Impact of care coordination on Australia's mental health service delivery system

Abstract

Care coordination models have developed in response to the recognition that Australia’s health and welfare service system can be difficult to access, navigate and is often inefficient in caring for people with severe and persistent mental illness (SPMI) and complex care and support needs. This paper explores how the Australian Government’s establishment of the Partners in Recovery (PIR) initiative provides an opportunity for the development of more effective and efficient models of coordinated care for the identified people with SPMI and their families and carers. In conceptualising how the impact of the PIR initiative could be maximised, the paper explores care coordination and what is known about current best practice. The key findings are the importance of having care coordinators who are well prepared for the role, can demonstrate competent practice and achieve better systemic responses focused on the needs of the client, thus addressing the barriers to effective care and treatment across complex service delivery systems. What is known about the topic? Care coordination, as an area of mental health practice in Australia, has not been well defined and the evidence available about its effectiveness is uneven. Even so, care coordination is increasingly identified as having the potential to deliver a more person-centred response to the health and social needs of people with severe and persistent mental illness (SPMI), as well as enhance the responsiveness of Australia’s mental health service delivery system. The introduction of Partners in Recovery (PIR), a new Australian Government initiative based on coordinated care approaches, provides the impetus to investigate the hoped for mental health system enhancements and related improved client outcomes. What does this paper add? This paper offers a rationale for care coordination, referred to in the PIR model as support facilitation, as a primary enabler for enhanced person-centred, cost-effective and sustainable mental health service delivery. The paper discusses support facilitation as an integral practice platform for supporting the successful implementation and sustainability of the PIR initiative. It also addresses issues that may be encountered in establishing the roles and functions of various components of the initiative’s care coordination model. What are the implications for practitioners? The key implications for PIR support facilitation practitioners are to reconsider their function and roles within a mental health service delivery system that places care coordination at its centre. This paper establishes that any model of care coordination requires well-trained and enthusiastic practitioners with a sophisticated appreciation of current barriers to care. Practitioners will be required to value partnerships as a means of addressing barriers that impact on the establishment and maintenance of robust, system-wide responses that are genuinely consumer focused.