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SMHSOP - Severe and persistently challenging behaviours model

What it is

An integrated specialist assessment model which provides specialist, multidisciplinary mental health (and aged care) assessment and some case management for older people with complex and severe behavioural and psychological symptoms in community and inpatient settings. This model includes a number of elements, with the key community-based service element being Behavioural Assessment and Intervention services. Other components (T-BASIS and MHACPI) are outlined above or are under development. The model may include extended inpatient care for older people with extreme behavioural symptoms who cannot be managed in other inpatient or community settings.

How it works

Behavioural Assessment and Intervention Service (BASIS)

The BASIS model is an extension of services provided by ACATs and SMHSOP community teams, providing a more structured, integrated and intensive role in assessment and case management for older people with severe and complex behavioural and psychosocial symptoms, often associated with dementia. The model provides integrated, comprehensive, multidisciplinary assessment, intervention and referral for the target group. In the example of the Behavioural Assessment and Intervention Services (BASIS) model, the key functions of the model are: development of formal links between SMHSOP and aged care services; provision of integrated assessment and intervention, and consultation, liaison and case management. Services are provided to identified clients in the community and residential aged care services. BASIS are generally integrated yet distinct components of SMHSOP community teams.

The T-BASIS Unit initiative is also an example of an interim assessment and treatment facilities under the severe and persistently challenging behaviours model (see above entry).

Resourcing

Specialist nursing and / or allied health clinicians, with access to and input from specialist medical support as required.

Success factors

  • Clear integration with SMHSOP clinical service stream
  • As per SMHSOP community team:
  • Clear point/s of entry and access arrangements
  • Multidisciplinary team with specialist mental health and aged care knowledge
  • Specialist geriatric/psychogeriatric assessment
  • Case management functions
  • Strong partnerships and collaboration with key partner services from mental health and aged care (particular focus of services)
  • Capacity building with families, carers and other service providers (particular focus of services)
  • Provision of integrated bio-psychosocial care
  • Strong clinical governance
  • Involvement in benchmarking
  • Integration of SMHSOP clinical service stream within the broader mental health service
  • Support from adult mental health services, especially for acute responses
  • Use of financial incentives to encourage less expensive, community-based care.

Models in operation

  • BASIS – various LHDs across NSW
  • (T-BASIS – see above)