Mental Health Services
Stepped care is defined as an evidence-based, staged system comprising a hierarchy of interventions, from the least to the most intensive, matched to the individual’s needs.
People with mental illness, drug and alcohol issues, or who are at risk of suicide will be matched to an appropriate service according to their level of need. A ‘stepped care’ model allows people to move between services depending on their individual needs. (SNPHN website)
The Primary Health Stepped Care Model will have a commencing interface with the Commonwealth Digital Gateway and will engage a range of technologies and information dissemination that provides a comprehensive range of self-help options to people with a mental illness or suicide enquiry in a primary health setting.
An individual does not generally have to start at the lowest, least intensive level of intervention in order to progress to the next ‘step’. Rather, they enter the system and have their service level aligned to their requirements. (source Dept. of Health PHN stepped care)
- GPs understand the different services available and feel confident referring.
- Services across the spectrum are effectively utilised.
- People get to the service that is right for them.
- People experience positive mental health & wellbeing outcomes.
- There is a seamless experience of service for clients.
- Commissioned services are integrated – meeting gaps, not duplicating.
Black Dog Stepped Care assessment
Black Dog are working with the PHN to provide a mental health assessment tool accessible via tablets delivered and installed at GP practices.
GPs are advised to recommend internet self-help treatments for people with mild and moderate symptoms, together with face to face psychological services and/or antidepressant medication for people with moderate symptoms, and psychological or psychiatric services and/or antidepressant medication for people with severe symptoms. The use of advanced online technologies allows online screening of patients, immediate online transmission of patient results to GP software, and online monitoring of patient symptoms with automated GP alerts as required.
- Identify: Patients are assessed via screening measures on a mobile tablet in the waiting room to identify mild, moderate and severe levels of anxiety and/or depression (as well as alcohol misuse).
- Recommend: Immediate feedback is provided to the patient on the mobile tablet and immediate evidenced based recommendations according to symptom severity are sent to the GP’s software via a secure messaging service.
- Monitor: Patients complete fortnightly online monitoring for 18 weeks. Regular feedback is sent online to patients and GPs to inform review and stepping up as required. Feedback is also sent to GPs notifying them if their patient does not follow through with on-line treatment recommendations.