Improving the ‘network planning and management’ of integrated primary mental health care for older people in rural regions

Aims

To validate and test the effectiveness of a 'Model for Integration' in a Medicare Local and Local Health Network to support the 'network planning and management' of integrated primary mental health care for older people in a rural region.

Synopsis

There is significant unmet need for mental health care for people aged over 65, with serious consequences for their mental and physical health. Older people in rural communities are particularly disadvantaged in terms of availability and access to mental health care services. Linkages and collaboration between mental health, generalist primary health, specialist medical and other human services has been advocated in Australian national policies relating to mental health care.

Medicare Locals have been established to coordinate the delivery of primary health care and address local health care needs and service gaps. The aim of this project is to validate and test a model for Medicare Locals to plan and manage the development of integrated primary mental health care for older people, using a participatory Plan, Do, Study, Act cycle. One rural region in South Australia will be used as a case study to examine the interaction between mental health services, primary health care, aged care and other community services as they seek to meet the mental health care needs of older people. An evidence-based theoretical model for managing integrated primary mental health care services has been developed that consists of two parts:

1. Model components - the linkage strategies and management enablers that lead to effective outcomes for integrated primary mental health care, derived from a systematic review of literature

2. Model process - the participatory process for exploring and developing a service system as a network Participatory Service Network Analysis (SNA). This theoretical Model will be face validated and further developed through a key stakeholder workshop.

SNA will be undertaken to assess:

  • the extent and effectiveness of the linkages in primary mental health care in the region
  • organisational readiness and capacity for change as assessed against the model
  • how the network can be improved.

Information about the structure and function of links between services, and barriers and enablers to effective linkages, will be collected from organisational key informants, consumers and their carers, and policy documents. Organisational links and overall network density will be analysed using SNA, and Framework Analysis will be used to analyse qualitative data. A Governance Group will meet to examine the data against the theoretical Model components, and develop priorities for action for improved integration in regional mental health services for older people. The Model process will be evaluated for its applicability in a Medicare Local through the analysis of the Governance Group meetings and interviews with key stakeholders.

The main outcome will be a tested network planning model for a Medicare Local to engage sub-acute and primary health care services in a rural region to improve service coordination develop agreed protocols, strengthen partnerships and establish network commitment for older persons‟ mental health care.

Partnerships

Chief investigator: Professor Jeffrey Fuller