Melbourne School of Population and Global Health - Research Publications
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ItemPrevention and Recovery Care Services in Australia: Describing the Role and Function of Sub-Acute Recovery-Based Residential Mental Health Services in Victoria(FRONTIERS MEDIA SA, 2019-10-24)Background: Prevention and Recovery Care (PARC) services are relatively new sub-acute residential services that have supported people with mental ill-health in Victoria since 2003. Operated from a partnership model between non-governmental agencies and clinical mental health services, PARC services integrate intensive recovery-focused psychosocial input with clinical mental health care. Aim: To describe and contrast the 19 PARC services operating in Victoria at the time of the study, in terms of structures and function, resources, and content and quality of care. Method: Nineteen participants, one representing each PARC, completed two surveys: the first, a purpose-designed survey relating to the government guidelines for PARC services, and the second, the Quality Indicator for Rehabilitative Care. Results: Descriptive analyses highlighted that PARC services have operated in inner-city, urban, and regional areas of Victoria, from between 1 and 14 years. Participants reported that a recovery approach was at the core of service delivery, with a vast array of group and individual programs on offer. Across the state, there was variation in the quality of services according to the Quality Indicator for Rehabilitative Care domains. Conclusions: This study has identified that there is variation in the structure and function, resourcing, and content and quality of care offered across Victoria's PARC services even though, in the main, they are guided by government guidelines. Hence it appears that the services adapt to local needs and changes in service systems occurring over time. The findings indicate emerging evidence that PARCs are providing recovery-oriented services, which offer consumers autonomy and social inclusion, and therefore likely enable a positive consumer experience. The range of individual and group programs is in line with the Victorian guidelines, offering practical assistance, therapeutic activities, and socialization opportunities consistent with consumer preferences. Further research into implementation processes and their impacts on quality of care is warranted concerning this and similar service models.
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ItemPrevention and Recovery Care Services in Australia: Developing a State-Wide Typology of a Subacute Residential Mental Health Service Model(FRONTIERS MEDIA SA, 2019-06-11)Aims: Community-based residential alternatives to hospitalization are an emerging service model. Evidence for their acceptability and effectiveness is promising but limited. Prevention and Recovery Care (PARC) services are one such residential model, offering short-term subacute treatment and care (usually between 7 and 28 days). PARC services in Victoria, Australia, are designed to support consumers with severe mental illness to either avoid a psychiatric hospital admission (step-up care) or transition from hospital back into the community (step-down care). As a precursor to a series of studies investigating the appropriateness, effectiveness and efficiency of PARC services, we aimed to investigate whether a typology of PARC services can be developed. Methods: A manager or other appropriately knowledgeable staff member from each of the 19 adult PARC services included in the study completed a tool based on PARC operational guidelines (the Victorian PARC service mapping questionnaire) and a validated instrument measuring the quality of care in residential mental health settings (the Quality Indicator for Rehabilitative Care, QuIRC). Thirty (of 42) stakeholders participated in a modified Delphi study to select 23 from the available 230 variables for entry into a hierarchical cluster analysis. Results: Cluster analysis produced three clusters of equal dissimilarity. At the 90% confidence level, there were four variables which were significantly different between clusters. These were the year the PARC was opened, the QuIRC Living Environment domain score, the proportion of all admissions that were a step-down admission from an inpatient unit, and how often families were invited to care meetings. Sensitivity analyses suggested the findings were robust to the method used to identify clusters. Conclusions: Although PARC services were broadly similar, their identified differences suggest there is variable model implementation across Victoria sufficient to generate a PARC service typology. This typology may prove important for interpreting differences in outcomes experienced by consumers and carers using PARC services, when applied in our analyses of service effectiveness. The value of conducting service mapping and typology studies is underscored. Further research to characterize subacute residential services, including recovery-promoting features of the built environment, is warranted.
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ItemA Process and Intermediate Outcomes Evaluation of an Australian Recovery College(University of Toronto, 2018)Recovery Colleges are a rapidly expanding innovative approach aimed at supporting the personal recovery of people with mental health issues, yet there is a dearth of high quality evidence that evaluates this service delivery model. Objective: The aim of this evaluation was to systematically examine the processes involved in the implementation of the Mind Recovery College™ model in Australia and to measure intermediate outcomes for people who engaged with it. Research Design and Methods: The evaluation employed a co-produced mixed-methods design, involving document review, individual semi-structured interviews, a survey and focus group discussion with people engaged with metropolitan and regional Victorian College campuses. Fifty-one people participated in the evaluation, including: previous and current students with a lived experience of mental ill-health; families and carers; staff members; and community stakeholders. Qualitative data were analyzed using framework and content analysis, and quantitative survey results were descriptively interpreted. Results: Students reported a high level of satisfaction with the Mind Recovery College™ and positive impacts on various aspects of their lives, such as regarding the promotion of learning and growth, the adoption and maintenance of a healthy lifestyle, employment and cultural activities. The results suggest that the Mind Recovery College™ is operating primarily as an educational service that uses a strengths-based and co-production model to emphasize hope in recovery, the utility of lived experience of mental ill-health, and the value of education and social inclusion. Conclusions: Through its emphasis on personal strength and education, the Mind Recovery College™ appears to be assisting people with mental illness to feel more empowered and able to address their personal recovery goals.
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ItemCo-producing the journey to recovery: The Mind Recovery College(The Mental Health Service Learning Network, 2017)
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ItemNo Preview AvailableA report on the process evaluation of the Mind Recovery College(University of Melbourne and Mind Australia, 2016-11-30)
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ItemA report on the early outcomes of the Mind Recovery College(University of Melbourne and Mind Australia, 2016-11-30)