Nossal Institute for Global Health - Research Publications

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    The Victorian Disaster Mental Health Workforce Capacity Survey
    Reifels, L ; Naccarella, L ; Blashki, G ; Pirkis, JE (The University of Melbourne, 2012)
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    An evaluation of an Australian initiative designed to improve interdisciplinary Collaboration in primary mental health care
    Fletcher, J ; King, K ; Christo, J ; Machlin, A ; Bassilios, B ; Blashki, G ; Gibbs, C ; Nicholas, A ; Pirkis, J (PERGAMON-ELSEVIER SCIENCE LTD, 2014-08)
    This paper reports on a multi-component evaluation of Australia's Mental Health Professionals Network (MHPN). MHPN aims to improve consumer outcomes by fostering a collaborative clinical approach to primary mental health care. MHPN has promoted interdisciplinary communication and networking through activity in three inter-related areas: interdisciplinary workshops supported by education and training materials; fostering ongoing, self-sustained interdisciplinary clinical networks; and a website, web portal (MHPN Online) and a toll-free telephone information line. The evaluation showed that MHPN's workshops were highly successful; almost 1200 workshops were attended by 11,930 individuals from a range of mental health professions. Participants from 81% of these workshops have gone on to join ongoing, interdisciplinary networks of local providers, and MHPN is now supporting these networks in a range of innovative ways to encourage them to become self-sustaining and to improve collaborative care practices.
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    Reflections on Expert Recommendations for US Research Priorities in Suicide Prevention
    Silverman, MM ; Pirkis, JE ; Pearson, JL ; Sherrill, JT (ELSEVIER SCIENCE INC, 2014-09)
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    Suicide prevention: Evaluation of a pilot intervention in a primary care context
    King, K ; Bassilios, B ; Reifels, L ; Fletcher, J ; Ftanou, M ; Blashki, G ; Burgess, P ; Pirkis, J (INFORMA HEALTHCARE, 2013-10)
    BACKGROUND: From July 2008 to June 2011, 19 Australian Divisions of General Practice piloted specialist services for consumers at risk of suicide within a broader primary mental health program. General practitioners and other mental health staff referred suicidal consumers to specially trained mental health professionals for intensive, time-limited care. AIMS: To report the findings from an evaluation of the pilot. METHOD: Data sources included a purpose-designed minimum data set, which collated consumer-level and session-level data, and a series of structured telephone interviews conducted with Divisional project officers, referrers and mental health professionals. RESULTS: There were 2312 referrals to the pilot; 2070 individuals took up the service. The pilot reached people who may not otherwise have had access to psychological care; over half of those who received services were on low incomes and about one-third had not previously accessed mental health care. Project officers, referrers and mental health professionals were all positive about the pilot and commented that it was meeting a previously unmet need. Consumers appeared to benefit, showing significant improvements in outcomes. CONCLUSION: This evaluation provides supportive evidence for the effectiveness of a suicide prevention intervention delivered by specially trained mental health professionals in a primary mental health environment.
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    Why did Divisions of General Practice implement some Access to Allied Psychological Services mental health initiatives and not others?
    King, K ; Nicholas, A ; Fletcher, J ; Bassilios, B ; Reifels, L ; Blashki, G ; Pirkis, J (CSIRO PUBLISHING, 2015)
    OBJECTIVE: The Access to Allied Psychological Services (ATAPS) programs implemented through Divisions of General Practice (now Medicare Locals) enables general practitioners (GPs) to refer consumers with high-prevalence mental disorders for up to 12 individual and/or group sessions of evidence-based mental health care. The great strength of ATAPS is its ability to target vulnerable and hard-to-reach populations. Several initiatives have been introduced that focus on particular at-risk populations. This study aimed to determine the factors that had influenced Divisions' decisions to implement the various Tier 2 initiatives. METHODS: An online survey was sent to all Divisions. The survey contained mostly multiple choice questions and sought to determine which factors had influenced their decision-making. RESULTS: The most common factors influencing the decision to implement an initiative were the perception of local need and whether there was an existing service model that made it easier to add in new programs. The most commonly cited factors for not implementing were related to resources and administrative capacity. CONCLUSIONS: This research provides valuable insights into the issues that primary care organisations face when implementing new programs; the lessons learnt here could be useful when considering the implementation of other new primary care programs.
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    Innovations in primary mental healthcare
    Reifels, L ; Bassilios, B ; King, KE ; Fletcher, JR ; Blashki, G ; Pirkis, JE (CSIRO PUBLISHING, 2013)
    OBJECTIVE: We review the evidence on innovations in Tier 2 of the Access to Allied Psychological Services (ATAPS) program, which is designed to facilitate the provision of primary mental healthcare to hard-to-reach and at-risk population groups (including women with perinatal depression, people at risk of self-harm or suicide, people experiencing or at risk of homelessness, people affected by the 2009 Victorian bushfires, people in remote locations, Aboriginal and Torres Strait Islanders and children with mental disorders) and the trialling of new modalities of service delivery (e.g. telephone-based or web-based CBT). The primary focus is on the uptake, outcomes and issues associated with the provision of ATAPS Tier 2. METHODS: Drawing on data from an ongoing national ATAPS evaluation, including a national minimum dataset, key informant interviews and surveys, the impact of ATAPS innovations is analysed and illustrated through program examples. RESULTS: ATAPS Tier 2 facilitates access to, uptake of and positive clinical outcomes from primary mental healthcare for population groups with particular needs, although it requires periods of time to implement locally. CONCLUSIONS: Relatively simple innovations in mental health program design can have important practical ramifications for service provision, extending program reach and improving mental health outcomes for target populations. What is known about the topic? It is recognised that innovative approaches are required to tailor mental health programs for hard-to-reach and at-risk population groups. Divisions of General Practice have implemented innovations in the Access to Allied Psychological Services (ATAPS) program for several years. What does this paper add? Drawing on data from an ongoing national ATAPS evaluation, this paper presents a systematic analysis of the uptake, outcomes and issues associated with provision of the innovative ATAPS program. What are the implications for practitioners? The findings highlight the benefits of introducing innovations in primary mental healthcare in terms of increased access to care and positive consumer outcomes. They also identify challenges to and facilitators of the implementation process, which can inform innovation efforts in other primary care contexts.
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    Evaluation of an Australian primary care telephone cognitive behavioural therapy pilot
    Bassilios, B ; Pirkis, J ; King, K ; Fletcher, J ; Blashki, G ; Burgess, P (CSIRO PUBLISHING, 2014)
    A telephone-based cognitive behavioural therapy pilot project was trialled from July 2008 to June 2010, via an Australian Government-funded primary mental health care program. A web-based minimum dataset was used to examine level of uptake, sociodemographic and clinical profile of consumers, precise nature of services delivered, and consumer outcomes. Key informant interviews with 22 project officers and 10 mental health professionals elicited lessons learnt from the implementation of the pilot. Overall, 548 general practitioners referred 908 consumers, who received 6607 sessions (33% via telephone). The sessions were delivered by 180 mental health professionals. Consumers were mainly females with an average age of 37 years and had a diagnosis of depressive and/or anxiety disorders. A combination of telephone and face-to-face sessions of 1h in duration were conducted, delivering behavioural and cognitive interventions, usually with no cost to consumers. Several implementation issues were identified by project officers and mental health professionals. Although face-to-face treatment is preferred by providers and consumers, the option of the telephone modality is valued, particularly for consumers who would not otherwise access psychological services. Evidence in the form of positive consumer outcomes supports the practice of multimodal service delivery.
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    Examining Disaster Mental Health Workforce Capacity
    Reifels, L ; Naccarella, L ; Blashki, G ; Pirkis, J (GUILFORD PUBLICATIONS INC, 2014)
    OBJECTIVE: We examined the capacity of the disaster mental health workforce in Victoria, Australia, to provide the three evidence-supported intervention types of psychological first aid, skills for psychological recovery, and intensive mental health treatments. METHOD: Utilizing data from a cross-professional, state-level disaster mental health workforce survey (n = 791), we developed composite capacity indicators (CCI) for each intervention and performed logistic regression analyses to examine key predictors of disaster mental health workforce capacity. RESULTS: CCI profiles highlighted significant gaps in the disaster mental health capacity of Victorian providers, with only 32-42% able to deliver current best practice interventions. Key predictors of workforce capacity common and unique to interventions were highlighted. CONCLUSIONS: Key strategies to raise Victoria's disaster mental health workforce capacity should focus on targeted multilevel training in best practice interventions, creation of practice opportunities, and structural provider support/engagement. CCIs focused on best practice interventions provide a methodology for rapid workforce capacity assessment that can facilitate disaster preparedness planning, capacity building, and delivery of quality disaster mental health services.