Mental Health Shared Care Model for metropolitan Adelaide

The project• The project aimed to develop one integrated model of GP –

mental health services shared care for mental health consumers.

• A steering group consisting of Consumers, carers, representatives from Divisions of General Practice, GPs, mental health services including mental health services for older persons, developed a series of agreed principles and goals for the a shared care model.

• Parallel projects about shared medical records, communication and Integrated IT systems that could follow the consumer into an acute setting and back out again were also developed.

• I am not aware that this model was implemented in its entirety due to a restructure and refocus of the mental health service. Nonetheless, I hope these documents may be of use to someone. This project also formed the basis of my Masters of Public Health thesis (also available on slideshare).

Core PrinciplesThese core principles for GP and Mental Health Services Shared Care recognise the unique physical,

social, psychological, emotional, cultural and spiritual dimensions of consumers’ lives and their right to choose services for their mental health care.[1]

• Mental Health Policy and service structure reflect a collaborative approach in working with individuals and their families.

• Mental Health Shared Care aims to promote a culture of collaboration, cooperation, mutual respect, trust and support between consumers, their families and all service providers (GPs, private practitioners, Non Government Organisations, local governments and other community based health care service providers), which recognises the importance of the contributions of all participants.[2]

• Services are supportive of the consumer’s individual recovery pathway. The recovery pathway is owned and determined by the consumer within the context of Shared Care collaboration. [3]

• A primary health care model of mental health service delivery will facilitate continuity of care between the public mental health system and the primary health care providers and integrate primary health care principles: Promotion, Prevention, Early Intervention (PPEI), social justice and equity. [4]

• Acknowledgement that the principle and the philosophy of recovery aims to align Mental Health Services with other specialist areas of medicine. In essence the GP is pivotal to the total health and wellbeing (mental health and physical co morbidities, drug & alcohol), requesting support and/or input from specialist services including mental health on an as-needs basis.

• Agreement and utilisation of communication protocols which include an understanding of each participant’s roles and responsibilities.

• Facilitating continuity of care and acknowledging the importance of reciprocity between the primary health care providers and the public mental health service so that optimal quality of care can be provided.

• Mental health services are provided in a convenient and local manner and linked to the consumer’s nominated primary health care provider.[5]

• Mental Health Shared Care models will reflect best practice and incorporate continuous quality improvement.

[1] National Mental Health Plan 2003-2008, July 2003, Key Direction 19.4, 19.5[2] National Mental Health Plan 2003-2008, July 2003, Key Direction 11.1, 11.2, 19.4, 19.5[3] for more information http://www.auseinet.com/journal/vol4iss3/glovereditorial.pdf [4] Second National Mental Health Plan, July 1998, p12; Primary Health Care Policy 2003-2007, SA Dept of Health[5] National Standards for Mental Health Services 1996, Standard 11.1.3

GoalsThese goals for GP and Mental Health Services Shared Care recognise the unique physical, social,

psychological, emotional, cultural and spiritual dimensions of consumers’ lives and their right to choose services for their mental health care.[1]

• To facilitate better holistic health outcomes for consumers • To integrate Shared Care systems and processes into service planning and development.• To improve working relationships and communication between service providers through the development

of a Shared Care culture• To improve communications and minimise gaps and barriers to service provision.• To facilitate continuity of care between the public mental health service and primary health care providers

so optimal quality of care can be provided. [2]• To minimise duplications in service through more effective use of resources.• To facilitate consistency of Shared Care care-planning across metropolitan Adelaide. • To provide a consistent approach to an individual consumer’s overall care through collaborative decision

making and care planning between services.• To reduce demand on ED, acute services, and emergency services through improved communication,

relationships, early intervention and coordinated care delivery between mental health services, consumers and their primary health care providers.

• To support the practice and working lives of GPs and Mental Health Service staff through a focus on improved communication, prevention and early intervention, reducing the need for crisis response. [3]

• To facilitate easy access to services for consumers and care providers.• To benefit all clinical partners through collaboration, observational learning, skill development and

understanding of roles and strengths of various clinical providers.[4]

[1] National Mental Health Plan 2003-2008, July 2003, Key Direction 19.4, 19.5[2] National Practice Standards for the Mental Health Workforce, Sept 2002, Standard 8, Integration and partnership[3] National Mental Health Plan 2003-2008, Key Direction 33.1, 33.3[4] National Mental Health Plan 2003-2008, Outcome 32, Key Direction 32.1