Impact of care coordination on Australia’s mental health service delivery system
Lisa Brophy A B C , Craig Hodges B , Kieran Halloran B , Margaret Grigg B and Mary Swift BA The Centre for Mental Health, Melbourne School of Population Health, The University of Melbourne, 4/207 Bouverie Street, Carlton, Vic. 3010, Australia.
B Mind Australia, 86–82 Mount Street, Heidelberg, Vic. 3084, Australia. Email: craig@chconsulting.net.au; khalloran@nmml.org.au; mgrigg@mindaustralia.org.au; mswift@mindaustralia.org.au
C Corresponding author. Email: lbrophy@unimelb.edu.au
Australian Health Review 38(4) 396-400 https://doi.org/10.1071/AH13181
Submitted: 31 January 2013 Accepted: 24 February 2014 Published: 8 July 2014
Journal Compilation © AHHA 2014
Abstract
Care coordination models have developed in response to the recognition that Australia’s health and welfare service system can be difficult to access, navigate and is often inefficient in caring for people with severe and persistent mental illness (SPMI) and complex care and support needs. This paper explores how the Australian Government’s establishment of the Partners in Recovery (PIR) initiative provides an opportunity for the development of more effective and efficient models of coordinated care for the identified people with SPMI and their families and carers. In conceptualising how the impact of the PIR initiative could be maximised, the paper explores care coordination and what is known about current best practice. The key findings are the importance of having care coordinators who are well prepared for the role, can demonstrate competent practice and achieve better systemic responses focused on the needs of the client, thus addressing the barriers to effective care and treatment across complex service delivery systems.
What is known about the topic? Care coordination, as an area of mental health practice in Australia, has not been well defined and the evidence available about its effectiveness is uneven. Even so, care coordination is increasingly identified as having the potential to deliver a more person-centred response to the health and social needs of people with severe and persistent mental illness (SPMI), as well as enhance the responsiveness of Australia’s mental health service delivery system. The introduction of Partners in Recovery (PIR), a new Australian Government initiative based on coordinated care approaches, provides the impetus to investigate the hoped for mental health system enhancements and related improved client outcomes.
What does this paper add? This paper offers a rationale for care coordination, referred to in the PIR model as support facilitation, as a primary enabler for enhanced person-centred, cost-effective and sustainable mental health service delivery. The paper discusses support facilitation as an integral practice platform for supporting the successful implementation and sustainability of the PIR initiative. It also addresses issues that may be encountered in establishing the roles and functions of various components of the initiative’s care coordination model.
What are the implications for practitioners? The key implications for PIR support facilitation practitioners are to reconsider their function and roles within a mental health service delivery system that places care coordination at its centre. This paper establishes that any model of care coordination requires well-trained and enthusiastic practitioners with a sophisticated appreciation of current barriers to care. Practitioners will be required to value partnerships as a means of addressing barriers that impact on the establishment and maintenance of robust, system-wide responses that are genuinely consumer focused.
References
[1] The National Advisory Council on Mental Health. Fitting together the pieces: collaborative care models for adults with severe and persistent mental illness. Final project report. Melbourne: The Alfred Hospital and Monash University; 2010.[2] Craig C, Eby D, Whittington J. Care coordination model: better care at lower cost for people with multiple health and social needs. Cambridge: Institute for Health Care Improvement; 2011.
[3] Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness: the chronic care model, part 2. JAMA 2002; 288 1909–14.
| Improving primary care for patients with chronic illness: the chronic care model, part 2.Crossref | GoogleScholarGoogle Scholar | 12377092PubMed |
[4] NHS Institute for Innovation and Improvement. Improving care for people with long-term condition: a review of UK and international frameworks. Birmingham: University of Birmingham HSMC; 2006.
[5] Compton B, Galaway B, Cournoyer B. Social work processes, 6th edn. Homewood, IL: Dorsey Press; 1984.
[6] Fine M. Individualization, risk and the body. Sociology and care. J Sociol 2005; 41 247–66.
| Individualization, risk and the body. Sociology and care.Crossref | GoogleScholarGoogle Scholar |
[7] Kanter J. Clinical case management: definition, principles, components. Psychiatr Serv 1989; 40 361–8.
| 1:STN:280:DyaL1M3jtlSiug%3D%3D&md5=deeb55c97d705fdad0984e2fed068c5eCAS |
[8] Rapp CA, Gosh RJ. The principles of effective case management of mental health services. Psychiatr Rehabil J 2004; 27 319–33.
| The principles of effective case management of mental health services.Crossref | GoogleScholarGoogle Scholar | 15222145PubMed |
[9] Sawyer A. Risk and new exclusions in community mental health practice. Aust Soc Work 2008; 61 327–41.
| Risk and new exclusions in community mental health practice.Crossref | GoogleScholarGoogle Scholar |
[10] Sawyer A, Green D, Moran A, Brett J. Should the nurse change the light globe? J Sociol 2009; 45 361–81.
| Should the nurse change the light globe?Crossref | GoogleScholarGoogle Scholar |
[11] Thornicroft G, Betts V. International mid-term review of the second national mental health plan for Australia. Canberra: Mental Health and Special Programs Branch, Department of Health and Ageing; 2002.
[12] Williams P. The competent boundary spanner. Public Adm 2002; 80 103–24.
| The competent boundary spanner.Crossref | GoogleScholarGoogle Scholar |
[13] Morgan VA, Waterreus A, Jablensky A, Mackinnon A, McGrath JJ, Carr V, et al People living with psychotic illness in 2010. The second Australian national survey of psychosis. Aust N Z J Psychiatry 2012; 46 735–52.
| People living with psychotic illness in 2010. The second Australian national survey of psychosis.Crossref | GoogleScholarGoogle Scholar | 22696547PubMed |
[14] Australia Government. National standards for mental health services 2010. Canberra: Commonwealth of Australia; 2010.
[15] Brophy L, Harvey C, Grigg M, Moeller-Saxone K, Siskind D. Recovery-enhancing service delivery in the mental health community managed (non-government) sector. In: Proceedings of the 23rd Annual TheMHS Conference, Melbourne, 20–23 August 2013. 2013. pp. 28. Available at: http://www.themhs.org/pages/conference-resources-and-proceedings-2013.html [verified June 2014].
[16] National Mental Health Commission (NHMC). A contributing life: the 2012 national report card on mental health and suicide prevention. Sydney: NMHC; 2013.
[17] Warner R. Does the scientific evidence support the recovery model? The Psychiatrist 2010; 34 3–5.
| Does the scientific evidence support the recovery model?Crossref | GoogleScholarGoogle Scholar |
[18] National Health Workforce Planning and Research Collaboration. Mental health non-government organisation workforce project final report. Adelaide: Health Workforce Australia; 2010.
[19] Mental Health Workforce Advisory Committee. National mental health workforce strategy. Melbourne: Victorian Government, Department of Health; 2011.
[20] Williams P. The life and times of the boundary spanner. J Integr Care 2011; 19 26–33.
[21] Kania J, Kramer M. Collective impact. Standford Social Innovation Review 2011; 65 http://www.ssireview.org/articles/entry/collective_impact/
