Quality in community mental health

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www.vicserv.org.au
Quality in community mental health
rehabilitation and support
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Building a. community based.
skilled.. rehabilitation and
support. recovery focused.. component
of the mental health service system. In
15 minutes
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Some key issues

• The case for NGOs as service providers in
  rehab and recovery services
• Evidence and outcomes
• The term rehabilitation
• What are these services doing ? The Victorian
  experience
• Worker skill sand competencies
• Effective linkages with a range of other
  services
• investment by the state and by opinion makers
  and opinion leaders.

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Psychiatric Disability Support Services in
Victoria

PDSS General CHC AMHS LGA
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The case for NGOs as service providers in rehab
and recovery services.

• Not NGOs NCOs. Why clinical services ?
• Community based orgs function differently to
  clinical services. They should function
  differently. These differences enhance the
  service system
• Community links
• Different organisational culture
• Focus on social/community outcomes
• Non statutory responsibilities
• Different governance focus
• Different staff profiles

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Evidence and outcomes

• Evidence case made
• Outcomes
• - Vic experience of values based system
  development. Not uncommon nor unsuccessful in
  SACS. Uncommon in medicine.
• - Research Social vs medical
• - Measure what ? Process vs outcome
• - Human services fields where outcomes are
  clinet driven and unique are suited to
  measuring process, until sophisticated, or the
  tail wags the dog
• - Later work on outcomes
• - how do you measure the acquisition of hope ?
  And who would be good at this work ?

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Terminology

• Psychosocial rehabilitation and use of term
  rehab
• Support/ differential client need
• Recovery as a journey/process, and the
  generation of hope.
• Appropriation of terms by the clinical services
  sector
• Illness/disability. Services are disability
  focused, on what happens when a person interacts
  with their community. Whoo would be good at this
  work?

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Effective linkages with a range of other
services.

• Cornerstone Project Clinical services/PDRS
  Protocols
• Links with other agencies diverse and complex
  client needs i.e. general health, dual
  diagnosis etc. GPs, community health,
  employment, training, housing, housing, housing
  etc
• Vertical/horizontal integration. Are acute care
  providers good at primary, secondary and tertiary
  care ?
• Current trends in this area

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Worker skills. Who fits this criteria ?

• Working with the client to travel from
  resignation, through despair, to generate hope
  and possibility
• Maintaining contact, and talking and listening
  when things arent working
• Linking into local groups of all types
• Referring to clinicians occasionally
• Creating goals and working with the consumer to
  monitor those goals
• Engaging with carers in a partnership

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PSR principles what orgns and what workers are
best suited to this ?

• Focus on strength rather than pathology
• Breaking down professional shields and barriers
• Whole of environment approach
• Changing the environment.

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Victorian profile of workers

• Qualified and skilled
• From a range of disciplines
• Ex-clinicians report greatest challenges in
  adjusting to PSR
• Includes nurses, OTs, psychologists, community
  devt workers, social workers
• None practice their discipline. They share the
  discipline of PSR.

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Summary

• Invest in non-clinical PSR and support. Its
  cheap.
• Clinical leaders and opinion makers support the
  process, or at least step aside
• Invest in training for workers
• Focus for at least 3 years on process and not
  outcomes
• Ensure strong links between Non clinical and
  clinical services, but not control. Other links
  more relevant to effective consumer outcomes.

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www.vicserv.org.au
Quality in community mental health
rehabilitation and support