Anna Machlin

Australia's Better Access initiative: an evaluation.

Background: Australias Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule (Better Access) initiative involves a series of Medicare Benefits Schedule (MBS) item numbers which offer a rebate for selected services delivered by eligible clinicians. There has been considerable debate about the appropriateness and effectiveness of Better Access, much of which has been based on limited evidence. The current paper contributes to this debate by presenting the findings of a study which profiled the clinical and treatment characteristics of Better Access patients and examined the outcomes of their care. Method: We approached a stratified random sample of providers who had billed for at least 100 occasions of service under the Better Access item numbers in 2008 (509 clinical psychologists, 640 registered psychologists, 1280 GPs) and invited them to participate. Those who agreed were asked to recruit 5–10 Better Access patients according to a specific protocol. We collected data that enabled us to profile providers, patients and sessions. We also collected pre- and post-treatment patient outcome data, using the Kessler-10 (K-10) and the Depression Anxiety Stress Scales (DASS-21). Results: In total, 883 patients were recruited into the study (289 by 41 clinical psychologists, 317 by 49 registered psychologists and 277 by 39 GPs). More than 90% of participating patients had diagnoses of depression and/or anxiety (compared with 13% of the general population). More than 80% were experiencing high or very high levels of psychological distress (compared with 10% of the general population). Around half of all participating patients had no previous history of mental health care. Patients experienced statistically significant improvements in average K-10 and DASS-21 scores from pre- to post-treatment. Conclusions: The findings suggest that Better Access is playing an important part in meeting the communitys previously unmet need for mental health care.

The sustainability of an Australian initiative designed to improve interdisciplinary collaboration in mental health care

BackgroundThe Australian Mental Health Professionals Network (MHPN) is fostering a collaborative, interdisciplinary approach to mental health care through the establishment of local interdisciplinary networks of mental health professionals. This paper reports on those factors seen by MHPN participants and staff as having affected the formation and continuation of interdisciplinary networks, and therefore the likely sustainability of these groups.MethodThe paper draws on qualitative data from focus groups with mental health professionals participating in MHPN activities and MHPN staff.ResultsThe findings suggest that MHPN’s approach to establishing sustainable interdisciplinary networks has been influenced by a number of factors at the micro-, meso-and macro levels. At the micro-level, factors such as clarity and structure of ongoing meetings, individual dynamics and the role of ‘champions’ can promote or constrain sustainability of ongoing networks. Those networks that had established following an initial workshop and had continued to meet as an interdisciplinary network tended to be led by well-respected co-ordinators, involve members who are enthusiastic and keen to learn from each other, have a flexible structure and meet regularly for a well-defined purpose. These features are underpinned by good communication between network members and with MHPN administration. At the meso- and macro-levels, the key issue relates to resourcing, as well as the wider policy context.ConclusionsThe support and practical resources provided by MHPN have been crucial in guiding successful networks as they form and continue to meet on a regular basis. The networks have also required internal leadership and support, and a clear purpose in order to form and to continue their activities. These findings are consistent with the literature, which states that sustainability of programs is reliant on factors at the project design and implementation level, as well as on factors inherent within the host organization and at the wider community level.

An evaluation of an Australian initiative designed to improve interdisciplinary collaboration in primary mental health care

This paper reports on a multi-component evaluation of Australias Mental Health Professionals Network (MHPN). MHPN aims to improve consumer outcomes by fostering a collaborative clinical approach to primary mental health care. MHPN has promoted interdisciplinary communication and networking through activity in three inter-related areas: interdisciplinary workshops supported by education and training materials; fostering ongoing, self-sustained interdisciplinary clinical networks; and a website, web portal (MHPN Online) and a toll-free telephone information line. The evaluation showed that MHPNs workshops were highly successful; almost 1200 workshops were attended by 11,930 individuals from a range of mental health professions. Participants from 81% of these workshops have gone on to join ongoing, interdisciplinary networks of local providers, and MHPN is now supporting these networks in a range of innovative ways to encourage them to become self-sustaining and to improve collaborative care practices.

Differing perspectives on what is important in media reporting of suicide

There is a substantial literature which demonstrates that irresponsible reporting of suicide can lead to copycat acts and, as a result, many countries have developed guidelines for media professionals. Some of the recommendations in these guidelines draw directly on the evidence and describe how reporting can be done in a measured fashion that minimises any likely negative influence. Other recommendations relate more to good journalistic practice and are about showing respect for the bereaved in their time of grieving. The study by Chapple et al, in this issue, indicates that there may sometimes be tensions between what media guidelines recommend and what those bereaved by suicide believe is important. We would argue that in such cases common ground can be reached.

Suicide Prevention Public Service Announcements (PSAs): Examples from Around the World

ABSTRACT Media campaigns have received increased attention as an intervention for combating suicide. Suicide prevention campaigns involving public service announcements (PSAs) have not been well described and have been subject to minimal evaluation. This study aimed to identify suicide prevention PSAs from around the world and analyze and describe their content. We searched the Internet for short, English-language PSAs that had been screened as part of suicide prevention campaigns and identified 35. Most commonly, these PSAs focused on the general population and/or people who might be at risk of suicide, and had a particular emphasis on young people. Almost 60% promoted open discussion about suicide, around 50% indicated that the life of a suicidal person was important, about 40% acknowledged the suffering associated with suicidal thoughts and feelings, about 25% stressed that suicide is preventable, and about 20% focused on the devastating impact of suicide for those left behind. Most PSAs promoted some sort of support for people at risk of suicide, usually a helpline or website. Although these messages appeared appropriate and practical there is a lack of research on the impact that they may have on people with varying degrees of suicide risk. Further work is needed to ensure that they are consistent with theories of behavior change, and that they are having their desired impacts.

Research Priorities in Suicide Prevention: Review of Australian Research from 2010–2017 Highlights Continued Need for Intervention Research

Suicide is a major public health concern in Australia and globally, requiring targeted research efforts to build the evidence base for its effective prevention. We examined current and future priorities in Australian suicide prevention research during the period 2010–2017, and compared these to 1999–2006 baseline data. We classified current research priorities in terms of the type of research published in 424 journal articles and 36 grants and fellowships funded during 2010–2017. A questionnaire administered to 390 stakeholders identified future research priorities. The total number of suicide prevention focussed journal articles and the value of funded grants increased dramatically. Congruent with baseline data, current research priorities in 2010–2017 reflected a strong emphasis on epidemiological studies, while funding for intervention studies declined. This is despite the fact that stakeholders continually identified intervention studies as being the highest future research priority. If we are to make real advances in suicide prevention, we need to know what works, and identify and test effective interventions. This study highlighted the existing dearth and continued need for intervention research. Mechanisms to support future intervention research in suicide prevention are likely to lead to significant gains in knowledge and population health.

Mental Health Professional Online Development (MHPOD): a web-based training tool for the non-government community mental health workforce

Purpose – The purpose of this paper is to evaluate the usefulness and relevance of the Mental Health Professional Online Development (MHPOD) training package in further developing the skills in mental health and recovery-informed practice of the Australian non-government community mental health workforce. MHPOD is an evidence-based, self-paced, online learning resource that consists of 58 mental health topics. Design/methodology/approach – A total of 349 e-learners were recruited from seven non-government community mental health services across Australia. E-learners were invited to complete up to twelve online surveys, a baseline survey, a topic completion survey for each completed topic, and a follow-up survey towards the end of the pilot. Findings – The majority of e-learners indicated that MHPOD was useful for professional development and relevant to their current employment. E-learners identified that MHPOD led to significant improvement in their knowledge and confidence in their ability. A number of ...

An Evaluation of the Implementation of the Australian ATAPS Suicide Prevention Services Initiative

The Access to Allied Psychological Services (ATAPS) Suicide Prevention Services initiative is an Australian Government-funded primary mental healthcare initiative providing free intensive psychological intervention for consumers at moderate risk of self-harm or suicide. Findings from a multi-method evaluation aimed at identifying whether the initiative is being implemented as stipulated within the operational guidelines, barriers and facilitators to implementation, and preliminary outcomes suggest that the Suicide Prevention Services are largely being implemented as stipulated in the Guidelines, but with some exceptions. In particular, service delivery barriers unique to rural and remote areas place limitations on implementation. Uptake of the ATAPS Suicide Prevention Services is high (10,428 consumers were referred to the Suicide Prevention Services between October 2008 and April 2013, and 86% of those attended at least one session), as is acceptance from organizations involved in its implementation.

Preliminary evidence for the role of newsprint media in encouraging males to make contact with helplines

Abstract This study explored the preliminary evidence for a relationship between constructive and affirming newsprint stories about depression or anxiety in males and use of helpline services by males. With the help of a Consumer Reference Group, we identified ten positive newsprint stories about males and depression or anxiety. We then obtained phone contact data from four national helplines in Australia: Lifeline, MensLine Australia, SANE Australia, and beyondblue. For each contact, we extracted the date, location and gender of the caller. Poisson regression analysis was used to determine the change in contact volume in the two weeks following each story, as compared to the two weeks prior to the story. Contact volume from males increased significantly in the two weeks after four of the ten stories, decreased after one story with no change after five of the stories. The stories that were associated with increased contacts were about men (including publicly revered role models) that male readers could identify with and tended to be stories of hope and recovery. The findings suggest newsprint media can positively influence male help-seeking and point to a need for articles to provide accurate representations of depression and anxiety, whilst maintaining an optimistic focus on recovery.