The Integrated Mental Health Atlas of the Central and Eastern Sydney PHN

Abstract

The 2014 National Review of Mental Health Programmes and Services by the National Mental Health Commission drew attention to the need of local planning of care for people with a lived experience of mental illness in Australia and the relevance of a bottom-up approach to understanding “services available locally [in] the development of national policy”. It also called for responsiveness to the diverse local needs of different communities across Australia (1).

The findings from the National Review were in line with the recommendations presented by the New South Wales (NSW) Mental Health Commission in the report Living Well: A Strategic Plan for Mental Health in NSW 2014-2024. Living Well (2) identified that Local Health Districts (LHD) and primary care organisations such as Medicare Locals and their replacement Primary Health Networks (PHN) should implement strategies to ensure that scarce clinical skills are employed to the best effect and the need to harness new technology to support clinicians and service providers with new tools to improve care, data collection and information sharing.

The Integrated Mental Health Atlas of Central and Eastern Sydney PHN (CESPHN) aligns with these recommendations. The Atlas is the region’s first inventory of available services specifically targeted for people with a lived experience of mental illness, from which it will be possible to derive benchmarks and comparisons with other regions of NSW. This will inform services planning and the allocation of resources where they are most needed. It is a tool for evidence-informed planning that critically analyses the pattern of mental health care provided within the boundaries of the CESPHN. We used a standard classification system, the "Description and Evaluation of Services and Directories in Europe for long-term care" model (DESDE-LTC), to describe and classify the services; as well as geographical information systems to geo-locate the services.

Utilisation of the DESDE-LTC tool, a system widely used in Europe, has enabled a more robust understanding of what services actually provide and will enable planners to make comparisons across areas and regions, once this methodology is more widely available.

The Atlas revealed major differences in the provision of mental health care in the CESPHN, when compared to other regions and countries. These are:

1) the good availability of inpatient acute care and outpatient care, 2) a lack of acute and sub-acute community residential care as alternatives to hospital care; 3) a comparative lack of services providing acute day care and non-acute day care (i.e. day centres providing structured activities to promote health and social inclusion); 4) lower availability of specific employment and housing services for people with a lived experience of mental illness; 5) lower availability of supported accommodation initiatives.

Taken together the information in this Atlas highlights key areas for consideration for future planning for the provision of mental health services in the CESPHN. The findings reflect some Framework Integrated Mental Health Atlas of Central and Eastern Sydney PHN of the recommendations in the recent report of the National Review of Mental Health Programmes and Services made by the National Mental Health Commission.