Mental Health, Suicide Prevention and Alcohol and Other Drugs (AOD) Service Reform
Improving the design and delivery of mental health and AOD services to better meet community needs.
Healthy North Coast is working with our local health partners, community members and health care providers on a new reform project for the North Coast. The project will evaluate how primary mental health and wellbeing services are currently responding to local needs. It will use a participatory model to help explore relevant issues, opportunities and future service solutions that can help to increase our return on service investment through the delivery of better health outcomes in our region.
Recent data and community insights shows us there are increasing challenges and we need to do things differently.
Key steps in the reform project include research, participatory workshops, solution design and commissioning, and evaluation.
The case for change
People across the North Coast experience high rates of mental health and behavioural conditions. About 1 in 5 people in the North Coast experience mental health challenges in any one year, with the number of people experiencing mental health conditions and issues with alcohol and other drugs (AOD) likely to grow.
This impacts on quality of life for people with lived experience of mental health and AOD challenges and their carers. It also puts pressure on all levels of our health system.
We also rate our own mental health poorly.
- In 2018-19, 1 in 7 people over the age of 18 had high or very high psychological distress. This was the 7th highest rate in Australia.
- Many of us on the North Coast drink risky levels of alcohol and the number of hospitalisations related to alcohol is higher than the NSW average.
- In 2019, we had the highest rate of illicit drug use of people aged 14 years and over in Australia.
Our region has a higher level of mental health, suicide and substance misuse challenges than the rest of NSW.
- Mental health disorders and substance misuse account for 12% of the total disease burden in the North Coast.
- A further 2.5% of burden is from suicide and self-inflicted injuries.
Recent data from the Healthy North Coast 2022-25 Health Needs Assessment and other sources also shows us that we need to do things differently.
Challenges that emerged from the Health North Coast community survey and data collected from our commissioned services include:
- Getting access to mental health and AOD support services
- Receiving appropriate care
- A lack of preventive, innovative or community-based care
- The rising cost of services
- The overall high levels of mental distress, self-harm, suicide and AOD use across the region.
We need to rethink the way we design and deliver mental health services, so that people:
- Receive care that is relevant to the level of need
- Can access services close to where they live
- Receive care that takes account of the whole self – their mental, emotional, physical and social wellbeing
- Have improved access to AOD support services tailored to their relevant stage of recovery.
For more information:
- The Fifth National Mental health and Suicide Prevention Plan (Mental Health Commission, 2017)
- Productivity Commission Inquiry Report: Mental Health (Productivity Commission, 2020)
Delivering the project
We need to do things differently to meet the mental health needs of our region. The best way to do that is to work with people who will use those services and to design them together. This can be referred to as participatory design.
We have used a participatory approach to plan and design mental health, suicide prevention and AOD services.
Our workshops brought together people involved with mental health, suicide prevention and AOD services, including:
- people using these services now or in the past
- carers
- service providers
- other organisations involved in advocacy or research.
The service reform has also taken into account the social and economic factors in the North Coast that impact mental health and wellbeing, including the impact of recent natural disasters in our region.
Project stages
Background research: understanding our local needs — complete
Healthy North Coast’s project team reviewed the mental health, suicide prevention and AOD programs that we funded to plan the way we undertook the reform.
We reviewed relevant data about people’s experience with mental health, suicide and AOD in the North Coast. This research guided discussion in the co-design workshops.
Workshops: August and September 2022 — complete
Service users, carers and service providers were involved in all stages of the project.
‘Define the problem’ face-to-face workshops were held in late August / early September. Locations included Tweed Heads, Lismore, Grafton, Coffs Harbour and Port Macquarie. Participants shared experiences and knowledge about mental health, suicide prevention and AOD services in the region. Based off this discussion, a range of challenges and ideas were identified to explore solutions in the next workshops. A report with the workshop outcomes can be found here.
Workshops October: November 2022 — complete
- General Practitioners
- Nambucca Valley community
- People with Lived Experience
Commissioning services — complete
The approach to service models has been led by the outcomes of the ideas and insights of stakeholders, including community members and service providers.
Three tenders were released to find suitable providers to deliver the services in December 2022.
Information about tender opportunities are published on the Healthy North Coast website.
Please ensure you are registered for Tenderlink to receive notifications of upcoming opportunities.
Reform evaluation: July 2023
Evaluation is an important element of reform as it helps to understand if the project has resulted in better health outcomes for our community.
To support this, we will consider short, medium, and long term indicators to assess impact. Healthy North Coast will evaluate the project in full, including the reform workshops, the planning and new commissioned services, which will support decisions around future investment.
Learn more about participatory design in mental health:
Reformed services
In our workshops, community members and service providers described current North Coast health and support services as complex and fragmented. In particular, services did not respond to the whole of health (mental, physical, social and cultural health) of individuals, communities, families and kinship groups.
We heard that a service hub, or co-location of services was one way to provide services to seek better health outcomes for our community. This means that services are better connected and can work in collaboration.
What is a hub and spoke model?
The hub and spoke is not a standard model, rather it is a way to deliver multidisciplinary services that responds to community’s diverse needs. In this model, services are based around a ‘hub’, which can be a physical space with a co-location of services. The ‘spokes’ deliver services at local level and don’t have to be in a standard office or service delivery space. Rather, a spoke can be anywhere collaboration or connections to key services or information can occur (e.g., community centre, pharmacy, GP clinic, schools).
Our reformed services will be delivered under three main areas:
Primary Mental Health
The Primary Mental Health Program will be delivered through a multidisciplinary, person centred, no-wrong-door hub & spoke service. This means that services are connected to a central point in regional centres (hubs) with services reaching out to smaller communities (spokes)
The services you can access as part of this program includes:
- Psychological therapies for underserviced or hard to reach groups/ people experiencing mild to moderate mental illness or thoughts of suicide (previously known as Healthy Minds)
- The Mental Health Nurse Program for people living with enduring mental ill-health
- Young people (aged 12-18 years) experiencing severe mental health challenges
- Suicide Prevention Program – Provision of evidence-based interventions targeted at men aged 35-65 that increase the prevalence of protective factors, increase hope and support for people at risk of suicide in the North Coast community.
- The Low Intensity Mental Health Service to support our community
- Counselling Support Program for Northern Rivers region.
Alcohol and Other Drugs
The Drug and Alcohol Treatment Program delivers services linked to the Primary Mental Health service to provide integrated health care- recognising the comorbidities often experienced by people in our communities.
The services you can access as part of this program include:
- Brief intervention support
- AOD Youth Program
- AOD Counselling program
- AOD Community Rehabilitation Program
- Withdrawal Management Outpatient Support Program
Psychosocial Support
The Commonwealth Psychosocial Support Program is a non-clinical community-based support for people with severe/and or episodic mental ill health (alongside their families and carers, as appropriate) to achieve recovery goals.
Services cover a range of non-clinical supports focused on one or more of the following areas:
- Social skills, friendships, and family connections
- Day-to-day living skills
- Financial management and budgeting
- Finding and maintaining a home
- Vocational skills and goals
- Maintaining physical wellbeing, including exercise
- Managing substance use issues
- Building broader life skills, including confidence and resilience; and
- Building capacity to live independently in the community.
- Support in building an application to test access to the NDIS
An example of how the hub and spoke model will work for Healthy North Coast’s Commissioned services.
If you have any questions please get in touch with our Mental Health, Suicide Prevention and AOD team at mh&[email protected]
