Riding the tides: Directions in mental health rehabilitation in NSW.

OBJECTIVE: This paper outlines the evolution of mental health rehabilitation in NSW, where allocation of health resources has repeatedly contradicted the policy intention to reorient services from inpatient to community-based services, leaving community rehabilitation the poor and disconnected cousin of inpatient services. The expanding role of community-managed organisations (CMOs) in psychosocial rehabilitation, the introduction of the National Disability Insurance Scheme (NDIS), and emerging service models have helped foster a maturing housing and social care environment, but present reality and the integration of health and social care services remains at a distance from best evidence practice. CONCLUSION: The challenge of the next decade of mental health reform is to embrace and consolidate greater service diversity and complexity. Understanding what factors influenced present reality is important in providing guardrails for the future, enabling the current wave of renewal and reinvestment in NSW to build on the strengths of past developments and steer a course around their weaknesses.

What about value for money? A cost benefit analysis of the South Eastern Sydney Recovery and Wellbeing College.

BACKGROUND: Recovery Colleges assist people in their personal recovery journeys by offering an approach that transforms conventional mental health care by using an educational framework. While evaluations of these colleges have demonstrated effectiveness in promoting personal recovery, scant research has been published regarding their economic evaluation. AIMS: To conduct a cost-benefit analysis of the South Eastern Sydney Recovery and Wellbeing College in Australia by exploring health utilisation and direct costs. METHOD: The overall costs of the Recovery College sample (reported from 2014 to 2017) were used to derive a per person, per year cost, adjusted for inflation to 2020 Australian dollars. Benefits were determined by analysing pre/post health service utilisation by service users, and subsequently calculating a net cost saving. RESULTS: There was a statistically significant reduction in Emergency Department and inpatient mental health utilisation following participation in the Recovery College. The net cost savings was A$269 per student per year. CONCLUSIONS: This study indicates that the Recovery College can play an important role in decreasing mental health service and ED utilisation. This reflects reduced reliance on traditional mental health services, thus suggesting that students develop improved self-agency and ability to manage their own mental health.

The impact of Vocational, Education, Training and Employment Coordinator positions on attitudes and practices in a NSW mental health service.

OBJECTIVE: To determine attitudes and practices of community mental health clinicians in relation to employment and education for consumers and to assess the impact of the establishment of Vocational, Education, Training and Employment (VETE) Coordinator positions. METHOD: A snapshot was conducted by surveying community mental health clinicians regarding every consumer on their caseload in 2007. This was repeated in 2010 and the results were compared. RESULTS: From 2007 to 2010, the overall rates of VETE interventions increased, including a doubling of the rate of linkage to employment agencies for job seekers. Services with the consistent presence of a VETE Coordinator showed a greater impact on a number of factors, highlighted by a positive shift in clinician attitudes regarding their consumers' capacity to work. CONCLUSION: The establishment of VETE Coordination positions in the mental health service appears to be an effective way of raising awareness of VETE issues and improving VETE service provision. An important role has been assisting clinicians to begin implementing the principles of the Individual Placement and Support model of Supported Employment and to incorporate support for employment and education as a routine part of practice.

The role of recovery colleges in supporting personal goal achievement.

OBJECTIVE: This study examined the types of goals set, the degree to which goals were achieved, and the factors influencing goal attainment for participants in a Recovery College, a recovery-based mental health education program that uses peer learning advisors to facilitate individual student learning plans. METHOD: Students of the Recovery College set baseline goals that were rated in terms of importance and difficulty in line with the Goal Attainment Scale (GAS) framework and reviewed at follow-up points. Goals were reviewed to determine areas of priority and an analysis of goal attainment was conducted using multinomial logit regression analysis. RESULTS: Sixty-four students recorded their goals. The most common goal areas identified related to education, socialization, physical health, mental health, and employment. Seventy percent of goals were fully or partially achieved with goals rated as having a lower difficulty more likely to be achieved. CONCLUSION AND IMPLICATIONS FOR PRACTICE: Recovery College is a program model that can effectively support personal goal achievement, a recommended indicator of personal recovery and program success. The GAS proved to be a useful instrument for measuring goal setting and attainment in students' recovery journeys and peer learning advisors were effective in facilitating this process. The setting and achievement of physical health goals is of clinical significance. (PsycINFO Database Record (c) 2019 APA, all rights reserved).