floresco had a excellent or very good impact on their overall:
owellbeing
oability to manage day to day life, and
o their hopefulness for the future.
Evaluation by QCMHR – UQ
Future Developments – Evaluation by QCMHR
Challenges to Service Integration
Bringing staff together from different organisations
Systemic information sharing
Resources
Recruitment and retention of private providers
Difficulties in responding to demand and clinical need
Complexities of operating a consortia
Inconsistent leadership and governance
Future Developments – Evaluation by QCMHR
Facilitators to Service Integration
Enabling environment
Support from senior management
Leadership (innovative, passionate)
Personality/ies
Committed and engaged staff
Open Communication
Co-location – one reception and all operating under one banner i.e. Floresco
Good reputation and high level credibility amongst consortia partners
Positive client outcomes
Flexibility in funding
Questions
Amelia Callaghan
General Manager – Integrated Services
Ph: 0407 813 963