There are many organisations and services offering treatment and supports for people with severe and complex mental illness (SCMI) in Australia today – but navigating between them can often be challenging. This makes improvements in coordination between services critical to unlocking more effective support for consumers.
In Australia, approximately 3% of the population have a SCMI. People with SCMI will often require access to and support from various health services and professionals, commonly delivered in combination with a range of other services including housing and community services, alcohol and other drugs services, psychosocial support services, education, employment and justice. The various services must work together and with the consumer to meet their needs, achieve their goals and work towards recovery.
Despite providing great value to consumers and the community when delivered effectively, the effectiveness of these treatments and supports can often be hampered by coordination problems. Ineffective coordination between these services is often the result of inefficient information sharing and communication, nonstandard referral pathways and difficult navigation of and between services. Despite ongoing efforts to break down these barriers, many people with SCMI still do not receive the treatment and supports they need.
The Australian Department of Health (DoH) engaged HTANALYSTS to develop guidelines that establish a common national approach to improve the coordination and communication within and between mental health and other relevant organisations and services in Australia.
HTANALYSTS developed national guidelines with extensive stakeholder engagement to improve coordination of treatment and supports for people with SCMI. At the heart of the guidelines was the goal of improving the patient recovery journey and therefore consumers and consumer advocates have a right to be involved in all aspects of the guideline development process. The development of the guidelines comprised of four key stages:
- Initial consultation with consumers and consumer advocates, the DoH and other government and non-government mental health service providers and organisations
- Development of draft guidelines
- Workshops to refine guidelines with consumers and consumer advocates as well as broader stakeholders (e.g. other government and non-government social service providers and organisations)
- Finalisation of guidelines
The initial consultations were based on common barriers identified through a targeted review of the published literature, guidelines, programs and program evaluations relevant to the coordination of treatment and supports for people with SCMI. The review formed the basis of several discussions about solutions that may bridge the gap between the barriers identified to good care coordination. Person-centred, attainable and mutually agreed upon solutions and recommendations were sought after.
Findings from the initial stakeholder consultations were considered and incorporated to develop the draft guidelines. The guidelines were distributed for review to invite written and verbal feedback through several workshops. We sought input from an even broader range of stakeholders in these workshops, including health and social care sectors, community managed organisations across Australia’s states and territories such as the Departments of Justice and Housing, as well as those that attended the initial consultations. Consumers and consumer advocates were again involved and care was taken to ensure voices were heard from a diverse range of stakeholder communities, including regional, rural and remote communities, Aboriginal and Torres Strait Islander populations and people from LGBTQIA+ and culturally and linguistically diverse communities.
A presentation was developed for each workshop outlining each recommendation within the draft guidelines. Stakeholders were asked to provide feedback and comment on each recommendation contained in the presentation, which was then continually updated with key findings. These findings were summarised by HTANALYSTS at each discussion point to minimise repetition and gain the most benefit. Stakeholders at each workshop were engaged, informed and given equal opportunity to provide feedback.
Practical, relevant and attainable recommendations were developed to improve the coordination of treatment and support for people with SCMI. Providing consumers and consumer advocates with the opportunity to share their lived experience from the beginning of the guideline development process resulted in patient centred recommendations that incorporated their values and preferences. Consumers and consumer advocates felt heard, understood and optimistic about the future. Feedback from the range of other organisations and services providers involved was valuable to ensure that the recommendations were practical and could be easily implemented. Overall, the involvement of consumers and consumer advocates showed that authentic consumer involvement can result in guidelines that are more relevant and provide important information and insights that may be missed from a purely evidence-based search.