Mental health, alcohol and other drugs hub

In preparation for new contracts with providers for primary mental health care services from 1July 2019, Brisbane North PHN has undertaken a number of reviews of services.

Over the past six months, the PHN has worked with consumers and carers, providers and other stakeholders to decide how existing and new primary mental health care services commissioned by the PHN will evolve (click here for further details on this work).

Based on the feedback provided the PHN has now developed a draft ‘Procurement Strategy’ that provides an overview of the proposed changes the PHN would like to make to our procurement of primary mental health and suicide prevention services from 1 July 2019.

CLICK HERE to view the draft Procurement Strategy.

This includes the continuation of a number of services and contracts as well as new procurement in the areas of psychological therapies for underserviced groups and services for people with severe mental illness.

We are seeking your comments on these proposals by Monday 10 December 2018. To provide your comments please send an email to MHAOD@brisbanenorethphn.org.au(External link).

In preparation for new contracts with providers for primary mental health care services from 1 July 2019, Brisbane North PHN is undertaking a number of reviews of services.

In line with ‘Planning for Wellbeing: A draft regional plan for North Brisbane and Moreton Bay focusing on mental health, suicide prevention and alcohol and other drug treatment services 2018-2013’, the goal of PHN commissioned services is to contribute to meeting the vision of:

• a healthy and inclusive community, where people experiencing mental health difficulties or issues related to substance use have a life with purpose and access to quality care and support focused on wellness and recovery, in an understanding, empathic and compassionate society.

The PHN and commissioned providers are committed to improving quality, coordination and integration of services to support people to achieve their goals.

Overall, our review of current and new commissioning of primary mental healthcare services will be guided by the following questions:

• How do people most easily connect to the services they need, in a timely manner?
• How can we clearly and simply structure and communicate what services are available and how to access them?
• What role do referrers have in this process, and how do we assist referrers to undertake initial assessment and referral?
• How do PHN commissioned services fit in with and complement other mental health services, in a stepped care framework?
• How do people step up or step down to different services as their needs change?
• How can we get the most benefit for the most number of people from our capped budget?
• How do we continually improve quality, coordination and integration of services?
• How can commissioned services actively involve Consumers and Carers in the planning, implementation and evaluation of services and programs?
• How do we know PHN commissioned services are making a difference?

To gain an overview of our review processes, please read the paper ‘What’s next’

In the document library specific papers are also available for reviews into:

• Infant, child and youth (including Brisbane Mind4KiDS, headspace and Asha)
• Psychological services (including Brisbane Mind and low intensity services)
• People with severe mental illness (including new psychosocial and continuity of support funding and MHNiB)

If you have any comments or questions about any of the reviews, or to express your interest in participating in co-design activities, please email myvoice@brisbanenorthphn.org.au

Brisbane North PHN and Metro North Hospital and Health Service have sponsored the development of a plan to improve mental health, suicide prevention and alcohol and other drug treatment services in North Brisbane and Moreton Bay

Stakeholders are invited to provide input on the draft five year plan, Planning for wellbeing, which sets out the challenges facing the sector and establishes future directions for the region as a whole, not just for the two sponsoring organisations.

Brisbane North PHN Executive Manager, Mental Health, Alcohol and Other Drugs Paul Martin said the plan had been developed in partnership with other healthcare providers and practitioners, people with a lived experience and carers.

“People with a lived experience are leading the change and actions to strengthen their involvement at all levels of planning, delivery and evaluation start off the plan,” Mr Martin said.

“The plan then outlines our shared objectives and priority actions to bring about whole of system and whole of community changes, including for carers and diversity groups, sustaining good mental health and how we commission and deliver services.”

You are invited to tell us what you think about the draft plan.

• Do you agree with the change agenda set out in the plan?
• What are the most important actions to you?
• What have we missed?
• How can you or your organisation contribute to delivering the vision outlined in the plan?

To have your say visit, https://myvoice.brisbanenorthphn.org.au/-MHSPAOD-regional-planYou can complete a short survey, post comments to the forum, or send an email to myvoice@brisbanenorthphn.org.au

Consultation closes on Sunday 8 July 2018.

Following finalisation of the plan a range of partnership groups and working groups will develop detailed implementation plans and drive the delivery of actions.

Brisbane North PHN is hosting a series of focused workshops to help develop the regional plan for mental health, suicide prevention and alcohol and other drug treatment.

Bringing together people with expertise and a stake or interest in the issue, each two and a half hour workshop will explore what is known about the issue, current challenges and actions that should be progressed through the plan.

Topics, dates and locations are outlined below. Please click on the corresponding link to register for whichever workshop you wish to attend. Please note places are limited, so get in quick.

• Staying healthy (prevention and health promotion) – Monday 4 September 1.30-4.00 pm – Lutwyche: Register here
• Older people – Wednesday 13 September 1.30-4.00 pm – Lutwyche: Register here
• Lesbian, Gay, Bisexual, Transgender or Intersex – Thursday 14 September – 9.00-11.30 am – North Lakes: Register here
• Perinatal – Tuesday 19 September 1.30-4.00 pm – North Lakes: Register here
• Culturally and Linguistically Diverse – Thursday 21 September 1.30-4.00 pm – Lutwyche: Register here

Venue details

For workshops held at Lutwyche, the address is:

Brisbane North PHN Lutwyche Office, Suite SP020, Ground Floor, Lutwyche City, 543 Lutwyche Road, PO Box 845, Lutwyche, QLD 4030

For workshops held at North Lakes, the address is:

Level 2, 10 Endeavour Boulevard, (PO Box 929), North Lakes QLD 4509

For any enquiries, please email Program Support Officer Mary Smareglia on Mary.Smareglia@brisbanenorthphn.org.au or phone 07 3630 7350.

PHNs are tasked with helping reform the mental health system through the implementation of a stepped care approach.

But what is stepped care?

Brisbane North PHN has produced a short video and consultation paper to explain our approach to stepped care to date and to get your input.

At its heart, stepped care is about understanding the needs of individual consumers and providing them with services and supports which best match their level of need. Services need to be available across the spectrum from prevention and early intervention to mild mental illness through to those with severe and complex issues.

Recent commissioning of new mental health services has occurred within a stepped care approach and the development of the regional plan for mental health is happening within this framework.

We invite you to view the Stepped care video on this page and read our consultation paper which includes a number of questions. You can provide feedback to these questions through the online survey, discussion forum or by submitting written comment to myvoice@brisbanenorthphn.org.au

Deadline for feedback is 18^th October 2017.

A vision for mental health, suicide prevention and alcohol and other drug treatment services in North Brisbane and Moreton Bay is shaping up, thanks to the input of stakeholders like you.

The vision will form part of the regional plan being developed by Brisbane North PHN together with Metro North Hospital and Health Service.

Background

In March over 70 stakeholders, including people with a lived experience, helped develop a vision for a quality, coordinated and integrated mental health, suicide prevention and alcohol and other drug treatment response in our community. A set of features were developed and actions suggested to move us from where we are now to where we want to be.

You now have the opportunity to provide feedback on the features and help further develop and prioritise actions.

Regional plan

Due to be released in October 2017, the Regional plan will set out a five year vision for the mental health, suicide prevention and alcohol and other drugs treatment service systems, along with detailed action plans for the next two years. Developed jointly by Brisbane North PHN and Metro North Hospital and Health Service, in conjunction with people with a lived experience, consumers, carers and service providers, the plan will provide an agreed blueprint for service and system development in the coming years.

While still in development, the plan will likely include a number of sections including:

• needs and context – overview of current health needs in North Brisbane and Moreton Bay, the current service response and the policy environment

• system features and actions – our shared vision and the actions that will enable us to achieve it (the focus of this consultation paper)

• lived experience participation – opportunities and support for people with a lived experience to participate policy, planning, delivery and evaluation

• services planning statement – projected health need and required service response and priorities for service investment

• performance indicators – how we will know if things are getting better

• chapters – focus areas including: staying healthy and early intervention, children and young people, psychological services, people with severe mental illness, suicide prevention, alcohol and other drugs treatment, crisis services, Aboriginal and Torres Strait Islander communities

Details regarding the vision, features and suggested actions is available in the consultation paper.

You can have your say, by completing our online survey, emailing your response to myvoice@brisbanenorthphn.org.au, or providing written comment on our consultation forum.

Deadline for written comments and the online survey is 9am Wednesday 14th June.

This summary covers the key themes from the symposia which along with all the feedback provided will inform the development of a regional plan for mental health, suicide prevention and alcohol and other drug services in the North Brisbane and Moreton Bay region.

Acknowledging that not everyone could be in the room on the day, the PHN will continue to engage broadly with the sector, to gather feedback in tandem with this ongoing symposia series.

Testing the vision: features of a system that works for me

Following 12 months of consultation with the sector, we proposed a vision of what an integrated and effective system should look and feel like for consumers which is available in the document library. The first part of the symposia focused on testing the features of this proposed system.

Generally, participants agreed that the features identified were important, but that the way in which they were expressed needed further work, and additional features were suggested.

From discussions on the day, we also identified an additional feature, ‘A system that drives health creation to keep people healthy in their communities’ which was included for further discussion during the Symposia.

The feedback from this session was broad, but included the following suggestions:

• consider the consumer and community view of the system and reorient the features from their viewpoint – ‘People should be the drivers not just the focus’ and ‘Features of a community that works for me’.
• include early intervention and the need for preventative services
• ensure ‘Accessible for all’ empowers people to seek help - ‘empowered to access services without judgement’
• ensure ‘Health creation’ includes health promotion and stigma reduction, which are vital to enabling access
• consider better articulation of ‘No wrong door’ to ensure a move beyond silos
• include the importance of safe and secure relationships, access to housing and other social determinants across the features
• reframe ‘evidence based’ to ‘evidence informed’ to drive opportunity for innovation
• include informed consent and ensure it is consumer driven
• extend integration to reach beyond the health and community services to include education, business and private sectors and encourage collaboration not competition
• revise ‘focused on outcomes’ to define outcomes by the person, not for the person
• include the concepts of recovery and define personal recovery versus clinical recovery
• recognise and address the power imbalance between services and consumers.

The vision and features will be revised based the feedback received and we will seek ongoing input from participants and the broader sector on this revised vision over the coming months.

What needs to change to achieve this vision

In the afternoon session, participants were asked to consider what needs to change in relation to each of the features so we can achieve an integrated and coordinated mental health, suicide prevention and alcohol and other drugs health system in our region.

A summary of the key themes was presented back to the group on the day, and has been compiled below:

A system where people are the focus

• shift from ‘people focused’ to ‘people led’, system change should be driven by consumer experience - ‘A system where people are the leaders, not just the focus.’
• development of shared language driven by the community’s language. Reducing the medical language used and decreasing stigma. Changing the story from disaster to hope.
• a consumer led storytelling tool to allow people to only have to tell their story once and then control who has access to their story based on their needs, values and goals
• changing what and how we measure the delivery of services, to focus on what is important and valued by consumers, not necessary governments or funders. Shifting from outputs to outcomes, as defined by consumers and community
• a support system for the workforce and broader community to allow them to be people-focused. Training and funding models which address this.

A system that is accessible for all whatever their circumstances

• services must be built around what people choose is best for them, including a range of delivery modes and models and must be available 24/7.
• a strong focus on one-stop-shops within neutral community-based services. Also mindful that these hubs do not become too generalist, and enable services to meet needs
• structural change with funding models and a shift to flexible funding models that allow for funding to best suit the person or needs. Recognition and value placed on the engagement between consumers and service providers
• shift in paradigm – health creation (health and wellbeing) and changes in the language used i.e. focus on health and wellbeing which will help reduce stigma and discrimination.

A system that enables providers to understand people’s needs holistically

• clearly define ‘holistically’ to include all aspects of life and health including physical health, housing, family, social, emotional wellbeing, community connection as well as mental health
• the role of support people needs to be recognised and included in the care. This includes family or natural supports as well as peer workers and volunteers. Support, training and recognition of these roles is required
• funding of services needs to be holistic to enable holistic service delivery. Cannot fund silos and expect to deliver holistic services. Move away from funding ‘symptomology’ and addressing the primary cause not the result
• services need to be able to adapt to a person’s priorities and choices. If we really want a consumer driven model, we need to enable services to deliver consumer choices
• provide mental health training and literacy to other professionals, including teachers and community groups
• after hours supports are required.

A system that integrates and interacts with the broader health and community services sector

• development of systems that enable easy sharing of information. Allowing consumers to control who they share their story with in an effective and efficient way. Ensuring appropriate guidance and policies exist which protect privacy and confidentially whilst recnognising the benefits of shared care
• enhanced service navigation tools and access so that consumers and providers can find out what services are available
• using existing community structures to provide outreach services, so that consumers do not need to navigate the system. Colocation of services which provide a holistic view of needs, including social determinants
• changing funding models to those that encourage integration and collaboration. Look at opportunities for private funding and private sector support of programs.
• addressing the stigma around mental health, suicide and alcohol and other drug use. Recognise the different stigmas that exist and address the language used by media, communities and service providers.

A system where there is no wrong door to access

• better relationships and linkages between community-based services, government services, private sector and improved collaboration between mental health services and non-clinical services
• improved service navigation and data systems to enable sharing of both individual and service level data and information. Utilising peer workers to assist with navigation of the system
• development of flexible funding models which allow for engagement to be undertaken as part of the service delivery as well as enabling assertive follow up
• ‘No wrong door’ is a very negative statement and should be revised to a more positive term such as ‘a welcoming service’ or similar
• sharing of patient information needs to be easier and more consistent, but also driven by the consumer and their needs, not by the clinicians
• out of hours services need to be enhanced and developed, as to truly offer a ‘no wrong door’ service it needs to be available 24/7.

A system focused on outcomes, as defined by people’s own experience

• outcomes need to be consumer lead and defined, at all levels – individual, service, system and policy - ‘a system focused on a person’s goals, values and individual recovery plan’
• need to change the way in which data is collected and reported, currently driven by contractual performance indicators. This needs to shift to being outcomes focused
• need to use non-medical language, shift the focus from medical outcomes to social outcomes
• ‘outcomes’ does not capture the human and social elements of a person, need to consider these in evaluating services i.e. quality of life indicators
• move from a problem-focused to strengths-focused model.

A system that provides evidence – based service

• need to connect with universities and research institutes in a way that supports the meaningful transition of knowledge back to the sector. Bring evaluation and research expertise to the sector, to engage with research in the real world
• need to value and measure the engagement work that occurs in the sector. This work is integral to our work, but is often not valued and not measured. Need to also acknowledge that we work in a complex space, and often learnings occur in hindsight
• need to develop systems that support data collection and provide appropriate training to ensure service providers can use these tools
• need to use data collection tools that are mutually beneficial for both the person and the service
• funding models need to recognize the need for longitudinal evaluation and the current stop-start funding approach can affect our ability to gather evidence and data.

A system that builds the capacity of the workforce to support people and each other

• building the consumer and carer workforces and recognising the difference between consumers and carers. Involving consumers and carers in all aspects of the system and workforce
• workforce collaboration across sectors to promote collaboration and minimise competition Colocation of services and service models that encourage working with other professionals.
• ongoing professional development of the workforce including peer workers
• public mental health literacy and ensuring people have access to appropriate training and support. Incentivising mental health literacy across the community including in roles such as education, councils as well as community clubs and groups
• changing funding models to enable stability and consistency in service delivery. Fee for service models limit the capacity of the workforce to make systemic changes to improve patient care.

A system that drives health creation to keep people healthy in their communities

• social connection and self-determination is the foundation; therefore we need to apply our knowledge in new ways to create health creation systems, learning from the past and previous health promotion waves
• addressing stigma through education, normalise and de-medicalise mental health. Personal stories and impacts make stigma relatable. Look at ways to use current and emerging technologies and media
• need to recognise and address barriers to health promotion i.e. poverty etc. Taking a social approach to mental health and focusing on the social determinants to health to support consumers and communities.

Summary

Across each of the features there are common themes and needs that must be addressed to achieve an integrated and coordinated mental health, suicide prevention and alcohol and other drugs health system in our region. We will continue to work with the sector to understand these needs and identify the barriers to change which need to be addressed as we develop the regional plan.

The next steps of this process will be to release a discussion paper for consultation regarding the revised features of the system and key themes for change identified. We will also be undertaking consultation regarding the stepped care model and how this could work across our region.

Regular updates will be provided through our Recovery eNewsletter and the My Voice online engagement hub.

As well as the symposia, the PHN will be undertaking a variety of engagement activities focusing on particular streams of activity (e.g. children and young people, people with severe mental illness) over the coming months. These will be open to all and will feed into symposium two in June 2017.

You can comment or provide feedback on this article below, or if you would like further information or if you have any questions about this work please contact myvoice@brisbanenorthphn.org.au.

From 1 July 2016, PHNs were tasked with commissioning mental health, suicide prevention and alcohol and other drug treatment services. As part of this, the Department of Health has asked all PHNs to develop a regional plan, which will identify needs and gaps, reduce duplication, remove inefficiencies and encourage innovation within the North Brisbane and Moreton Bay region.

The Big Thinking; Local Planning Symposia is one step in the process for developing the regional plan. The Agenda and Pre-reading for the Symposia are available in the document library.