Melbourne School of Population and Global Health - Research Publications
Permanent URI for this collection
Search Results
1 - 10 of 16
-
ItemAn Evaluation of the Implementation of the Australian ATAPS Suicide Prevention Services Initiative(SPRINGER, 2019-01)The Access to Allied Psychological Services (ATAPS) Suicide Prevention Services initiative is an Australian Government-funded primary mental healthcare initiative providing free intensive psychological intervention for consumers at moderate risk of self-harm or suicide. Findings from a multi-method evaluation aimed at identifying whether the initiative is being implemented as stipulated within the operational guidelines, barriers and facilitators to implementation, and preliminary outcomes suggest that the Suicide Prevention Services are largely being implemented as stipulated in the Guidelines, but with some exceptions. In particular, service delivery barriers unique to rural and remote areas place limitations on implementation. Uptake of the ATAPS Suicide Prevention Services is high (10,428 consumers were referred to the Suicide Prevention Services between October 2008 and April 2013, and 86% of those attended at least one session), as is acceptance from organizations involved in its implementation.
-
ItemEnhanced primary mental healthcare for Indigenous Australians: service implementation strategies and perspectives of providers(Biomed Central Ltd, 2018)Background: Improving access to culturally appropriate mental healthcare has been recognised as a key strategy to address the often greater burden of mental health issues experienced by Indigenous populations. We present data from the evaluation of a national attempt at improving access to culturally appropriate mental healthcare for Indigenous Australians through a mainstream primary mental healthcare program, the Access to Allied Psychological Services program, whilst specifically focusing on the implementation strategies and perspectives of service providers. Methods: We conducted semi-structured interviews with 31 service providers (primary care agency staff, referrers, and mental health professionals) that were analysed thematically and descriptively. Results: Agency-level implementation strategies to enhance service access and cultural appropriateness included: the conduct of local service needs assessments; Indigenous stakeholder consultation and partnership development; establishment of clinical governance frameworks; workforce recruitment, clinical/cultural training and supervision; stakeholder and referrer education; and service co-location at Indigenous health organisations. Dedicated provider-level strategies to ensure the cultural appropriateness of services were primarily aimed at the context and process of delivery (involving, flexible referral pathways, suitable locations, adaptation of client engagement and service feedback processes) and, to a lesser extent, the nature and content of interventions (provision of culturally adapted therapy). Conclusions: This study offers insights into key factors underpinning the successful national service implementation approach. Study findings highlight that concerted national attempts to enhance mainstream primary mental healthcare for Indigenous people are critically dependent on effective local agency- and provider-level strategies to optimise the integration, adaptation and broader utility of these services within local Indigenous community and healthcare service contexts. Despite the explicit provider focus, this study was limited by a lack of Indigenous stakeholder perspectives. Key study findings are of direct relevance to inform the future implementation and delivery of culturally appropriate primary mental healthcare programs for Indigenous populations in Australia and internationally.
-
ItemImproving access to primary mental health care for Australian children(SAGE PUBLICATIONS LTD, 2016-11)OBJECTIVE: This study examines the uptake by children aged predominantly 0-11 years of an Australian primary mental health service - the Access to Allied Psychological Services programme - which began in 2001. In particular, it considers access to, and use of, the child component of Access to Allied Psychological Services, the Child Mental Health Service, introduced in 2010. METHOD: Using routinely collected programme data from a national minimum dataset and regional population data, we conducted descriptive and regression analysis to examine programme uptake, predictors of service reach and consumer- and treatment-based characteristics of service. RESULTS: Between 2003 and 2013, 18,631 referrals for children were made and 75,178 sessions were scheduled via Access to Allied Psychological Services, over 50% of which were via the Child Mental Health Service in its first 3 years of operation. The rate of referrals for children to the Child Mental Health Service was associated with the rate of Access to Allied Psychological Services referrals for consumers aged 12+ years. CONCLUSIONS: The Child Mental Health Service has increased services provided within the Access to Allied Psychological Services programme for children with emotional and behavioural issues and their families, and is potentially filling a service gap in the area of prevention and early intervention for children who have significant levels of need but are unable to access other mental health services. Our findings are policy-relevant for other developed countries with a similar primary mental health care system that are considering means of improving service access by children.
-
Item
-
ItemAchievements of the Australian Access to Allied Psychological Services (ATAPS) program: summarising (almost) a decade of key evaluation data(BMC, 2016-09-26)BACKGROUND: Introduced in July 2001, Australian Access to Allied Psychological Services (ATAPS) was the inaugural national policy initiative to provide community access to government-funded psychological services in primary care. Our aim was to examine the achievements of ATAPS in relation to its stated objectives using a set of indicators that largely drew on data from a minimum data set that we designed for the evaluation of ATAPS. METHODS: We used de-identified professional-, consumer- and session-level data from the minimum dataset, and secondary analyses of our quantitative and qualitative data collected for a series of specific evaluation studies. Available data covered the period from 1 July 2003 to 31 December 2012. RESULTS: Approximately 350,000 referrals were made to the ATAPS program over the 9.5 year analysis period, 79 % of which resulted in services. Over 1.4 million sessions were offered. Overall, 29 % of consumers were male, 4 % children, and 3 % Aboriginal people; 54 % of consumers had depression and 41 % an anxiety disorder; at least 60 % were on low incomes; and around 50 % resided outside of major cities. The most common interventions delivered were cognitive and behavioural therapies. Selected outcome measures indicated improvement in mental health symptoms. CONCLUSIONS: Access to Allied Psychological Services achieved its objectives within a decade of operation. The program delivered evidence-based services to a substantial number of consumers who were disadvantaged and historically would not have accessed services. Importantly, where data were available, there were indications that ATAPS achieved positive clinical outcomes for consumers. This suggests that ATAPS carved an important niche by successfully addressing unmet need of hard-to-reach consumers and through means that were not available via other programs. It will be interesting to see the effects from July 2016 of the reform of ATAPS, which will see ATAPS subsumed under psychological services commissioned by regional primary care organisations.
-
ItemNo Preview AvailableImproving access to primary mental healthcare for Indigenous Australians(SAGE PUBLICATIONS LTD, 2015-02)OBJECTIVE: To examine the uptake, population reach and outcomes of primary mental healthcare services provided to Indigenous Australians via the Access to Allied Psychological Services (ATAPS) program between 2003 and 2013, with particular reference to enhanced Indigenous ATAPS services introduced from 2010. METHOD: Utilising ATAPS program data from a national minimum data set and comparative population data, we conducted descriptive analyses, regression analyses and t-tests to examine the uptake of ATAPS services, provider agency level predictors of service reach, and preliminary outcome data on consumer level outcomes. RESULTS: Between 2003 and 2013, 15,450 Indigenous client referrals were made that resulted in 55,134 ATAPS sessions. National Indigenous service volume more than doubled between 2010 and 2012, following the introduction of enhanced Indigenous ATAPS services. Non-Indigenous ATAPS service volume of primary care agencies was uniquely predictive of Indigenous service reach. Preliminary analysis of limited consumer outcome data indicated positive treatment gains and the need to enhance future outcome data collection. CONCLUSIONS: Concerted national efforts to enhance mainstream primary mental healthcare programs can result in significant gains in access to mental healthcare for Indigenous populations.
-
ItemSuicide prevention: Evaluation of a pilot intervention in a primary care context(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.
-
ItemEnhanced Primary Mental Health Services in Response to Disaster(AMER PSYCHIATRIC PUBLISHING, INC, 2012-09)OBJECTIVE: Although postdisaster mental health sequelae are recognized, the role of mental health services in primary care after disasters has not been investigated. This study examined the uptake of enhanced primary mental health services delivered via the Australian government mental health response to the 2009 Victorian bushfires and considered the consumer outcomes associated with them. METHODS: Data from a national Web-based minimum data set enabled description of consumers, sessions, and treatment outcomes. Key informant interviews provided supplementary qualitative data. RESULTS: From January 2009 to June 2011, a total of 1,535 consumers received 9,949 sessions via enhanced primary mental health services. Most had depressive disorders, anxiety disorders, or both. Clinical outcomes data from standardized mental health outcome measures demonstrated statistically significant gains indicative of clinical improvement. CONCLUSIONS: Primary mental health services were well utilized and received by bushfire-affected individuals in most areas and produced positive outcomes for consumers in terms of reducing symptoms and improving psychosocial functioning. Enhancing existing primary mental health services shows promise as a means of responding to bushfires and may be applicable internationally in other disaster contexts.
-
ItemNational telemental health responses to a major bushfire disaster(ROYAL SOC MEDICINE PRESS LTD, 2012)In response to the Victorian bushfire disaster in 2009, various telemental health services were provided by three national agencies: Kids Helpline (BoysTown), MensLine Australia (Crisis Support Services) and Lifeline Australia. All provider agencies used their existing national service structures and staff resources, which were expanded to respond to bushfire-related service demand. We examined service provider reports and conducted key informant interviews. Despite a lack of quantitative data on consumer outcomes and perspectives, it appears that all three telemental health services experienced significant increases in overall service uptake levels in the wake of the bushfires. Uptake of specialized telephone-, web-, email- and crisis counselling services was substantial, although that of callback services was very limited. Potential clients encountered specific barriers in relation to service access and the callback model. The bushfire experience highlighted the impact of transitory living circumstances and the increased complexity of post-disaster calls on service provision. Telemental health services need to be integrated into mainstream services and disaster response structures.
-
ItemWhy did Divisions of General Practice implement some Access to Allied Psychological Services mental health initiatives and not others?(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.