Back to accessibility links

Specialist Mental Health Services for Older People - Non- acute inpatient service

What it is

Non acute mental health inpatient services have a primary focus on intervention to reduce functional impairments that limit the independence of the person and promote recovery.

How it works

Non acute mental health inpatient services provide specialist clinical assessment, treatment and rehabilitation where patients are not able to be managed in the community, with an expectation that consumers will improve sufficiently for discharge to a mainstream service or community setting with additional support from SMHSOP and other services. Strong links with residential and community services are important in these models.

Transitional Behavioural Assessment and Intervention Service (TBASIS) Units

Specialist interim care inpatient facilities provide multidisciplinary assessment, care planning and intensive treatment for older people with severe behavioural and psychological symptoms of dementia (BPSD). This includes iterative behavioural assessment and treatment, such as medication planning, psychosocial interventions and environmental approaches. The T-BASIS Unit is a model which provides a non-acute assessment/treatment/management-discharge service for older people with severe behavioural and psychological symptoms of dementia (BPSD). An evaluation of the T-BASIS Unit initiative found that where the T-BASIS model is more fully implemented, it can be both clinically effective and cost effective, with few readmissions and high family and carer satisfaction.

The mid-term evaluation of the NSW Service Plan for SMHSOP found that together, SMHSOP non-acute and T-BASIS units represented 34% of episodes for clients in the target group requiring non-acute/extended care in 2009/10. 

Resourcing

Specialist nursing and allied health staffing, specialist clinical input from mental health and aged care services (including old age psychiatrist/psychiatrist and/or geriatrician).

Success factors

  • Clear target population supported by admission and discharge policies and processes
  • Clinical support from specialist mental health and aged care services and medical coverage
  • Multi-disciplinary input and collaborative staff care planning and case review processes
  • GP involvement in admission, discharge and medical attendance
  • Dedicated staffing and focus on discharge planning and liaison with families and carers, and key services
  • Dedicated staffing and focus on outreach support to promote linkages with community aged care services (including residential aged care services)
  • Partnerships to facilitate appropriately supported discharge (ACATs, geriatric medical, residential aged care, HACC and GPs)
  • Full implementation of the T-BASIS model of care as a step-up / step-down model
  • Integration within SMHSOP clinical service stream
  • Strong medical and nursing leadership
  • Access to ongoing education and training for unit staff to maintain their expertise
  • Strong clinical governance and security arrangements.

Models in operation

  • Non-acute SMHSOP inpatient units (Southern NSW, Western NSW, Northern Sydney, Hunter New England LHDs)
  • SMHSOP sub-acute/non-acute inpatient unit in South Eastern Sydney LHD (opening late-2013).
  • T-BASIS Units (Western Sydney, Hunter New England, Southern NSW, Murrumbidgee LHDs)