psychological-therapies
psychological-therapies

Psychological therapies

Overview

A broad range of psychological therapies are available to people in the Brisbane North and Moreton Bay region, but there is little currently known about the preferences of consumers using these services. Chapter ten of Planning for Wellbeing is focused on ensuring psychological therapies more effectively respond to the needs and preferences of people, especially those whose disadvantaged circumstances compound their mental health issues.

Facts and figures

An estimated 22,000 adults (18 to 65 years of age) in Brisbane North are expected to experience severe mental illness in 2018, all of whom are expected to require treatment

An estimated 93,000 adults in Brisbane North are expected to experience moderate or mild mental illness in 2018, with 25,000 adults expected to require treatment for moderate illness and 31,000 for mild mental illness.

15,600 adults over 65 years of age in Brisbane North are expected to experience moderate or mild mental illness in 2018, with 4,500 expected to require treatment for moderate mental illness and 5,000 for mild mental illness.

In 2011, an estimated 19% of adults over 65 years of age in Brisbane North accessed PBS subsidised antidepressants, with 2.6% of the same group accessing MBS subsided GP mental health services.

Key documents

My Mental Health services map

Stepped care fact sheet

Planning for Wellbeing - Year one implementation report

Objectives and actions

10.1.1

Research consumer preferences and needs and promote findings of this research.

Planned completion

Ongoing

Status

On track

Updated

10.1.2

Align existing and newly-commissioned services with: 1. consumer preferences and needs on modality of delivery, access hours and type of practitioner; and 2. the needs of specific population groups that cannot access appropriate options.

Planned completion

Ongoing

Status

On track

Updated

10.1.3

Develop, trial and evaluate an incentivised community-based service delivery model for specific population groups in Moreton Bay North.

Planned completion

2020/21

Status

Not started

Updated

10.1.4

Support a flexible approach to service delivery that emphasises client choice (i.e. combination of face-to-face and online options regardless of client’s geographical locations with equal access to rebates)

Planned completion

Ongoing

Status

On track

Updated

10.1.5

Better understand the impact of Mental Health Care plans on people’s willingness to access psychological therapies

Planned completion

2020/21

Status

On track

Updated

10.1.6

Improve client levels of technological literacy to maximise effective telehealth delivery

Planned completion

2020/21

Status

Not started

Updated

10.1.7

Develop and promote lived experience narratives that include how professional support can meet individual needs

Planned completion

2020/21

Status

On track

Updated

10.2.1

Develop an education strategy for GPs, other healthcare practitioners and NGOs on psychological therapies, including low intensity psychological therapies.

Planned completion

2018/2019

Status

Completed

10.2.2

Build GP and public understanding about which style of therapist best meets different needs (i.e. difference between Counsellors, Psychologists, Social Workers, Mental Health Nurse, Brief therapy providers etc.)

Planned completion

2020/21

Status

On track

Updated

10.2.3

Identify options for improving integration between community services and psychological services.

Planned completion

Ongoing

Status

On track

10.2.4

Promote examples enhancing integration between community services and psychological services.

Planned completion

2020/2021

Status

On track

10.2.5

Commission outcomes-focused practice models that achieve greater integration between psychological and community support services.

Planned completion

Ongoing

Status

On track

10.3.1

Expand access to psychological therapies, including brief therapies, via phone, e-mental health, telehealth, face-to-face and groups, ensuring reach to high need communities.

Planned completion

Ongoing

Status

On track

Updated

10.3.2

increase delivery of psychological therapies in high need geographic areas by improving workforce distribution

Planned completion

2020/21

Status

On track

10.3.3

Improve use of e- and tele-mental health services in high need areas.

Planned completion

ongoing

Status

On track

10.3.4

Increase the number of skilled peers and students delivering low intensity psychological services for hard to reach population groups.

Planned completion

Ongoing

Status

On track

10.3.5

Develop evidence informed Telehealth Practice Guidelines (i.e. guidance and advice for providers on secure IT service delivery platforms, appropriate insurance, how to deliver services well online)

Planned completion

2020/21

Status

Completed

Updated

10.3.6

Provide professional development opportunities for telehealth service delivery

Planned completion

Ongoing

Status

On track

Updated

10.4.1

Analyse service uptake and outcomes data to better understand the effectiveness of different service delivery options as a response for different population groups.

Planned completion

2020/2021

Status

On track

10.4.2

Publish and share findings about effective use of psychological therapies as part of the stepped care framework.

Planned completion

2020/2021

Status

On track

10.5.1

Identify low cost methods of effectively promoting evidence-informed approaches to reducing stigma across the community, including to different population groups.

Planned completion

2020/21

Status

On track

10.5.2

Develop an approach to de-stigmatise and normalise the need to access psychological therapies (i.e. promote help seeking behaviours with lived experience narratives)

Planned completion

2020/21

Status

On track

Updated

10.6.1

MBS/NDIS access for Counsellors

Planned completion

2020/21

Status

On track

Updated

10.6.2

Single tier rebate for non-clinical psychologists

Planned completion

2020/21

Status

On track

Updated

10.6.3

Ongoing funding for telehealth service delivery

Planned completion

2020/21

Status

On track

Updated

10.6.4

Increased number of sessions available

Planned completion

2020/21

Status

On track

Updated

10.6.5

Improve technological infrastructure and financial support to better enable telehealth delivery (for both providers and users)

Planned completion

2020/21

Status

On track

Updated

Governance

The psychological therapies partnership group is in the process of being established.

Membership

Membership will be advised once this partnership group has been established.

Achievements

Planning for Wellbeing recognises the breadth of providers of psychological therapies across the region, including the huge numbers of allied health professionals delivering Better Access services through Medicare, but acknowledges that little is known about genuine consumer preference for what, how and who delivers these services.  Importantly, research to inform Planning for Wellbeing also highlighted the lack of empirical evidence on the performance of these services – noting that routinely collected data tracks activities rather than outcomes.  The shared objectives within the Psychological Therapies chapter seeks to address these concerns.

A summary of key achievements against the five shared objectives is included below.

Summary of Achievements

Work to achieve this objective is progressing well – with the PHN undertaking a review of consumer needs and preferences in late 2018, and using this information to inform a revised service model for the Brisbane MIND Program.  The new service model was launched in July 2019.

The actions to achieve this objective include a range of strategies to promote and advocate for service delivery to occur in the context of the PHN’s approach to  stepped care.  Work progressed to date includes a suite of educational materials to inform referrers of the range of referral options that exist within the stepped care framework – including the:

  • Stepped Care Factsheet[1] and Video[2]
  • Brisbane MIND Plus Services Map[3]
  • PHN Commissioned Services Magazine

As well as other resources which support connection between services as needed – including the My Mental Health Service Navigators, and rediCASE – the online assessment, triage and referral tool available to referrers and service providers, which supports stepping up/down as required

[1] http://www.brisbanenorthphn.org.au/ – Stepped care fact sheet
[2] https://www.youtube.com/ – Our approach to stepped care
[3] http://www.brisbanenorthphn.org.au – Services Map

Work to achieve this objective has been assisted by two region-wide e-based services delivering psychological therapies – namely the phone-based New Access Program [1] delivered by Richmond Fellowship Queensland, and the app-based Daybreak Program [2] delivered by Hello Sunday Morning.  Both programs have attracted high numbers, operating at capacity for much of the year.

Further work to diversify the workforce is also progressing, including a number of programs purposely engaging and upskilling peers to provide services, including the Sunshine Parenting Program[3] delivered by Peach Tree Perinatal Wellness, and the Problem Management Plus[4]Program delivered by Culture in Mind.

[1] https://www.rfq.com.au/newaccess/
[2] https://www.hellosundaymorning.org/daybreak/
[3] https://peachtree.org.au/what-we-do/the-sunshine-parenting-program-spp/
[4] https://worldwellnessgroup.org.au/culture-in-mind/our-services/problem-management-plus-pm/

Work in this area will follow the implementation of the revised Brisbane MIND service model – analysing uptake of services and monitoring wellbeing outcomes to better understand the effectiveness of different psychological therapies.

To achieve this objective, the PHN has purposely engaged a range of service modalities for psychological therapies available in the region.  For those who do not wish to access services face-to-face, phone and app-based services are available.  In addition to locally delivered services, a broader suite of e-based services listed on the national Head to Health [1] website are routinely promoted.

Table 10 presents an overview of the 13 actions that were considered necessary to achieve the five shared objectives in this chapter, noting their expected year of completion, and progress to date.

[1] https://headtohealth.gov.au/

Success stories

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