Evaluation of a Residential Mental Health Recovery Service in North Queensland

Abstract

BackgroundEvidence shows that subacute mental health recovery occurs best when a person remains active within the community and fulfils meaningful and satisfying roles of their choosing. Several residential care services that incorporate these values have been established in Australia and overseas.AimsThis study describes (a) the development of an evaluation framework for a new subacute residential mental health recovery service in regional Australia and (b) reports on the formative evaluation outcomes.MethodsContinuous quality improvement and participatory research approaches informed all stages of the development of the evaluation framework. A program logic was established and subsequently tested for practicability. The resultant logic utilizes the Scottish Recovery Indicator 2 (SRI 2) service development tool, Individual Recovery Plans (IRPs), and the impact assessment of the service on psychiatric inpatient admissions (reported separately).ResultsService strengths included a recovery-focused practice that identifies and addresses the basic needs of residents (consumers). The consumers of the service were encouraged to develop their own goals and self-manage their recovery plans. The staff of the service were identified as working effectively in the context of the recovery process; the staff were seen as supported and valued. Areas for improvement included more opportunities for self-management for residents and more feedback from residents and carers.

Prevention and Recovery Care Services in Australia: Developing a State-Wide Typology of a Subacute Residential Mental Health Service Model

“…Further, the involvement of families and carers is highlighted in the Victorian Framework for recovery-oriented practice (39), and this may have particularly influenced PARC services which emphasize recovery-oriented care. The many obstacles and challenges to family-inclusive practice and widespread culture change needed to embed this practice have been identified (15, 38), but we did not find that the local MHCSS service operator was a factor which distinguished between clusters in this regard. Our finding concerning family invitations to care meetings may also speak to increasing social openness of the PARC services.…”

“…The PARC services framework and operational guidelines were developed by the Victorian government Department of Health (now known as the Department of Health and Human Services, DHHS) to support service planning and delivery (9). Several uncontrolled, quasi-experimental or small mixed-methods studies of the Victorian PARC service model or equivalents in other states have suggested improved symptomatic, functional and recovery outcomes for consumers, although findings are mixed concerning reductions in psychiatric bed usage (10–15).…”

Key features of an innovative sub-acute residential service for young people experiencing mental ill health

“…It has been well established that the therapeutic relationship is an important facilitator of recovery for both young people and adults with aspects such as trust, respect and ‘caring’ being important to both [17, 18, 60]. However, the value placed on a friendship-like relational experience with staff among young people tends to be less prominent in studies with adults [20].…”

“…Provision of sub-acute residential services for adults has become increasingly common in Australia [17, 20, 21]. Recovery-oriented models of care are embedded into many of these [19, 22–24].…”

“…Prevention and Recovery Care (PARC) services have sought to fill a gap in the continuum of mental health treatment and care by enhancing consumer access and options required for their individual needs [48]. These services initially targeted adults (over 18 years), providing short term (up to 28 days) mental health residential support and have been described elsewhere [20, 24]. In Victoria, this service has now been extended through the more recent establishment of Youth PARCs (Y-PARCs).…”