Better Access to Mental Health Support Project (BAMHS)

In a post COVID-19 pandemic world, there has been an increase in the prevalence of mental health and substance use conditions, currently representing the second most prevalent disease category in Australia.¹ From 2020 to 2021, 45% of people accessing public mental health services in New South Wales were registered as ‘new consumers’.² The South Eastern Sydney Local Health District (SESLHD) population is projected to reach 1,000,000 people by 2033. Without change, there will be an increase in emergency department (ED) presentations and hospital admissions by 24–25%.^3,4

In 2021, the SESLHD Mental Health Service invested in the development of the purpose-built Mental Health Virtual Care Centre (MH VCC) delivering two district-wide services, the Virtual Short-term Assessmenta and Support Service, and the Blended Adult Rehabilitation Program. In the two years following its official launch, the MH VCC has received valuable feedback showing that an increasing number of individuals are experiencing barriers to accessing mental health support within their community.

Removing barriers to mental health care

To address the rise in demand for public mental health services and the projected population growth in SESLHD, the MH VCC initiated the Better Access to Mental Health Support Clinical Redesign (BAMHS) Project. This project, led by MH VCC, aims to address the barriers to accessing community mental health support following an admission to a mental health inpatient unit (MH IPU) within SESLHD.  By using the services delivered at the MH VCC, the project strives to facilitate seamless transitions from SESLHD mental health services to the primary health and non-government sector.

Through this initiative, the team has engaged in collaborative co-design processes to develop solutions aimed at enhancing service frameworks that expands the scope of the MH VCC, standardising referral pathways and conducting comprehensive data analysis activities. Benefits include enhanced consumer lead experiences, empowering decision-making, improved continuity of care, and transparent referral processes offered on time. These improvements align with broader health goals, fostering consumer trust, satisfaction, and sustainable health care systems.

Addressing demand through co-design

The project team conducted a comprehensive diagnostic analysis across the district to find barriers to accessing community mental health support post-discharge from a MH IPU. The team employed a multi-faceted approach, including surveys of 54 staff members, audits of 28-day readmissions and interviews with two consumers and four staff, complemented by high-level process mapping. Through these activities, the following key issues emerged:

• there is a lack of prompt support available for consumers who are discharged from a MH IPU
• the rigidity of service’s referral criteria is affecting consumers getting support
• it is difficult to navigate referrals to community mental health services because of inconsistent referral processes.

Following this, the project team held solution design workshops, engaging 17 staff and three consumers, leading to the proposal of 33 potential solutions. From these, three in-scope solutions appeared:

• enhance the current service frameworks at the MH VCC to broaden access
• transition the MH VCC referral process from email to an eReferral order in the eMR
• implement a data analysis initiative to gain insights into the consumers journey for people who return to ambulatory services within 28 days of discharge from a MH IPU.

The project began implementation in February 2023. Evaluation results will be available by December 2024.

View this project's poster from the Centre for Healthcare Redesign graduation May 2024.

References