Use of a mental health emergency care-rural access programme in emergency departments

Saurman, Emily; Lyle, David; Kirby, Sue; Roberts, Russell

doi:10.1177/1357633x14544422

Cited by 19 publications

(33 citation statements)

References 8 publications

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“…National and state‐wide policy initiatives such as e‐health and tele‐health impact the rural mental health workforce and service delivery, but consideration of the rural implications of these policies is beyond the remit of this paper. Likewise, key workforce themes such as leadership, Aboriginal and Torres Strait Islander workforce, peer workforce, cross‐sector collaboration, education and training are also beyond the scope of this paper.…”

Section: Discussionmentioning

confidence: 99%

Is rural mental health workforce a policy imperative?

Roberts

Maylea

2019

Australian J Rural Health

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An available and effective rural mental health workforce is critical to the provision of contemporary mental health care. During the last 5 years new mental health plans and strategies have been released every state and territory of Australia. This policy analysis examines the extent to which workforce, and particularly rural workforce issues are considered in these policies. The analysis revealed that rural workforce issues receive scant attention in state and territory mental health plans. Rural Australians comprise 28% of the total population, yet rural workforce issues are canvased, on average only 6% of the time general workforce issues are addressed. National mental health workforce plans do focus on the rural workforce, but these are not referenced in the state or territory strategies or workforce plans. Given the rural mental health workforce shortages, and consumer challenges in accessing rural mental health services, more planning and consideration to supporting and developing a rural workforce appears warranted.

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Section: Discussionmentioning

confidence: 99%

Is rural mental health workforce a policy imperative?

Roberts

Maylea

2019

Australian J Rural Health

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“…They also felt that patient outcomes were improved, that fewer patients were being transferred for specialist mental health care, and that there were fewer representations of mental health patients in crisis. Initial studies support this, but further research is necessary to determine such outcomes [32,33]. …”

Section: Discussionmentioning

confidence: 99%

“…Access is the degree of fit between the consumer and the service, and activity data from the evaluation showed that MHEC-RAP was well used by the ED providers, offering further evidence of access through use [33]. Understanding the experience of the program users through the lens of access, MHEC-RAP is able to identify modifications to ensure its services continue to be relevant and responsive to the needs of their consumers.…”

Section: Discussionmentioning

confidence: 99%

“…But it was the first to provide 24-hour access to a dedicated, regionally-based team of mental health specialists offering timely information and support, emergency telephone triage, and video assessment for all providers, patients, and residents needing urgent mental health care in rural and remote communities. The MHEC-RAP evaluation has already reported findings from earlier studies that demonstrate use of the program by those in need and examined clinical service activity from the area EDs [32,33]. This was the first evaluation to use a time and motion study method to assess program efficiency and to present a translatable program model for transferability [34,35].…”

Section: Introductionmentioning

confidence: 99%

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No longer ‘flying blind’: how access has changed emergency mental health care in rural and remote emergency departments, a qualitative study

Saurman

Kirby

Lyle

2015

BMC Health Serv Res

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BackgroundMental health presentations are considered to be a difficult aspect of emergency care. Although emergency department (ED) staff is qualified to provide emergency mental health care, for some, such presentations pose a challenge to their training, confidence, and time. Providing access to relevant and responsive specialist mental health care can influence care and management for these patients. The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telepsychiatry program that was established to improve access to specialist emergency mental health care across rural and remote western NSW, Australia.MethodThis study uses interviews with ED providers to understand their experience of managing emergency mental health patients and their use of MHEC-RAP. The lens of access was applied to assess program impact and inform continuing program development.ResultsWith MHEC-RAP, these ED providers are no longer ‘flying blind’. They are also more confident to manage and care for emergency mental health patients locally. For these providers, access to specialists who are able to conduct assessments and provide relevant and responsive advice for emergency mental health presentations was valued. Assessing the fit between the consumer and service as a requirement for the development, evaluation, and ongoing management of the service should result in decisions about design and delivery that achieve improved access to care and meet the needs of their consumers. The experience of these providers prior to MHEC-RAP is consistent with that reported in other rural and remote populations suggesting that MHEC-RAP could address limitations in access to specialist care and change the provision of emergency mental health care elsewhere.ConclusionMHEC-RAP has not only provided access to specialist mental health care for local ED providers, but it has changed their practice and perspective. MHEC-RAP could be adapted for implementation elsewhere. Provider experience confirms that the program is accessible and offers insights to those considering how to establish an emergency telepyschiatry service in other settings.

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“…• Regional service reform: Two regional outreach service models were evaluated: provision of diabetes cycle of care to patients through the Royal Flying Doctor Service (South Eastern Section) network of fly-in fly-out clinics in far west New South Wales (NSW) 14,15 , and a virtual outreach, telehealth service established by a local health district (LHD) to improve access to emergency mental healthcare across western NSW [16][17][18][19][20] .…”

Section: Contextmentioning

confidence: 99%

What do evaluations tell us about implementing new models in rural and remote primary health care? Findings from a narrative analysis of seven service evaluations conducted by an Australian Centre of Research Excellence

Lyle

Saurman

Kirby

et al. 2017

Rural Remote Health

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A B S T R A C TIntroduction: A Centre of Research Excellence (CRE) in Rural and Remote Primary Healthcare was established in 2012 with the goal of providing evidence to inform policy development to increase equity of access to quality health care and the identification of services that should be available to the diverse communities characterising Australia. This article reports on the key findings from seven CRE service evaluations to better understand what made these primary health care (PHC) models work where they worked, and why. Methods: We conducted a narrative synthesis of 15 articles reporting on seven CRE service evaluations of different PHC models published between 2012 and 2015.Results: Three different contexts for PHC reform were evaluated: community, regional and clinic based. Themes identified were factors that enabled changes to PHC delivery, processes that supported services to improve access to PHC and requirements for © D Lyle, E Saurman, S Kirby, D Jones, J Humphreys, J Wakerman 2017. A Licence to publish this material has been given to James Cook University, http://www.jcu.edu.au 2 service adaptation to promote sustainability. In both Indigenous and mainstream community settings, the active engagement with local communities, and their participation in, or leadership of, shared decision-making was reported across the three themes. In addition, local governance processes, informed by service activity and impact data, enabled these service changes to be sustained over time. The considerations were different for the outreach, regional and clinic services that relied on internal processes to drive change because they did not require the cooperation of multiple organisations to succeed. Conclusions:The review highlighted that shared decision-making, negotiation and consultation with communities is important and should be used to promote feasible strategies that improve access to community-based PHC services. There is a growing need for service evaluations to report on the feasibility, acceptability and fit of successful service models within context, in addition to reach and effectiveness in order to provide evidence for local dissemination, adaption and implementation strategies.

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Use of a mental health emergency care-rural access programme in emergency departments

Cited by 19 publications

References 8 publications

Is rural mental health workforce a policy imperative?

Is rural mental health workforce a policy imperative?

No longer ‘flying blind’: how access has changed emergency mental health care in rural and remote emergency departments, a qualitative study

What do evaluations tell us about implementing new models in rural and remote primary health care? Findings from a narrative analysis of seven service evaluations conducted by an Australian Centre of Research Excellence

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