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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Partners in Recovery program evaluation: changes in unmet needs and recovery

Nicola Hancock A D , Justin Newton Scanlan A , James A. Gillespie B C , Jennifer Smith-Merry A B and Ivy Yen B
+ Author Affiliations
- Author Affiliations

A The University of Sydney, Faculty of Health Sciences, PO Box 170, Lidcombe, NSW 1825, Australia. Email: justin.scanlan@sydney.edu.au; jennifer.smith-merry@sydney.edu.au

B The University of Sydney, Menzies Centre for Health Policy, University of Sydney, NSW 2006, Australia. Email: ivy.yen@sydney.edu.au

C The University of Sydney, School of Public Health, University of Sydney, NSW 2006, Australia. Email: james.gillespie@sydney.edu.au

D Corresponding author. Email: nicola.hancock@sydney.edu.au

Australian Health Review 42(4) 445-452 https://doi.org/10.1071/AH17004
Submitted: 11 January 2017  Accepted: 26 April 2017   Published: 11 July 2017

Abstract

Objective Partners in Recovery (PIR) is an Australian government initiative designed to provide support and service linkage for individuals with complex needs living with severe and persistent mental illness. The aim of the present study was to examine whether consumers engaged in PIR programs in two large regions of Sydney experienced: (1) a reduction in unmet needs (either via self- or staff report); and (2) progress in their self-reported mental health recovery.

Methods Unmet needs were measured using the Camberwell Assessment of Need Short Appraisal Scale and recovery was measured using the Recovery Assessment Scale – Domains and Stages. For individuals with initial and follow-up data, paired t-tests were used to examine change over time.

Results At follow-up, individuals reported an average of two to three fewer unmet needs, and recovery scores increased by approximately 5% across each domain and the total score. At follow-up, the most common unmet needs were in the areas of ‘company’ and ‘daytime activities’.

Conclusions The results of the present study suggest that PIR services in these two geographical regions have achieved positive results. Individuals with severe and persistent mental illness engaged with PIR appear to have reduced their unmet needs and enhanced their mental health recovery.

What is known about the topic? PIR services were established to support individuals with severe and persistent mental illness by creating service linkages to address unmet needs in order to facilitate recovery. Services were delivered through the new role of ‘support facilitator’.

What does this paper add? By examining routinely collected outcome measures, this paper shows the success of the PIR program. Individuals engaged with PIR reported fewer unmet needs and enhanced recovery over the time they were involved with the program. However, they still faced serious challenges in building successful social interactions, such as developing friendships, and participating in meaningful activities.

What are the implications for practitioners? The support facilitator role developed as part of PIR appears to be a useful method of supporting individuals to reduce unmet needs and enhance recovery. However, further work is required to address the challenges associated with overcoming social isolation and participation in meaningful activities.


References

[1]  Department of Health and Ageing. National mental health report: tracking progress of mental health reform in Australia 1993–2011. Canberra: Commonwealth of Australia; 2013.

[2]  Morgan VA, Waterreus A, Jablensky A, Mackinnon A, McGrath JJ, Carr V, Bush R, Castle D, Cohen M, Harvey C, Galletly C, Stain HJ, Neil AL, McGorry P, Hocking B, Shah S, Saw S. 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 |

[3]  Slade T, Johnston A, Teesson M, Whiteford H, Burgess P, Pirkis J, Saw S. The mental health of Australians 2. Report on the 2007 National Survey of Mental Health and Wellbeing. Canberra: Department of Health and Ageing; 2009.

[4]  Whiteford HA, Buckingham WJ, Harris MG, Burgess PM, Pirkis JE, Barendregt JJ, Hall DD. Estimating treatment rates for mental disorders in Australia. Aust Health Rev 2014; 38 80–5.
Estimating treatment rates for mental disorders in Australia.Crossref | GoogleScholarGoogle Scholar |

[5]  Department of Health and Ageing. Partners in Recovery (PIR). Coordinated support and flexible funding for people with severe, persistent mental illness and complex needs initiative. Program guidelines for the engagement of PIR organisations 2012–13 to 2015–16. Canberra: Commonwealth of Australia; 2012. Available at: http://www.pirinitiative.com.au/resources/doc/doha/pirguide.pdf [verified 8 May 2017].

[6]  National Mental Health Commission (NMHC). The national review of mental health programmes and services. Sydney: NMHC; 2014.

[7]  Hancock N, Smith-Merry J, Gillespie JA, Yen I. Is the Partners in Recovery program connecting with the intended population of people living with severe and persistent mental illness? What are their prioritised needs? Aust Health Rev 2016;
Is the Partners in Recovery program connecting with the intended population of people living with severe and persistent mental illness? What are their prioritised needs?Crossref | GoogleScholarGoogle Scholar |

[8]  Smith-Merry J, Gillespie J, Hancock N, Yen I. Doing mental health care integration: a qualitative study of a new work role. Int J Ment Health Syst 2015; 9 32
Doing mental health care integration: a qualitative study of a new work role.Crossref | GoogleScholarGoogle Scholar |

[9]  Brophy L, Hodges C, Halloran K, Grigg M, Swift M. Impact of care coordination on Australia’s mental health service delivery system. Aust Health Rev 2014; 38 396–400.

[10]  Sutton K, Isaacs AN, Dalziel K, Maybery D. Roles and competencies of the support facilitator in Australia’s recovery-oriented mental health initiative: a qualitative study from Gippsland, Victoria. Aust Health Rev 2017; 41 91–7.
Roles and competencies of the support facilitator in Australia’s recovery-oriented mental health initiative: a qualitative study from Gippsland, Victoria.Crossref | GoogleScholarGoogle Scholar |

[11]  Isaacs AN, Sutton K, Dalziel K, Maybery D. Outcomes of a care coordinated service model for persons with severe and persistent mental illness: a qualitative study. Int J Soc Psych 2017; 63 40–7.

[12]  National Mental Health Strategy. A national framework for recovery-oriented mental health services: guide for practitioners and providers. Canberra: Commonwealth of Australia; 2013.

[13]  Anthony WA. Recovery from mental illness: the guiding vision of the mental health service system in the 1990s. Psychosoc Rehabil J 1993; 16 11–23.
Recovery from mental illness: the guiding vision of the mental health service system in the 1990s.Crossref | GoogleScholarGoogle Scholar |

[14]  Slade M, Thornicroft G, Loftus L, Phelan M, Wykes T. CAN: Camberwell assessment of need. London: Gaskell; 1999.

[15]  Macpherson R, Varah M, Summerfield L, Foy C, Slade M. Staff and patient assessments of need in an epidemiologically representative sample of patients with psychosis. Soc Psychiatry Psychiatric Epidemiol 2003; 38 662–7.
Staff and patient assessments of need in an epidemiologically representative sample of patients with psychosis.Crossref | GoogleScholarGoogle Scholar |

[16]  Andresen R, Caputi P, Oades LG. Interrater reliability of the Camberwell Assessment of Need Short Appraisal Schedule. Aust N Z J Psychiatry 2000; 34 856–61.
Interrater reliability of the Camberwell Assessment of Need Short Appraisal Schedule.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3cvos12htA%3D%3D&md5=9e18329cc8b6bcb16d1dc26f90361521CAS |

[17]  Slade M, Leese M, Cahill S, Thornicroft G, Kuipers E. Patient-rated mental health needs and quality of life improvement. Br J Psychiatry 2005; 187 256–61.
Patient-rated mental health needs and quality of life improvement.Crossref | GoogleScholarGoogle Scholar |

[18]  Hancock N, Scanlan JN, Honey A, Bundy AC, O’Shea K. Recovery Assessment Scale – Domains and Stages (RAS-DS): its feasibility and outcome measurement capacity. Aust N Z J Psychiatry 2015; 49 624–33.
Recovery Assessment Scale – Domains and Stages (RAS-DS): its feasibility and outcome measurement capacity.Crossref | GoogleScholarGoogle Scholar |

[19]  Hancock N, Scanlan JN, Bundy AC, Honey A. Recovery Assessment Scale – Domains and Stages (RAS-DS) manual. Version 2. Sydney: University of Sydney; 2016.

[20]  Philip Amos Consulting. Creating better system responses for people with severe and persistent mental illness and complex needs: a project of New South Wales Partners in Recovery organisations. Sydney: Philip Amos Consulting; 2015.

[21]  Argentzell E, Håkansson C, Eklund M. Experience of meaning in everyday occupations among unemployed people with severe mental illness. Scand J Occup Ther 2012; 19 49–58.
Experience of meaning in everyday occupations among unemployed people with severe mental illness.Crossref | GoogleScholarGoogle Scholar |

[22]  Duff C. Exploring the role of ‘enabling places’ in promoting recovery from mental illness: a qualitative test of a relational model. Health Place 2012; 18 1388–95.
Exploring the role of ‘enabling places’ in promoting recovery from mental illness: a qualitative test of a relational model.Crossref | GoogleScholarGoogle Scholar |

[23]  Hancock N, Honey A, Bundy AC. Sources of meaning derived from occupational engagement for people recovering from mental illness. Br J Occup Ther 2015; 78 508–15.
Sources of meaning derived from occupational engagement for people recovering from mental illness.Crossref | GoogleScholarGoogle Scholar |

[24]  Coniglio FD, Hancock N, Ellis LA. Peer support within clubhouse: a grounded theory study. Community Ment Health J 2012; 48 153–60.
Peer support within clubhouse: a grounded theory study.Crossref | GoogleScholarGoogle Scholar |

[25]  Tjörnstrand C, Bejerholm U, Eklund M. Factors influencing occupational engagement in day centers for people with psychiatric disabilities. Community Ment Health J 2015; 51 48–53.
Factors influencing occupational engagement in day centers for people with psychiatric disabilities.Crossref | GoogleScholarGoogle Scholar |

[26]  Perkins R, Repper J, Rinaldi M, Brown H. Recovery colleges. Implementing recovery through organisational change. London: Centre for Mental Health; 2012.

[27]  Fernandez A, Gillespie J, Smith-Merry J, Feng X, Astell-Burt T, Maas C, Salvador-Carulla L. Integrated mental health atlas of the Western Sydney Local Health District: gaps and recommendations. Aust Health Rev 2017; 41 38–44.
Integrated mental health atlas of the Western Sydney Local Health District: gaps and recommendations.Crossref | GoogleScholarGoogle Scholar |

[28]  Hancock N, Bundy A, Honey A, Helich S, Tamsett S. Measuring the later stages of the recovery journey: insights gained from clubhouse members. Community Ment Health J 2013; 49 323–30.
Measuring the later stages of the recovery journey: insights gained from clubhouse members.Crossref | GoogleScholarGoogle Scholar |

[29]  Corrigan PW, Sokol KA, Rüsch N. The impact of self-stigma and mutual help programs on the quality of life of people with serious mental illnesses. Community Ment Health J 2013; 49 1–6.
The impact of self-stigma and mutual help programs on the quality of life of people with serious mental illnesses.Crossref | GoogleScholarGoogle Scholar |

[30]  Hartz SM, Pato CN, Medeiros H, Cavazos-Rehg P, Sobell JL, Knowles JA, Bierut LJ, Pato MT, The Genomic Psychiatry Cohort Consortium Comorbidity of severe psychotic disorders with measures of substance use. J Am Med Assoc Psychiatry 2014; 71 248–54.

[31]  Hunt GE, Malhi GS, Cleary M, Lai HMX, Sitharthan T. Prevalence of comorbid bipolar and substance use disorders in clinical settings, 1990–2015: systematic review and meta-analysis. J Affect Disord 2016; 206 331–49.
Prevalence of comorbid bipolar and substance use disorders in clinical settings, 1990–2015: systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar |

[32]  Bellack AS, Bennett ME, Gearon JS, Brown CH, Yang Y. A randomized clinical trial of a new behavioral treatment for drug abuse in people with severe and persistent mental illness. Arch Gen Psychiatry 2006; 63 426–32.
A randomized clinical trial of a new behavioral treatment for drug abuse in people with severe and persistent mental illness.Crossref | GoogleScholarGoogle Scholar |

[33]  Quinn C, Happell B, Browne G. Talking or avoiding? Mental health nurses’ views about discussing sexual health with consumers. Int J Mental Health Nurs 2011; 20 21–8.

[34]  Wright ER, Wright DE, Perry BL, Foote-Ardah CE. Stigma and the sexual isolation of people with serious mental illness. Soc Probl 2007; 54 78–98.
Stigma and the sexual isolation of people with serious mental illness.Crossref | GoogleScholarGoogle Scholar |

[35]  Quinn C, Happell B. Talking about sexuality with consumers of mental health services. Persp Psychiatric Care 2013; 49 13–20.
Talking about sexuality with consumers of mental health services.Crossref | GoogleScholarGoogle Scholar |

[36]  Quinn C, Happell B, Welch A. Talking about sex as part of our role: making and sustaining practice change. Int J Mental Health Nurs 2013; 22 231–40.
Talking about sex as part of our role: making and sustaining practice change.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXisVOjtLY%3D&md5=effed7805c75d68a46dcca3cf3cd07a2CAS |

[37]  Kightley M, Einfeld S, Hancock N. Routine outcome measurement in mental health: feasibility for examining effectiveness of an NGO. Australas Psychiatry 2010; 18 167–9.
Routine outcome measurement in mental health: feasibility for examining effectiveness of an NGO.Crossref | GoogleScholarGoogle Scholar |