Updated Activity Work Plan 2016-2019: Primary Mental Health Care Funding

Updated Activity Work Plan 2016-2019: Primary Mental Health Care Funding

1 Updated Activity Work Plan 2016-2019: Primary Mental Health Care Funding The Mental Health Activity Work Plan template has two parts: 1) The updated Annual Mental Health Activity Work Plan for 2016-2019, which will provide: a) A strategic vision which outlines the approach to addressing the mental health and suicide prevention priorities of each PHN; b) A description of planned activities funded under the Primary Mental Health Care Schedule which incorporates: i) Primary Mental Health Care funding (PHN: Mental Health and Suicide Prevention Operational and Flexible Activity); and ii) Indigenous Australians’ Health Programme funding (quarantined to support Objective 6 – see pages 2-3) (PHN: Indigenous Mental Health Flexible Activity). 2) The updated Budget for 2016-2019 for (attach an excel spreadsheet using template provided): a) Primary Mental Health Care (PHN: Mental Health and Suicide Prevention Operational and Flexible Activity); and b) Indigenous Australians’ Health Programme (quarantined to support Objective 6) (PHN: Indigenous Mental Health Flexible Activity).

Central and Eastern Sydney PHN When submitting this Mental Health Activity Work Plan (referred to as the Regional Operational Mental Health and Suicide Prevention Plan in the 2015-16 Schedule for Operational Mental Health and Suicide Prevention, and Drug and Alcohol Activities) to the Department of Health, the Primary Health Network (PHN) must ensure that all internal clearances have been obtained and it has been endorsed by the CEO. Additional planning and reporting requirements including documentation, data collection and evaluation activities for those PHNs selected as lead sites and/or suicide prevention trial sites will be managed separately.

The Mental Health Activity Work Plan must be lodged via email to your Grant Officer on or before 17 February 2018.

2 Overview This Activity Work Plan is an update to the 2016-18 Activity Work Plan submitted to the Department in February 2017. However, activities can be proposed in the Plan beyond this period. Mental Health Activity Work Plan 2016-2019 The template for the Plan requires PHNs to outline activities against each and every one of the six priorities for mental health and suicide prevention. The Plan should also lay the foundation for regional planning and implementation of a broader stepped care model in the PHN region. This Plan recognises that 2016-17 is a transition year and full flexibility in programme design and delivery will not occur until 2018-19.

The Plan should: a) Provide an update on the planned mental health services to be commissioned from 1 July 2016, consistent with the grant funding guidelines. b) Outline the approach to be undertaken by the PHN in leading the development with regional stakeholders including LHNs of a longer term, more substantial Regional Mental Health and Suicide Prevention plan (which is aligned with the Australian Government Response to the Review of Mental Health Programmes and Services (available on the Department’s website). This will include an outline of the approach to be undertaken by the PHN to seek agreement to the longer term regional mental health and suicide prevention plan from the relevant organisational signatories in the region, including LHNs.

c) Outline the approach to be taken to integrating and linking programmes transitioning to PHNs (such as headspace, and the Mental Health Nurse Incentive Programme services) into broader primary care activities, and to supporting links between mental health and drug and alcohol service delivery. d) Have a particular focus on the approach to new or significantly reformed areas of activity – particularly Aboriginal and Torres Strait Islander mental health, suicide prevention activity, and early activity in relation to supporting young people presenting with severe mental illness.

In addition, PHNs will be expected to provide advice in their Mental Health Activity Work Plan on how they are going to approach the following specific areas of activity in 2016-19 to support these areas of activity: • Develop and implement clinical governance and quality assurance arrangements to guide the primary mental health care activity undertaken by the PHN, in a way which is consistent with section 1.3 of the Primary Health Networks Grant Programme Guidelines available on the PHN website at http://www.health.gov.au/internet/main/publishing.nsf/Content/PHN- Program_Guidelines, and which is consistent with the National Standards for Mental Health Services and National Practice Standards for the Mental Health Workforce. • Ensure appropriate data collection and reporting systems are in place for all commissioned services to inform service planning and facilitate ongoing performance monitoring and evaluation at the regional and national level, utilising existing infrastructure where possible and appropriate.

• Develop and implement systems to support sharing of consumer clinical information between service providers and consumers, with appropriate consent and building on the foundation provided by myHealth Record. • Establish and maintain appropriate consumer feedback procedures, including complaint handling procedures, in relation to services commissioned under the activity. Value for money in relation to the cost and outcomes of commissioned services needs to be considered within this planning process.

3 1. (a) Strategic Vision Please provide a strategic vision statement (no more than 500 words) on the PHN’s approach to addressing the mental health and suicide prevention priorities for the period covering this Work Plan (2016-17), including governance arrangements, that demonstrates how the PHN will achieve the six key objectives of the PHN mental health care funding underpinned by: • a stepped care approach; and • evidence based regional mental health and suicide prevention planning. CESPHN is committed to building a person centred, integrated system of care for the Central and Eastern Sydney region. CESPHN is working collaboratively with stakeholders to ensure people with any level of mental health need can access timely and effective care that improves their mental health, optimises their recovery, and supports better self-management of their mental health needs. The integrated system of care is based on: • a stepped care model of services; • improved access to care through a broader range of access points across the community and greater utilisation of digital platforms; • a regional approach to planning, commissioning and performance monitoring involving the Local Health Districts, the Specialty Health Networks and other key stakeholders; • regional workforce development enabling professionals from different settings to collaborate and learn together to build ‘one team, one system’; and • evidence-based regional mental health and suicide prevention planning and action. A key element of our approach, is a regional governance structure that coordinates service planning, commissioning, integration and monitoring. The governance structure includes consumer and carer representatives as well as representatives from the Local Health Districts (LHDs), Specialty Health Networks (SHNs), NGO mental health sector, general practice and allied health in our region. This group will guide the development of the regional mental health and suicide prevention plan to be completed in 2019.

Another key element continues to be the application of co-design in the development, revision and enhancement of services. Co-design methods involves consumers as experts of their domain and actively engages them in the design process. Commissioned services will require a minimum of a program logic evaluation framework to ensure monitoring and reporting is both comprehensive, timely and integrated with regional performance metrics. This plan outlines our commitment to leading a robust, effective, person-centred, evidence based mental health service system for the people of Central and Eastern Sydney. CESPHN serves as a commissioning organisation and develops quality primary health care services and associated interventions that deliver better health outcomes for people with mental health support needs, meet population health needs and reduce inequities in the system. Commissioned services address specific regional priorities and national health priorities as determined by the Commonwealth.

4 1. (b) Planned activities funded under the Primary Mental Health Care Schedule – Template 1 Note 1: For Priority Area 1, 2, and 5-8 use Template 1 below. Note 2: For Priority Areas 3 and 4, please use Template 2 on page 9. Priority Area 1: Low intensity mental health services Proposed Activities - copy and complete the table as many times as necessary to report on each Priority Area Priority Area Priority Area 1: Low intensity mental health services Activity(ies) / Reference (e.g. Activity 1.1, 1.2, etc) 1.1 Commission coaching services to support or guide people experiencing mild to moderate mental illness.

Existing, Modified, or New Activity 1.1 Existing Description of Activity 1.1 AIM: Increase access to low intensity mental health services for people experiencing mild forms of mental illness DESCRIPTION: Continue to commission coaching services in the CESPHN region for people experiencing mild forms of mental illness. CESPHN Needs assessment Dec 2017: Health Needs Analysis (p. 6) For the CESPHN population, the estimated prevalence rates of people who would benefit from access to low intensity mental health services each year is approximately: o 241,256 people under early intervention o 143,135 people under Mild severity Service Needs Analysis (p.14) A review of the eMHPrac listing shows 88 types of low intensity e-mental health supports available to the CESPHN community, 70 of which have no charge to access the service (79.5%) Listings through eMHPrac are categorised by tags which fits into 35 categories. The most common tag is ‘Online program’ with 27 listings (31%), followed by App (n=23), Anxiety (n=22), Depression (21), Information (20) and Youth (19) all having tags which cover over 20% of listed services.

5 Additional mapping of the CESPHN area identified 129 low intensity services available in the region. Access to these services has been categorised as: o In person (n=100) o Online (n=44) o Phone (n=73) o 24-hour phone (n=5) • 91 of these services are free to the consumer EXPECTED OUTCOME: Increased access to coaching services available in the region. Target population cohort People experiencing mild forms of mental illness in the CESPHN region Consultation Consultation with academic and research institutions and the CESPHN Mental Health and Suicide Prevention Advisory Committee (MHSPAC) regarding best practice coaching models. Collaboration General Practitioners and health providers in the region to promote access to commissioned services. Beyond Blue national PHN group to share best practice implementation strategies. Duration Activity duration: 1 July 2018 -30 June 2019 Key Milestones: Q1 July- Sept 2018: Monitoring and reporting Q2 Oct- Dec 2018: Monitoring and reporting Q3 Jan-March 2019: Monitoring and reporting Q4 April – June 2019: Monitoring, reporting and Evaluation Coverage Whole CESPHN region.

Commissioning method (if relevant) Activity currently commissioned until June 30, 2019.

6 Approach to market Open Tender Decommissioning N/A Performance Indicator Priority Area 1 - Mandatory performance indicators: • Proportion of regional population receiving PHN-commissioned mental health services – Low intensity services. • Average cost per PHN-commissioned mental health service – Low intensity services. • Clinical outcomes for people receiving PHN-commissioned low intensity mental health services. Local Performance Indicator: • Effectiveness – Consumer reported experiences of service Is this a process, output or outcome indicator?

Outcome Local Performance Indicator target (where possible) Performance Target: 80% of clients who complete a satisfaction survey are reporting high level of satisfaction with care. Baseline: Baseline will be determined by 30 June 2018. Level of aggregation: Age and gender Local Performance Indicator Data source Data source: Experience of service survey. National data set: No Data collection commencement: July 2018 Priority Area 2: Child and youth mental health services Proposed Activities - copy and complete the table as many times as necessary to report on each Priority Area Priority Area Priority Area 2: Child and youth mental health services

7 Activity(ies) / Reference (e.g. Activity 1.1, 1.2, etc) 2.1 Commission Lead Agencies of headspace Centres in CESPHN region to deliver youth mental health services 2.2 Commission early intervention model services for young people with or at risk of Severe Mental Illness including early psychosis and eating disorders. 2.3 Commission Child and Youth Psychological Support Services 2.4 Access to low intensity digital mental health services for young people. Existing, Modified, or New Activity 2.1 Existing 2.2 Existing 2.3 Existing 2.4 Modified – from 1.1. in 2017-18 AWP Description of Activity 2.1 AIM: Increase access and care pathways for young people experiencing or at risk of mental illness DESCRIPTION: This activity builds on the established headspace infrastructure, and is supported by 2016-2017 activities 2.2 (Services for young people with or at risk of severe mental illness) and 2.3 (Psychological Support Services) which are provided via the 5 headspace Centres in the CESPHN region The 5 headspace Centres in the CESPHN region will continue to run keeping the hNO Model Integrity Framework as their core model.

CESPHN Needs assessment Dec 2017: Health Needs Analysis (p 6-7) • From 1 July 2016 to 30 June 2017 3,621 young people accessed one of the five headspace centres in the CESPHN region. 2,460 of these young people accessed a centre for the first time during this period. Across the region, females are more likely to access Headspace compared to males. • The main reasons young people attend headspace Centres within the region are for mental health support. Service Needs Analysis (p15)

8 • Young people within the CESPHN region have higher rates of self-referral into headspace sites than nationally, particularly in Camperdown. EXPECTED OUTCOMES: • Increased access to youth health services in the region • Young people accessing headspace Centres are receiving care within a stepped care approach to support their needs 2.2 AIM: The primary aim is to Increase access to appropriate services for young people with severe mental illness. Secondary aims are to; • Identify youth at risk of developing a severe mental illness including early psychosis to provide early intervention support in the primary care setting • Provide access to a stepped care model of services through headspace centres in a youth friendly environment.

DESCRIPTION: To continue to commission and provide access to appropriate early intervention services for young people at risk of experiencing severe mental illness in the primary care setting of the headspace centres. CESPHN Needs Assessment Nov 2017: Health Needs Analysis (p.9)

9 • An estimated 3.5% of the Australian population will have a severe mental illness or substance use disorder; 2.2% of individuals aged 0-14 years, 3.4% of individuals aged 15-24 years, 4.1% of individuals aged 25-64 years and 2.9% of individuals aged 65 years + EXPECTED OUTCOME: Young people with or at risk of developing a severe mental illness are assessed, treated, and supported in their recovery within the primary care platform of headspace 2.3 AIM: Increase access for children and young people to a range of applied psychological therapies. DESCRIPTION: To continue to commission and provide access to a range of applied psychological therapies to children and young people.

CESPHN Needs assessment Dec 2017: Health Needs Analysis (p6): • The Young Minds Matter data provides synthetic estimates on mental disorders among 4-17- year-olds. The estimates are based on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing and provides rough data on the prevalence of Mental disorder of 4-17-year-olds in the region. • The data shows that the rates for both 4-11-year-olds and 12-17-year-olds across all mental disorders are lower than the national rate. Within CESPHN the SA3s with the highest rates for 4-11-year-olds are; Sydney Inner City, Cronulla – Miranda – Caringbah and Sutherland – Menai – Heathcote. The SA3s with the highest rates for 12-17-year-olds are; Sydney Inner City, Botany and Marrickville - Sydenham – Petersham.

• Prevalence is also estimated at mild, moderate and severe levels, with rates across CESPHN lower than the national rate in all categories. EXPECTED OUTCOME: Increased access to psychosocial therapies for children and young people in the CESPHN region

10 2.4 AIM: Implement the 'Synergy Online System' (SOS) to support Clinicians with real time assessment. DESCRIPTION: Trial 4 of 'Project Synergy' (Nov 2016- Jun 2018) evaluated the engagement with, and effectiveness of, the Brain and Mind Centre (University of Sydney) Mental Health eClinic (MHeC) when embedded in 5 CESPHN headspace services. The Mental Health eClinic is a real-time primary care e- clinic that offers online assessment available at first request for service, resulting in an immediate dashboard of results. To date, across the five headspace sites, 498 young people (aged 16 to 25 years) who are newly presenting for care have been recruited to the trial. As part of the evaluation of the MHeC, both young people as well as health professionals working at each headspace trial site play an active role in the research.

A new version of the MHeC known as the 'Synergy Online System' (SOS) is in the process of being built and the plan is to build upon the foundational work done at these five headspace sites and implement the upgraded version of the technology that aims to improve access and quality of care for young people using these services. The technology will enable young people to complete an online assessment prior to their first face-to-face appointment at headspace, resulting in a dashboard of results that can be used by the young person and the service to access the right level of service at the right time (stepped care). The collaborative use of the platform between young people and clinicians will result in between shared decision making ('share plan') and the system's tracking of treatment progress can help young people 'step up' or 'step down' in service intensity based on need. Data would also be available to services and the CESPHN to evaluate service quality and outcomes. CESPHN Needs assessment Dec 2017: Health Needs Analysis (p 7) • The main reasons young people attend headspace Centres within the region are for mental health, followed by engagement and assessment.

EXPECTED OUTCOME: Young people accessing headspace Centres are receiving care and support within a stepped care approach to support their needs

11 Target population cohort 2.1 Young people aged 12-25 in the CESPHN region 2.2 Young people aged 12-25 in the CESPHN region 2.3 Children and young people in the CESPHN region 2.4 Young people aged 12-25 who access the five headspace Centres within the CESPHN region Consultation 2.1 Consultation with headspace National Office, headspace Lead Agencies and headspace teams 2.2 SESLHD, SLHD, Orygen Centre of Excellence for Youth Mental Health, headspace Lead Agencies and headspace teams 2.3 Consultation occurred through co-design and relevant stakeholders 2.4 Consultation University of Sydney - Brain Mind Youth Platform, headspace lead agencies and headspace teams, young people, health professionals and service providers. Collaboration 2.1 Collaboration with headspace Lead Agencies to ensure implementation of model integrity framework and ongoing performance of Headspace centres 2.2 Collaboration with SESLHD, SLHD, Orygen and headspace lead agencies and teams to design and implement services for young people which are integrated into existing service structures and to address needs 2.3 Collaboration with Consumers, Carers, and service providers in the design of the service model. Collaboration with CMOs, Primary Care providers, and headspace centres to implement and deliver psychological support services.

2.4 The platform has undergone 15 months of co-design and co-development with young people, health professionals and service providers in CESPHN, assisting in the development of the new version of the SOS. Duration Activity duration: 1 July 2018 -30 June 2019 Key Milestones: Q1 July- Sept 2018: Monitoring and reporting

12 Q2 Oct- Dec 2018: Monitoring and reporting Q3 Jan-March 2019: Monitoring and reporting Q4 April – June 2019: Monitoring, reporting and Evaluation Coverage Whole PHN region Commissioning method (if relevant) All activities are currently commissioned until June 30, 2019. Approach to market 2.1 Direct engagement 2.2 Direct engagement 2.3 Open tender 2.4 Direct engagement Decommissioning N/A Performance Indicator Priority Area 2 - Mandatory performance indicator: • support region-specific, cross sectoral approaches to early intervention for children and young people with, or at risk of mental illness (including those with severe mental illness who are being managed in primary care) and implementation of an equitable and integrated approach to primary mental health services for this population group.

• Proportion of regional youth population receiving youth-specific PHN-commissioned mental health services Local Performance Indicators: 2.1 Effectiveness – Consumer reported experiences of service 2.2 Effectiveness – Consumer reported experiences of service 2.3 Effectiveness – Consumer reported experiences of service 2.4 N/A Is this a process, output or outcome indicator? 2.1 Outcome

13 2.2 Outcome 2.3 Outcome 2.4 N/A Local Performance Indicator target (where possible) Performance Target: 2.1 80% of clients who complete a satisfaction survey are reporting high level of satisfaction with service 2.2 80% of clients who complete a satisfaction survey are reporting high level of satisfaction with service 2.3 80% of clients who complete a satisfaction survey are reporting high level of satisfaction with service 2.4 N/A Baseline: Baseline will be determined by 30 June 2018. Level of aggregation: Age, Gender and Aboriginal and/or Torres Strait Islander. Local Performance Indicator Data source Data source: Experience of Service survey National data set: No Data collection commencement: July 2018 Priority Area 5: Community based suicide prevention activities Proposed Activities - copy and complete the table as many times as necessary to report on each Priority Area Priority Area Priority Area 5: Community based suicide prevention activities Activity(ies) / Reference (e.g. Activity 1.1, 1.2, etc) 5.1 Psychological Support Services (PSS) 5.2 Commission Suicide Prevention Activities including Indigenous specific initiatives Existing, Modified, or New Activity 5.1 Existing 5.2 Modified

14 Description of Activity 5.1 AIM: Increase access to support and psychological therapies for people at risk of suicide DESCRIPTION: Continue to commission and provide access to a range of applied psychological therapies for people at risk of suicide. CESPHN Needs assessment Dec 2017: Health Needs Analysis (p.10) • There is limited data available at the local level regarding suicide and self-harm however it has been identified as an issue within pockets of our population. In 2016 nationally, Intentional self-harm accounted for over one-third of deaths (35.4%) among people 15-24 years of age, and over a quarter of deaths (28.6%) among those 25-34 years of age. For those people 35-44 years of age, 16.0% of deaths were due to intentional self-harm Health Service Analysis (p.21) • Across CESPHN in 2015-16, intentional self-harm overnight hospitalisations were at a rate of 12 per 10,000, lower than the national rate of 17 per 10,000. Residents living in Botany SA3 had the highest rate of hospitalisations (20 per 10,000), followed by Marrickville – Sydenham- Petersham (15 per 10,000), Sydney Inner Sydney (17 per 10,000), Eastern Suburb South (15 per 10,000) and Leichhardt (15 per 10,000) SA3s.

• Bed days for Intentional Self Harm across CESPHN were 87 per 10,000. This is higher than the national rate of 81 per 10,000 and an increase on the 2014-15 rate (66 per 10,000). EXPECTED OUTCOME: Increased access to support and psychological therapies for people at risk of suicide 5.2 AIM: Provide one-on-one care coordination for people who have attempted suicide or experienced a suicidal crisis

15 DESCRIPTION: Continue to commission a Service which will provide one-on-one care coordination for people of all ages who have attempted suicide or experienced a suicidal crisis and have been discharged from an emergency department, acute setting or following admission to hospital CESPHN Needs assessment Dec 2017: Health Needs Analysis (p.10) • There is limited data available at the local level regarding suicide and self-harm however it has been identified as an issue within pockets of our population. In 2016 nationally, Intentional self-harm accounted for over one-third of deaths (35.4%) among people 15-24 years of age, and over a quarter of deaths (28.6%) among those 25-34 years of age. For those people 35-44 years of age, 16.0% of deaths were due to intentional self-harm Health Service Analysis (p.21) • Across CESPHN in 2015-16, intentional self-harm overnight hospitalisations were at a rate of 12 per 10,000, lower than the national rate of 17 per 10,000. Residents living in Botany SA3 had the highest rate of hospitalisations (20 per 10,000), followed by Marrickville – Sydenham- Petersham (15 per 10,000), Sydney Inner Sydney (17 per 10,000), Eastern Suburb South (15 per 10,000) and Leichhardt (15 per 10,000) SA3s.

• Bed days for Intentional Self Harm across CESPHN were 87 per 10,000. This is higher than the national rate of 81 per 10,000 and an increase on the 2014-15 rate (66 per 10,000). EXPECTED OUTCOMES: • A reduction in the incidence of suicide and suicide attempts after discharge in the northern sector of the CESPHN region. • Improved access to suicide prevention support through primary health care Target population cohort 5.1 People experiencing suicidal behaviour or assessed at risk of suicide or self-harm 5.2 People of all ages who have attempted suicide or experienced a suicidal crisis and have been discharged from the emergency departments, acute settings or following admission at St Vincent’s, Prince of Wales or Royal Prince Alfred hospitals

16 Consultation 5.1 Consultation occurred through co-design in 2016 and relevant stakeholders and ongoing 5.2 Consultation with CESPHN Mental Health and Suicide Prevention Advisory Group, and the Suicide Prevention Working group which includes people with lived experience of suicide and suicide bereavement Collaboration 5.1 Ongoing consultation and collaboration with previous ATAPS providers, NGO’s, Allied Health Providers, GP’s, consumers and carers. 5.2 Collaboration with CESPHN Mental Health and Suicide Prevention Advisory Group, and the Suicide Prevention Working group which includes people with lived experience of suicide and suicide bereavement, NGOs and LHDs Duration Activity duration: 1 July 2018 -30 June 2019 Key Milestones: Q1 July- Sept 2018: Monitoring and reporting Q2 Oct- Dec 2018: Monitoring and reporting Q3 Jan-March 2019: Monitoring and reporting Q4 April – June 2019: Monitoring, reporting and Evaluation Coverage 5.1 CESPHN region 5.2 Northern sector of the CESPHN region, covering the SA3 areas of Botany, Marrickville- Sydenham- Petersham, Eastern Suburbs-North, Eastern Suburbs-South and Inner Sydney. Commissioning method (if relevant) 5.1 Activity currently commissioned until June 2019 5.2 Activity currently commissioned until June 2019 Approach to market 5.1 Open tender

17 5.2 Open tender Decommissioning 5.1 N/A 5.2 N/A Performance Indicator Priority Area 5 - Mandatory performance indicator: • Number of people who are followed up by PHN-commissioned services following a recent suicide attempt. Local Performance Indicators: 5.1 Consumer reported experience of service 5.2 Proportion of Aboriginal and/or Torres Strait Islander clients remain engaged in the Service until planned transition/exit Is this a process, output or outcome indicator? 5.1 Outcome 5.2 Outcome Local Performance Indicator target (where possible) Performance Target: 5.1 80% of clients who complete the survey are reporting high level of satisfaction with care 5.2 65% of Aboriginal and/or Torres Strait Islander clients remain engaged in the Service until planned transition/exit Baseline: 5.1 Baseline will be determined by 30 June 2018. 5.2 Baseline to be established during activity period. Level of aggregation: 5.1 Age, gender, ethnicity and Aboriginal and/or Torres Strait Islander status 5.2 Age, gender and Aboriginal and/or Torres Strait Islander status

18 Local Performance Indicator Data source Data source: 5.1 CESPHN 5.2 Commissioned Providers National data set: 5.1 No 5.2 No Data collection commencement: 5.1 July 2018 5.2 July 2018 Priority Area 6: Aboriginal and Torres Strait Islander mental health services Proposed Activities - copy and complete the table as many times as necessary to report on each Priority Area Priority Area Priority Area 6: Aboriginal and Torres Strait Islander mental health services Activity(ies) / Reference (e.g. Activity 1.1, 1.2, etc) 6.1 Health and Wellbeing of Aboriginal Young People in the Inner City and Eastern Suburbs of Sydney 6.2 Aboriginal and Torres Strait Mental Health Services - Psychological Support Services (PSS) 6.3 Health and wellbeing of Aboriginal young people in the Inner West Suburbs of Sydney Existing, Modified, or New Activity 6.1 Existing 6.2 Existing 6.3 Existing Description of Activity 6.1 AIM: Increase access to culturally appropriate health and wellbeing support for Aboriginal and/or Torres Strait Islander young people

19 DESCRIPTION: To commission Aboriginal Community Controlled Organisations to engage Health and Wellbeing Coordinators to work with young people 12 - 25 years, in the community, to support health and wellbeing. CESPHN Needs assessment Dec 2017: Health Needs Analysis (p. 7,11) • CESPHN headspace Centres have lower rates of Aboriginal and/or Torres Strait Islander young people particularly in Camperdown and Hurstville. • The number of residents that identified as Aboriginal and/or Torres Strait Islander was 12,765 (1% CESPHN population). The distribution of this population group followed a similar trend as the total population with the highest number and proportion of Aboriginal and/or Torres Strait Islander residents living in Inner Sydney City (0.17%, n=2,489).

• In NSW, rates of high or very high psychological distress among Aboriginal people (2015) was reported at 21.7% compared with 11.6% of the non-Aboriginal population. Between 2011-15 the cause of death attributed to Mental and Behavioural disorders was 34.9 per 100,000 population. This is higher than the Non-Aboriginal Rate of 29.3 per 100,000 population Service Needs Analysis (p.22) • In 2015/16, across the CESPHN region, hospitalisations rates for Mental Disorders (5051.5 per 100,000 population; n=684) was higher than NSW (3179.9 per 100,000), and was the highest rate across NSW PHNs. Within the CESPHN region in 2015/16, both the Sydney LHD (6,038.8 per 100,000) and South Eastern Sydney LHD (4,215.6 per 100,000) had higher rates of hospitalisations for mental health disorders than NSW.

• Consultation with the CESPHN Mental Health and Suicide Prevention Advisory Committee found the following service gaps around access to service for Aboriginal and Torres Strait Islander people; a lack of Aboriginal and/or Torres Strait Islander staff and cultural competency, poor service alignment to where the community needs services resulting in lack of access to (competent) services, poor data collection and the need for further consideration of social and emotional well-being being greater than Mental Health. EXPECTED OUTCOME: Services address the health and wellbeing needs of the Aboriginal and/or Torres Strait Islander young people

20 6.2 AIM: Increase access for Aboriginal and/or Torres Strait Islander people to culturally appropriate Applied Psychological Therapies DESCRIPTION: To continue to commission and provide culturally appropriate psychological therapy services to Aboriginal and Torres Strait Islander people • Activity will be focussed on supporting and monitoring commissioned services and ensuring that activities are aligned to objectives of program and to meet key performance indicators. • Provisional referral pathways will be incorporated into the referral pathways available for PSS CESPHN Needs assessment Dec 2017: Health Needs Analysis (p. 11) • The number of residents that identified as Aboriginal and/or Torres Strait Islander was 12,765 (1% CESPHN population). The distribution of this population group followed a similar trend as the total population with the highest number and proportion of Aboriginal and/or Torres Strait Islander residents living in Inner Sydney City (0.17%, n=2,489).

• In NSW, rates of high or very high psychological distress among Aboriginal people (2015) was reported at 21.7% compared with 11.6% of the non-Aboriginal population. Between 2011-15 the cause of death attributed to Mental and Behavioural disorders was 34.9 per 100,000 population. This is higher than the Non-Aboriginal Rate of 29.3 per 100,000 population Service Needs Analysis (p 22) • During 2015/16, 220 clients accessing Psychological Support Services funded by CESPHN identified as being Aboriginal and/or Torres Strait Islander. 40.5% of Aboriginal and/or Torres Strait Islander clients are aged 12-24 years, 29.5% are aged 25-34 years, 12.5% are aged 35-44 and 12.5% are aged 45-54.

EXPECTED OUTCOMES: • Increased access to psychosocial therapies for Aboriginal and/or Torres Strait Islander people the CESPHN region • Services address the health and wellbeing needs of the Aboriginal communities

21 6.3 AIM: Increase access to headspace services for Aboriginal and/or Torres Strait Islander young people. DESCRIPTION: To continue to commission headspace Ashfield Lead Agency to recruit Aboriginal Outreach worker(s) to work to facilitate access to services for Aboriginal and Torres Strait Islander young people. CESPHN Needs assessment Dec 2017: Health Needs Analysis (p. 7,11) • CESPHN headspace Centres have lower rates of Aboriginal and/or Torres Strait Islander young people particularly in Camperdown and Hurstville.

• The number of residents that identified as Aboriginal and/or Torres Strait Islander was 12,765 (1% CESPHN population). The distribution of this population group followed a similar trend as the total population with the highest number and proportion of Aboriginal and/or Torres Strait Islander residents living in Inner Sydney City (0.17%, n=2,489). • In NSW, rates of high or very high psychological distress among Aboriginal people (2015) was reported at 21.7% compared with 11.6% of the non-Aboriginal population. Between 2011-15 the cause of death attributed to Mental and Behavioural disorders was 34.9 per 100,000 population. This is higher than the Non-Aboriginal Rate of 29.3 per 100,000 population Service Needs Analysis (p.22) • In 2015/16, across the CESPHN region, hospitalisations rates for Mental Disorders (5051.5 per 100,000 population; n=684) was higher than NSW (3179.9 per 100,000), and was the highest rate across NSW PHNs. Within the CESPHN region in 2015/16, both the Sydney LHD (6,038.8 per 100,000) and South Eastern Sydney LHD (4,215.6 per 100,000) had higher rates of hospitalisations for mental health disorders than NSW.

• Consultation with the CESPHN Mental Health and Suicide Prevention Advisory Committee found the following service gaps around access to service for Aboriginal and Torres Strait Islander people; a lack of Aboriginal and/or Torres Strait Islander staff and cultural competency, poor service alignment to where the community needs services resulting in lack

22 of access to (competent) services, poor data collection and the need for further consideration of social and emotional well-being being greater than Mental Health. EXPECTED OUTCOMES: • Increased access to services for Aboriginal and/or Torres Strait Islander young people • Services address the health and wellbeing needs of Aboriginal and/or Torres Strait Islander young people Target population cohort 6.1 Aboriginal and/or Torres Strait Islander young people within the underserviced area covered by La Perouse Local Aboriginal Land Council and the Metropolitan Local Aboriginal Land Council (Inner City). 6.2 Aboriginal and/or Torres Strait Islander young people in the CESPHN region 6.3 Aboriginal and/or Torres Strait Islander young people in the Inner West LGA Consultation 6.1 Consultations held 2016-2017 with stakeholders, community and Aboriginal Young People 6.2 Co design held 2016-2017 with stakeholders, community and Aboriginal Young People 6.3 Consultations held 2016-2017 with stakeholders, community, Aboriginal Young People and headspace Ashfield Collaboration 6.1 AMS Redfern, La Perouse Local Aboriginal Land Council, La Perouse Youth Haven, South Eastern Sydney LHD, Department of Education, WEAVE and headspace Bondi Junction around service approach. La Perouse Local Aboriginal Land Council, La Perouse Youth Haven, South Eastern Sydney LHD, Department of Education, Tribal Warrior 6.2 Provisional referrers. Culturally trained and proficient primary and allied health providers 6.3 New Horizons, headspace Ashfield, local Aboriginal elders and Aboriginal youth services and community groups, Inner West Council, Weave, Sydney LHD Duration Activity duration: 6.1 1 July 2018- 30 June 2019 6.2 1 July 2018 – 30 June 2019

23 6.3 Jan 2018 – 30 June 2019 Key Milestones: Q1 July- Sept 2018: Monitoring and reporting Q2 Oct- Dec 2018: Monitoring and reporting Q3 Jan-March 2019: Monitoring and reporting Q4 April – June 2019: Monitoring, reporting and Evaluation Coverage 6.1 Area covered by La Perouse Local Aboriginal Land Council and the Metropolitan Local Aboriginal Land Council (Inner City). 6.2 Whole CESPHN region 6.3 Inner West LGA Commissioning method (if relevant) All activities commissioned till 30 June 2019 Approach to market 6.1 Direct engagement 6.2 Open tender 6.3 Direct engagement Decommissioning N/A Performance Indicator Mandatory performance indicator: • Proportion of Indigenous population receiving PHN-commissioned mental health services where the services were culturally appropriate.

Local Performance Indicator:

24 6.1 Appropriateness – Proportion of young people identifying as Aboriginal and/or Torres Strait Islander within the area accessing the program 6.2 Access – Number of people identifying as Aboriginal and/or Torres Strait Islander 6.3 Access - Number of Aboriginal and/or Torres Strait Islander young people accessing headspace Ashfield Is this a process, output or outcome indicator? Output Local Performance Indicator target (where possible) Performance Target: 6.1 15% of young people identifying as Aboriginal and/or Torres Strait Islanders who live in the area are accessing the service 6.2 150 people accessing PSS identify as Aboriginal and/or Torres Strait Islander 6.3 Number of Aboriginal and/or Torres Strait Islander young people accessing headspace Ashfield is increased by 20% Baseline: 6.1 Baseline to be established after 12 months of implementation. 6.2 128 people who accessed PSS services identified as Aboriginal and/or Torres Strait Islander in 2016 - 17 6.3 27 young Aboriginal and/or Torres Strait Islander people accessed headspace Ashfield in 2016-2017 Level of aggregation: Age, gender, Aboriginal and/or Torres Strait Islanders Local Performance Indicator Data source Data source: 6.1 Commissioned provider 6.2 PMHC – MDS 6.3 headspace MDS (hapi)

25 National data set: 6.1 No 6.2 Yes - PMHC – MDS 6.3 Yes - headspace MDS Data collection commencement: 1 July 2018 for all activities Priority Area 7: Stepped care approach Proposed Activities - copy and complete the table as many times as necessary to report on each Priority Area Priority Area Priority Area 7: Stepped care approach Activity(ies) / Reference (e.g. Activity 1.1, 1.2, etc) 7.1 Stepped care promotion 7.2 Workforce Development Existing, Modified, or New Activity 7.1 Modified and incorporates 2017-2018 activities 7.2 and 7.3 7.2 Existing and modified from 2017-2018 Activity 7.5 Description of Activity 7.1 AIM: Promote a stepped care approach within the CESPHN region DESCRIPTION: This activity builds on the established mental health reform. Primary mental health care service delivery is moving towards a stepped care approach as part of the reforms implemented by the Commonwealth Department of Health. This approach will support people to access services based on their needs, at the right time. The activity will: • Promote a stepped care approach, including HealthPathways, to service providers (actual and prospective) in CESPHN Region

26 • Incorporate and monitor the implementation of a stepped care approach as part of commissioning mental health models of service. CESPHN Needs assessment Dec 2017: Service needs analysis (p26) Over the past 12 months (October 2016 - September 2017) Non-urgent Mental Health Assessment and advice had the third highest unique page views of all referral pathways (n=251). During the same time period the Psychological Support Services (PSS) pathway had the 11th highest unique page views (n=194). EXPECTED OUTCOMES: • Clear and accessible pathways to care for people with mental health concerns at all levels of intensity/acuity • Referrers and service providers will understand how to navigate, refer to and provide services using a stepped care approach 7.2 AIM: Increase the capacity of service providers to provide services that meet the needs of the community.

DESCRIPTION: • Promote and/or provide access to training for the primary care workforce to enhance competence in cultural appropriateness, trauma informed practice, suicide prevention, stepped care and other areas of practice as identified • Promote engagement of bi-lingual service providers across all priority areas. CESPHN Needs assessment Dec 2017: Service Needs analysis (p. 24)

27 • The CESPHN database of health professionals identifies that 11% of psychologists in the region speak a language other than English. The top languages include Cantonese, Greek, Spanish and Mandarin. However, this workforce is not located in areas of highest need with the LGAs of Bayside, Woollahra and Georges River having the lowest access. EXPECTED OUTCOME: CESPHN region has a skilled workforce to provide services to meet the needs of communities. Target population cohort Mental health service providers in CESPHN region Consultation GPs, CMOs, service providers, LHDs, SHNs Collaboration GPs, CMOs, service providers, LHDs, SHNs Duration 2018-2019 Coverage CESPHN region Commissioning method (if relevant) Operational function Approach to market N/A Decommissioning N/A Performance Indicator Priority Area 7 - Mandatory performance indicator: • Proportion of PHN flexible mental health funding allocated to low intensity services, psychological therapies and for clinical care coordination for those with severe and complex mental illness.

Local Performance Indicator: N/A Is this a process, output or outcome indicator? N/A Local Performance Indicator target (where possible) N/A

28 Local Performance Indicator Data source N/A Priority Area 8: Regional mental health and suicide prevention plan Proposed Activities - copy and complete the table as many times as necessary to report on each Priority Area Priority Area Priority Area 8: Regional mental health and suicide prevention plan Activity(ies) / Reference (e.g. Activity 1.1, 1.2, etc) 8.1 Develop a regional mental health and suicide prevention plan Existing, Modified, or New Activity 8.1 Existing activity Description of Activity AIM: Develop an evidence based Regional Mental Health and Suicide Prevention Plan, in collaboration with LHDs, and other stakeholders.

DESCRIPTION: The Regional plan will support the integrated delivery of mental health and suicide prevention services within the community by identifying needs and gaps, and aiming to reduce duplication, remove inefficiencies, and encouraging innovation. EXPECTED OUTCOME An evidence based Regional Mental Health and Suicide Prevention Plan which can be used to support the integrated delivery of mental health and suicide prevention services. Target population cohort CESPHN Region Consultation CESPHN has engaged a Mental Health and Suicide Prevention Advisory Committee including LHDs, SHNs, Community Stakeholders and Consumers. This committee will steer the development of the plan. Consultations will be held with state based services, community managed organisations and consumers.

This plan will be developed with further guidance from DoH and in line with the Fifth National Mental Health and Suicide Prevention Plan

29 Collaboration Mental Health and Suicide Prevention Advisory Committee, LHD Health Planners, LHD Mental Health Services, NGOs, consumers and carers and relevant peak bodies Duration Key Milestones: Phase 1 - Agree parameters – March 2018 Phase 2 – Data, consultation, priorities, needs, embed integration, measures of success – December 2018 Phase 3 – Develop plan for review – April 2019 Phase 4 – Seeking agreement to the plan - June 2019 Coverage Whole CESPHN region Commissioning method (if relevant) A consultant will be engaged to support the development of a regional plan Approach to market Closed tender Decommissioning N/A Performance Indicator Priority Area 8 - Mandatory performance indicators: • Evidence of formalised partnerships with other regional service providers to support integrated regional planning and service delivery.

Local Performance Indicator: N/A Is this a process, output or outcome indicator? N/A

30 1. (b) Planned activities funded under the Primary Mental Health Care Schedule – Template 2 Use this template table for Priority Areas 3 and 4 Priority Area 3: Psychological therapies for rural and remote, under-serviced and / or hard to reach groups Proposed Activities - copy and complete the table as many times as necessary to report on each Priority Area Priority Area Priority Area 3: Psychological therapies for rural and remote, under-serviced and / or hard to reach groups Activity(ies) / Reference (e.g. Activity 1.1, 1.2, etc) 3.1 Commission Psychological Support Services 3.2 Provide a central intake service for mental health services commissioned by the PHN, in particular PSS, to ensure a stepped care approach Existing, Modified, or New Activity 3.1 Existing 3.2 Existing Description of Activity 3.1 AIM: Increase access to a range of applied psychological therapies for people from under serviced or hard to reach populations DESCRIPTION: • Continue to commission and provide access to a range of applied psychological therapies for people from underserviced and or hard to reach populations.

• Activity will be focussed on supporting and monitoring commissioned services and ensuring that activities are aligned to objectives of program and to meet key performance indicators. • Provisional referral pathways will be incorporated into the referral pathways available for PSS CESPHN Needs assessment Dec 2017: Health Needs Analysis (p 7-8) • In the last 12 months the former ATAPS program has undergone a redesign process to have resources better placed to meet community needs, particularly for hard to reach populations. The new target groups for the program are; Children, Young people, Women Experiencing perinatal depression, Culturally and Linguistically Diverse (CALD) Communities, People who

31 have attempted or are at risk of suicide or self-harm, those who Identify as Aboriginal and/or Torres Strait Islander and adults living in the LGAs of Bayside, Georges River, the Canterbury portion of Canterbury-Bankstown and Strathfield. • Women experiencing prenatal or postnatal depression In 2012, the Australian Institute of Health and Welfare released a report identifying several indicators associated with prevalence of perinatal depression including; being aged under 25, being a smoker, born in Australia, living in a household where English is the main language, living in an area of disadvantage and being overweight or obese. Within the CESPHN region, Botany SA3 has high rates in four of the six indicators, and Sutherland – Menai – Heathcote, and Cronulla-Miranda-Caringbah SA3s have high rates within the CESPHN region for three of the six indicators putting women in these areas at higher risk. • Culturally and Linguistically Diverse (CALD) Communities • There is significant cultural diversity across the CESPHN region, including diversity in language spoken and country of birth. Within cultural groups, variation exists amplifying diversity across the cultural groups. It is acknowledged that variation between individual cultural groups exists, creating an additional level of heterogeneity. Language, recognition of overseas qualifications, limited support networks, and confidence in authorities’ impact level of engagement, understanding and confidence in the health care sector.

• The highest rates of CALD populations were comparable to the total population with Sydney Inner City (n=162,619) and Kogarah-Rockdale (n= 162,619) having the highest number and proportion of CALD residents at rate of 10.88%, followed by Canterbury (n=98,178) at 6.57% of the total CESPHN population. Service Needs Analysis (pp 16-17) • Consultation with the child and maternal health team identified the following service gaps around access to Perinatal Mental health services; the only Mother /baby Unit in the region is a private hospital (St John of God Burwood), there are long waiting lists for ECSW and Tresillian. There is limited promotion /awareness of PND resources for women and limited/no bulk billing psychiatrists

32 • Consultation with the CESPHN Mental Health and Suicide Prevention Advisory Committee found the following service gaps for the LGBTI community; Lack of welcoming environments, lack of services for social and emotional wellbeing of this client group, lack of inclusive mainstream services and a lack of intersection between; Homelessness, Ageing populations, CALD, Aboriginal and/or Torres Strait Islander and Alcohol and other Drugs EXPECTED OUTCOME: Increased access to psychosocial therapies for underserviced or hard to reach populations in the CESPHN region 3.2 AIM: Provide a central intake service to ensure people with mental illness are receiving the right service DESCRIPTION: Continue to provide a central intake service for mental health services commissioned by the PHN, in particular PSS, to ensure a stepped care approach CESPHN Needs assessment Dec 2017: Service Needs Analysis (p26) • Over the past 12 months (October 2016 - September 2017) Non-urgent Mental Health Assessment and advice had the third highest unique page views of all referral pathways (n=251). During the same time period the Psychological Support Services (PSS) pathway had the 11th highest unique page views (n=194). EXPECTED OUTCOMES: • Referrals to Central Intake are triaged and allocated to the appropriate commissioned services. • Ensure stepped care approach via matching client need and service is provided Target population cohort 3.1 CALD, Underserviced LGA’s (Bayside, Canterbury City (former LGA), Georges River and Strathfield), Women experiencing Perinatal Depression

33 3.2 Clients of identified commissioned services including - children, young people, adults, CALD, Aboriginal and/or Torres Strait Islander people across the CESPHN region Consultation 3.1 Consultation occurred through co-design in 2016 and relevant stakeholders and ongoing 3.2 Consultation occurred through co-design in 2016 and relevant stakeholders and ongoing Collaboration 3.1 Collaboration with Consumers, Carers, and service providers in the design of the service model. Collaboration with CMOs, Primary Care providers to implement and deliver psychological support services.

3.2 Collaboration with Consumers, Carers, and service providers in the design of the service model. Collaboration with CMOs, Primary Care providers to implement and deliver psychological support services. Duration Activity duration: 1 July 2018 -30 June 2019 Key Milestones: 3.1: Q1 July- Sept 2018: Monitoring and reporting Q2 Oct- Dec 2018: Monitoring and reporting Q3 Jan-March 2019: Monitoring and reporting Q4 April – June 2019: Monitoring, reporting and Evaluation 3.2 Ongoing Coverage 3.1 Whole CESPHN region 3.2 Whole CESPHN region Continuity of care 3.1 CESPHN Client Information Management system enables for the monitoring of the client journey 3.2 CESPHN Client Information Management system enables for the monitoring of the client journey

34 Commissioning method (if relevant) 3.1 Services commissioned in January 2017 3.2 N/A Approach to market 3.1 Open tender 3.2 N/A Decommissioning 3.1 N/A 3.2 N/A Performance Indicator Priority Area 3 - mandatory performance indicators: • Proportion of regional population receiving PHN-commissioned mental health services – Psychological therapies delivered by mental health professionals. • Average cost per PHN-commissioned mental health service – Psychological therapies delivered by mental health professionals.

• Clinical outcomes for people receiving PHN-commissioned Psychological therapies delivered by mental health professionals. Local Performance Indicator: 3.1 Effectiveness – Consumer reported experiences of service 3.2 N/A Is this a process, output or outcome indicator? Outcome Local Performance Indicator target (where possible) Performance Target: 80% of client who complete a satisfaction survey report high levels of satisfaction Baseline: To be determined June 2018 Level of disaggregation:

35 Age, Gender, identified underserviced groups and Aboriginal and/or Torres Strait Islander. Local Performance Indicator Data source Data source: Experience of service survey National data set: No Data collection commencement: July 2018

36 Priority Area 4: Mental health services for people with severe and complex mental illness including care packages Proposed Activities Priority Area Priority Area 4: Mental health services for people with severe and complex mental illness including care packages Activity(ies) / Reference (e.g. Activity 1.1, 1.2, etc) 4.1 Commission services to address the needs of people who experience severe and complex mental illness in primary care 4.2 GP access to psychiatry support in them management of people experiencing severe mental illness Existing, Modified, or New Activity 4.1 Modified 4.2 Modified from previous 4.3 Description of Activity 4.1 AIM: Increase access to clinical mental health services and links to psychosocial supports for people experiencing severe and complex mental illness in the primary care setting. DESCRIPTION To continue to commission and provide access to clinical mental health services and links to psychosocial supports for people experiencing severe and complex mental illness in the primary care setting.

NEEDS ASSESMENT 2017: Health Needs analysis (p. 5,9) • For the CESPHN population, it is estimated that 46,372 people have a lived experience of severe mental illness. • The life expectancy for people experiencing severe mental illness is reduced by 15 to 20 years – largely due to cardiovascular disease and cancer rather than suicide – and the gap is widening.

37 • An estimated 3.5% of the Australian population will have a severe mental illness or substance use disorder; 2.2% of individuals aged 0-14 years, 3.4% of individuals aged 15-24 years, 4.1% of individuals aged 25-64 years and 2.9% of individuals aged 65 years + Services Needs Analysis (pp 18-19, 23) • A review of the service provision and a co-design process found that the funding model, access and equity across the region were constraints of the Mental Health Nurse Incentive Program (MHNIP).

• At 30 June 2017, 14 Mental Health Nurses (MHN) were working across 14 provider organisations with 7.0 FTE across all provider organisations. Referrals of clients into the program could only be made by health professionals attached to the provider organisation and provider organisations were not necessarily servicing clients in the geographic areas of most need. MHNs were found to have been taken away from their clinical and care coordination roles to support their clients in other ways, particularly around psycho-social needs. • The life expectancy for people experiencing severe mental illness is reduced by 15 to 20 years – largely due to cardiovascular disease and cancer rather than suicide – and the gap is widening. Despite improvements in physical health and longevity in the general population through better lifestyle and medical advances, people with severe mental illness have not shared in these benefits. They often experience economic and social marginalisation, including from health care professionals and systems, in addition to severe metabolic consequences from antipsychotic medication.

EXPECTED OUTCOME • Increase in primary health care service provision to people experiencing severe and complex mental illness 4.2 AIM: Support GPs to access psychiatry support in them management of people experiencing severe mental illness DESCRIPTION:

38 Explore and commission a psychiatry support line for GP to assist in the management of people experiencing severe mental illness NEEDS ASSESMENT 2017: Health Needs analysis (p. 5,9) For the CESPHN population, it is estimated that 46,372 people have a lived experience of severe mental illness. • An estimated 3.5% of the Australian population will have a severe mental illness or substance use disorder; 2.2% of individuals aged 0-14 years, 3.4% of individuals aged 15-24 years, 4.1% of individuals aged 25-64 years and 2.9% of individuals aged 65 years + Services Needs Analysis (pp 18-19, 23) • There has been an increase in the number of psychiatrists including a person other than the patient during initial diagnosis of a patient and continuing management of a patient within our region, however uptake is still low. There is also low uptake of home visits by psychiatrists and low availability of psychiatrists willing to bulk bill patients. Low uptake of use of psychiatrists to conduct an assessment and management plan and/or review on behalf of GPs. • Health Workforce Australia data shows that in 2015 there were 330 Psychiatrists working in a clinical role in the CESPHN region, however the availability of access to bulk billing Psychiatrists across the region is still being identified.

EXPECTED OUTCOME: Increase in access to and support from psychiatrists for GPs which enables better support for people experiencing severe and complex mental illness in the primary care setting. Target population cohort 4.1 People experiencing severe and complex mental illness. 4.2 GPs supporting people experiencing severe and complex mental illness. Consultation 4.1 Consumers, Carers, GPs, Allied Health Professionals, ACMHN, LHD’s, SHN/s, CMO’s, Peaks, research /academic institute and other mental health professionals.

39 4.2 GPs, other NSW PHN’s Collaboration 4.1 Consumers, carers, GP’s, Allied Health Professionals, ACMHN, LHD’s, SHN’s, CMO’s, peak bodies 4.2 Other NSW PHN’s Duration Activity duration: 1 July 2018 -30 June 2019 Key Milestones: 4.1 Q1 July- Sept 2018: Monitoring and reporting Q2 Oct- Dec 2018: Monitoring and reporting Q3 Jan-March 2019: Monitoring and reporting Q4 April – June 2019: Monitoring, reporting and Evaluation 4.2 Q1 July- Sept 2018: Establishment Q2 Oct- Dec 2018: Monitoring and reporting Q3 Jan-March 2019: Monitoring and reporting Q4 April – June 2019: Monitoring, reporting and Evaluation Coverage Whole CESPHN region Continuity of care 4.1 Clients of the former MHNiP program were transitioned to the new provider organisation along with the mental health nurses. This was monitored via CESPHN’s client management system. 4.2 N/A Commissioning method (if relevant) 4.1 Activity currently commissioned until June 30, 2019 4.2 This activity will be co commissioned with other NSW PNHs Approach to market 4.1 Open tender

40 4.2 Open tender Decommissioning decommissioning potential implications: 4.1 Successfully transitioned clients and nurses from MHNIP Oct 2017 4.2 N/A Provider service is transitioned to: 4.1 One Door Mental Health 4.2 N/A Strategies to manage transition and continuity of care for patients or clients: 4.1 Client Information management system to monitor client journey 4.2 N/A Performance Indicator Priority Area 4 - mandatory performance indicators: • Proportion of regional population receiving PHN-commissioned mental health services – Clinical care coordination for people with severe and complex mental illness (including clinical care coordination by mental health nurses).

• Average cost per PHN-commissioned mental health service – Clinical care coordination for people with severe and complex mental illness. Local Performance Indicator: 4.1 Effectiveness – Consumer reported experiences of service Is this a process, output or outcome indicator? 4.1 Outcome Local Performance Indicator target (where possible) Performance Target: 4.1 70% of client who complete a satisfaction survey report high levels of satisfaction Baseline: 4.1 To be determined June 2018

41 Level of disaggregation: 4.1 Gender, age, ethnicity, Indigenous status Local Performance Indicator Data source Data source: 4.1 Experience of care survey National data set: No Data collection commencement: July 2018

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