Capacity and Structure of Mental Health Services for High Prevalence Psychological Disorders in Rura

1
Capacity and Structure of Mental Health Services
for High Prevalence Psychological Disorders in
Rural Southwest Victoria
GERBER T, MORRISON J, TORNEUS I, REDDY P ONEIL
A GGT UDRH, Flinders and Deakin Universities
2
Geographical Scope

• 30,000 square kilometres from Geelong to SA
  border
• 7 of Victorias population

3
Demographics

• Population 121,938
• IRSD score 1,012
• Population per FTE GP services 1,410
• Very high levels of psychological distress - 35.7
  per 1000 population
• Mental health and behavioural disorders - 98.8
  per 1000 population

PHIDU (2005) Population Health Profile of the
Otway Division of General Practice
4
Greater Green Triangle Risk Factor Study

• 31.3 participants had moderate to high levels of
  psychological distress (K-10)
• 8.1 had moderate to high levels of depression
  (HADS-D)
• 11 had moderate to high levels of anxiety
  (HADS-A)

GGT UDRH (2007) Greater Green Triangle Risk
Factor Study
5
Diagnosis or Treatment for Depression or Anxiety

• Depression - 7.2
• Anxiety - 3.3
• Either - 8.4

GGT UDRH (2007) Greater Green Triangle Risk
Factor Study Adult population (25-74) age
adjusted to local populations
6
Mental Health Mapping Project Specific Aims

• Identify the capacity and structure of the
  current service system for those with depression
  and anxiety
• Determine patterns of service usage, including
  the impact of the new MBS items and other
  relevant MBS items
• Identify service gaps, barriers and enablers to
  service utilisation
• Make recommendations for an improved model of
  service delivery

7
Methodology
Phase 3
Phase 1
Phase 2

• Service Provider and Consumer Engagement
• SP focus groups
• SP Survey
• Current Consumer Interviews
• Social Network Analysis

• Initial Scoping
• Reference group engagement
• Service provider interviews
• Service mapping
• Literature review
• Statistics

• General Consumer Engagement
• Telephone Survey
• Social Network Analysis

Appreciative Inquiry
FINAL REPORT
Jun
Aug-Nov
Jan-Mar
Apr-May
Mar-Jul
8
Mental Health System Structure
REFERRAL NETWORKS
INFORMATION SERVICES
MENTAL HEALTH PROMOTION
9
Mental Health System - Capacity
10
Ratio of Psychologists to Population - Melbourne
Metro vs. Rural Victoria vs. ODGP
APS (2007)
11
Population per Psychologist Metro vs. Rural vs.
ODGP
APS (2007)
12
Key Findings

• Workforce
• Recruitment
• Retention
• Service Provision
• Service network
• Referral network
• Collaboration
• MBS
• Better Access
• Better Outcomes
• Consumer perspectives
• Service awareness and knowledge
• Confusion regarding MBS
• Specific barriers

13
Next steps

• Social Network Analysis
• Appreciative Inquiry
• Mental Health Promotion
• Grassroots feedback - especially MBS
• Input to DHS Area Based Planning

14
Our thanks to DHS Barwon South-West for funding
this project