Integrated mental health atlas of the Western Sydney Local Health District: gaps and recommendations

Abstract

Objective Australian mental health care remains hospital centric and fragmented; it is riddled with gaps and does little to promote recovery. Reform must be built on better knowledge of the shape of existing services. Mental health atlases are an essential part of this knowledge base, enabling comparison with other regions and jurisdictions, but must be based on a rigorous classification of services. The main aim of this study is to create an integrated mental health atlas of the Western Sydney LHD in order to help decision makers to better plan informed by local evidence. Methods The standard classification system, namely the Description and Evaluation of Services and Directories in Europe for Long-term Care model, was used to describe and classify adult mental health services in the Western Sydney Local Health District (LHD). This information provided the foundation for accessibility maps and the analysis of the provision of care for people with a lived experience of mental illness in Western Sydney LHD. All this data was used to create the Integrated Mental Health Atlas of Western Sydney LHD. Results The atlas identified four major gaps in mental health care in Western Sydney LHD: (1) a lack of acute and sub-acute community residential care; (2) an absence of services providing acute day care and non-acute day care; (3) low availability of specific employment services for people with a lived experience of mental ill-health; and (4) a lack of comprehensive data on the availability of supported housing. Conclusions The integrated mental health atlas of the Western Sydney LHD provides a tool for evidence-informed planning and critical analysis of the pattern of adult mental health care. What is known about the topic? Several reports have highlighted that the Australian mental health system is hospital based and fragmented. However, this knowledge has had little effect on actually changing the system. What does this paper add? This paper provides a critical analysis of the pattern of adult mental health care provided within the boundaries of the Western Sydney LHD using a standard, internationally validated tool to describe and classify the services. This provides a good picture of the availability of adult mental health care at the local level that was hitherto lacking. What are the implications for practitioners? The data presented herein provide a better understanding of the context in which mental health practitioners work. Managers and planners of services providing care for people with a lived experience of mental illness can use the information herein for better planning informed by local evidence.

Standardised description of health and social care: A systematic review of use of the ESMS/DESDE (European Service Mapping Schedule/Description and Evaluation of Services and DirectoriEs)

“…Pilot and demonstration studies have been carried out in Spain [41, 20], Italy [17] and Australia [48].…”

Use of the self-organising map network (SOMNet) as a decision support system for regional mental health planning

“…Nevertheless, many of the functional aspects of this study have been previously published (e.g. [ 3 , 12 , 17 , 45 ]). New contributions include the extension of the mid-processing phase of KDD or the feasibility analysis of the SOMNet approach within the context of the TRL of DSS in mental health care research.…”

“…This approach has been used to conduct context analysis and to produce local Atlases of Mental Health Care. These Atlases are basic tools for developing DSS in practice, providing bottom-up information on service availability, placement and workforce capacity, and resource utilisation in small catchment areas that are aggregated to the regional or national level [ 15 – 17 ]. The information on the context of the provision is then combined with resource utilisation data to perform systems analytics.…”

Integrated mapping of local mental health systems in Central Chile

“…This local survey of MH service provision in small catchment areas in Central Chile generated useful information and new organizational learning on the provision of MH care, complementing data collected in other surveys at the national and regional level. Use of the DESDE-LTC and the ESMS/DESDE tools allows for comparison of identified patterns of care in selected areas of Chile with those found in selected areas in Europe (20) and Australia (26). This bottom-up approach is useful for assessing health service equity and accessibility, and for local planning.…”