Cross-Sectional Comparison of Treatment Provided Under the Clinical, Integrated, and Partnership Staffing Models for Community-Based Residential Mental Health Rehabilitation

Comparative Effectiveness of Integrated Peer Support and Clinical Staffing Models for Community-Based Residential Mental Health Rehabilitation: A Prospective Observational Study

“…Our findings indicate that the integrated staffing model achieved at least equivalent outcomes and that consumers under this model were more likely to have their involuntary treatment revoked prior to discharge. These findings provide reassurance that reduced restrictive and pharmacologically focused treatment at CCUs under the integrated staffing model (Karan et al, 2022) is not associated with inferior clinical and functional outcomes. Additionally, our findings add weight to the relevance of considering consumer preferences in terms of their emphasis on the value of the availability of PSWs under an integrated staffing model (Parker et al, 2021).…”

“…Providing intensive support over an extended duration in a residential setting incurs high costs per episode of care (Parker et al, 2020). Despite the costs associated with these services, there have been limited comparative studies to establish their effectiveness (Dalton-Locke et al, 2020;Parker et al, 2019aParker et al, , 2019bParker et al, , 2019c, and TRR service capacity has expanded considerably in Australia over the last decade (Karan et al, 2022).…”

“…Australian TRR-type services have been adapted based on changing policy agendas and local service priorities. For example, services have generally shifted from a focus on providing a permanent residence to transitional support (Gerrand et al, 2007), increasingly emphasize recoveryoriented practice (McKenna et al, 2016), and are exploring novel staffing configurations with reduced emphasis on clinical roles (Karan et al, 2022;Parker et al, 2016;Saraf & Newton, 2017). Including staff with a lived experience of mental illness (Peer Support Workers, PSWs) in traditional clinical mental health services is increasingly encouraged in Australia (Saraf & Newton, 2017;State of Victoria, 2021).…”

“…One such approach is the 'integrated staffing model' (Karan et al, 2022). Under this model, PSWs, rather than mental health nurses, represent the majority staffing component and draw on their personal recovery experiences to support consumers.…”

“…Furthermore, 12-18 months following service entry, consumers supported under this staffing approach emphasized the value of PSW availability (Parker et al, 2021). A recent cross-sectional study in Queensland found that the integrated staffing model was associated with lower levels of restrictive practice, pharmacological treatment, and greater staff-rated consumer engagement than the clinical staffing model (Karan et al, 2022). The authors of this study emphasized the need for findings to be interpreted with caution as no inferences could be drawn as to whether the differential treatment was appropriate or preferable.…”