Keith Sutton

Roles and competencies of the Support Facilitator in Australia’s recovery-oriented mental health initiative: a qualitative study from Gippsland, Victoria

Objective This study explored the roles and competencies of Support Facilitators (SFs) engaged in the implementation of the Partners in Recovery initiative in a rural region of Victoria. Methods Semi-structured interviews were conducted with 32 stakeholders involved in the initiative, of which 15 were SFs. Results Two main themes and 10 subthemes emerged from the data: (1) SF competencies (which included an understanding of local services as well as administrative and social skills); and (2) the SF role (which included them being a single point of contact, providing care coordination, assisting the client to become self-reliant, achieving good outcomes for clients with confronting behaviours, judiciously using flexible funding, clearly outlining their role with clients and maintaining boundaries and performing a different role from that of the mental health case manager). Conclusions The roles and competencies of the SF in the Partners in Recovery initiative in Gippsland were congruent with the defined characteristics of a care coordination approach. The results highlight how the SF role differs from that of traditional clinical case managers. These findings are important for future mental health service policy development, education and training of mental health practitioners and recruitment of personnel to care coordination roles. What is known about the topic? There is a growing body of literature highlighting the importance of care coordination in delivery of positive outcomes for people with chronic and complex health problems. However, little is documented about the care coordination role of SFs as part of the Partners in Recovery initiative in Australia. What does this paper add? This paper identifies the roles and competencies of SFs in the Partners in Recovery initiative in a rural region of Victoria. The paper highlights that the emergent competencies and role functions are congruent with the defined characteristics of a care coordination approach but differ from that of mental health case managers. What are the implications for practitioners? These findings are important for future mental health service policy development, education and training of mental health practitioners and recruitment of personnel to care coordination roles.

Outcomes of a care coordinated service model for persons with severe and persistent mental illness: A qualitative study

Background: Owing to difficulties faced by individuals with severe and persistent mental illness (SPMI) in accessing multiple services, the Australian Government trialed a care coordinated service model called the Partners in Recovery (PIR) initiative. Material: A total of 45 stakeholders in Gippsland were asked what difference the initiative had made. Discussion: The PIR initiative benefited not only clients and carers but also service providers. It addressed an unmet need in service delivery for individuals with SPMI. Conclusion: The PIR initiative has filled a gap in delivery of care for individuals with SPMI in Gippsland.

The interplay of rural issues, mental illness, substance use and housing problems

Abstract Background: People with mental illness and substance use problems form a significant subgroup of the homeless population. International research has begun to document the complex experiences of this vulnerable group; however, less attention has focused on those living in rural areas. Aim: This study sought to determine the experiences of people with mental illness and/or substance use issues, experiencing significant housing problems in rural areas. Methods: Within a qualitative framework, individual interviews were conducted with 40 respondents in Australia. Results: Themes generated a discussion around three main areas; (1) current housing problems, (2) pathways into unsuitable housing, and (3) factors contributing to appropriate accommodation. Conclusion: The need for agency staff to identify and assist with the housing issues of their clients is underscored.

The Jekkora group: an Aboriginal model of early identification, and support of persons with psychological distress and suicidal ideation in rural communities

ABSTRACT Objective: To describe a community developed Aboriginal model for early identification and referral of people with psychological distress and suicidal ideation. Method: A description of an Aboriginal mental health service model is presented, as established at the Njernda Aboriginal Corporation, Echuca, Victoria. Results: The model is presented under five headings: Setting; Recruitment and appointment of Voluntary Trained Support Persons; Identifying persons at risk; Follow-up and referral by Voluntary Trained Support Persons; Expansion and Sustainability. Conclusions: The Jekkora group model is in its early stages of implementation and no evaluation data are available on its outcomes. However, the model has potential to enable early identification, treatment and follow-up support for Aboriginal people in distress that is undisclosed. Factors that support its acceptability in the community are that the model was developed by Aboriginal people for their community. The network of voluntary trained and untrained support persons might help strengthen bonds and build resilience in the community. Implications: The principles used in this model can be used to develop models for suicide prevention in other settings.

An Aboriginal youth suicide prevention project in rural Victoria

ABSTRACT Objective: To describe an Aboriginal youth suicide prevention project developed by Njernda Aboriginal Corporation. Method: This is a descriptive study of an Aboriginal youth suicide prevention project developed by Njernda Aboriginal Corporation based in Echuca, Victoria. Information about the program was obtained from interviewing the project worker and the social and emotional wellbeing worker. Further information was obtained about the program by examining activity registers, program flyers and posters. Results: The Aboriginal youth suicide prevention project was designed and implemented by Njernda Aboriginal Corporation over a period of three years. The main components of the project were building resilience, early intervention response and immediate postvention support. Resilience was built through the Bullroarer program, the Red Dust Healing program and community awareness programs. Another program, the Jekkora group was developed and implemented as an early intervention response. A postvention service is in the planning stage. Conclusions: During a three-year period Njernda Aboriginal Corporation established community resilience building and early intervention programs. Developing and implementing a comprehensive suicide prevention plan at the community level requires adequate time as well as support from mainstream services. These findings therefore have implications for future planning of Aboriginal suicide prevention projects.

The longer term impact of a novel rural mental health recruitment strategy: A quasi-experimental study

This study examines the longer term impact of the Gippsland Mental Health Vacation School program, an initiative designed to orientate preregistration allied health and nursing students to rural mental health employment and career opportunities.

Ruralization of students’ horizons: insights into Australian health professional students’ rural and remote placements

Introduction Health workforce shortages have driven the Australian and other Western governments to invest in engaging more health professional students in rural and remote placements. The aim of this qualitative study was to provide an understanding of the lived experiences of students undertaking placements in various nonmetropolitan locations across Australia. In addition to providing their suggestions to improve rural placements, the study provides insight into factors contributing to positive and negative experiences that influence students’ future rural practice intentions. Methods Responses to open-ended survey questions from 3,204 students from multiple health professions and universities were analyzed using two independent methods applied concurrently: manual thematic analysis and computerized content analysis using Leximancer software. Results The core concept identified from the thematic analysis was “ruralization of students’ horizons,” a construct representing the importance of preparing health professional students for practice in nonmetropolitan locations. Ruralization embodies three interrelated themes, “preparation and support,” “rural or remote health experience,” and “rural lifestyle and socialization,” each of which includes multiple subthemes. From the content analysis, factors that promoted students’ rural practice intentions were having a “positive” practice experience, interactions with “supportive staff,” and interactions with the “community” in general. It was apparent that “difficulties,” eg, with “accommodation,” “Internet” access, “transport,” and “financial” support, negatively impacted students’ placement experience and rural practice intentions. Conclusions The study findings have policy and practice implications for continuing to support students undertaking regional, rural, and remote placements and preparing them for future practice in nonmetropolitan locations. This study may, therefore, further inform ongoing strategies for improving rural placement experiences and enhancing rural health workforce recruitment, retention, and capacity building.

Concepts, Practices and Advantages of Spirituality Among People with a Chronic Mental Illness in Melbourne

There is a relative paucity of literature in the field of spirituality among people who have a lived experience of severe mental illness from Australia. Sixteen individuals with a severe mental illness were interviewed on their experiences of spirituality. The three themes that emerged from the data were concepts of spirituality, benefits of intentional spiritual practices and perceived spiritual benefits of recreational pursuits and physical activity. This paper adds to the relatively sparse literature on spirituality among persons with a mental illness in Australia.

Referral patterns and implementation costs of the Partners in Recovery initiative in Gippsland: learnings for the National Disability Insurance Scheme:

Objective: The purpose of this paper is to provide some learnings for the NDIS from the referral pattern and cost of implementing the Partners in Recovery initiative of Gippsland. Method: Information on referral areas made for each consumer was collated from support facilitators. Cost estimates were determined using budget estimates, administrative costs and a literature review and are reported from a government perspective. Results: Sixty-three per cent of all referrals were made to organisations that provided multiple types of services. Thirty-one per cent were to Mental Health Community Support Services. Eighteen per cent of referrals were made to clinical mental health services. The total cost of providing the service for a consumer per year (set-up and ongoing) was estimated to be AUD

The immediate impact of a brief rural mental health workforce recruitment strategy

15,755 and the ongoing cost per year was estimated to be AUD