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Mental Health
Introduction
—The policy context
—The Mental Health Integration Program
—The three projects
—Inner Urban East Melbourne
—Illawarra
—Far West NSW
—Evaluation method
—Synthesis of evaluation findings: results and discussion
—What were the impacts of the projects funded under MHIP? What elements of the projects facilitated or impeded these impacts?
—Did the projects represent value for money?
—Were the projects sustainable?
—Were the models adopted by the projects generalisable?
—Are lessons from the evaluation model useful elsewhere?
—Key messages
—Key message 1: Improving integration is hard but possible
—Key message 2: Improved integration can only occur in the context of structural and cultural change
—Key message 3: Integration needs to be planned at the local area level
—Key message 4: System-level integration is required within the specialist mental health sector and beyond
—Key message 5: The magnitude of change depends on the starting point
—Key message 6: No one model fits all
—Key message 7: Change requires leadership
—Key message 8: Fee-for-service arrangements are limited
—Key message 9: Money alone does not drive change
—Key message 10: Changes occur in a policy context
—Conclusions and future directions
—Acknowledgements
—Competing interests
—References
—Author details
Three projects were funded under the national Mental Health Integration Program (MHIP) in 1999, each of which employed a different model aimed at improving linkages between disparate parts of the mental health system. A national evaluation framework guided local evaluations of these projects, and this paper presents a synthesis of the findings. For providers, the projects improved working relationships, created learning opportunities and increased referral and shared care opportunities. For consumers and carers, the projects resulted in a greater range of options and increased continuity of care. For the wider system, the projects achieved significant structural and cultural change. Cost-wise, there were no increases in expenditure, and even some reductions. Many of the lessons from the projects (and their evaluations) may be generalised to other mental health settings and beyond.
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Kathy Eagar, PhD, Director Alan Owen, Senior Research Fellow Natasha Posner, PhD, Senior Research Fellow
Centre for Health Service Development, Faculty of Commerce, University of Wollongong, Wollongong, NSW.
Jane E Pirkis, PhD, Principal Research Fellow
Program Evaluation Unit, School of Population Health, University of Melbourne, Carlton, VIC.
Philip M Burgess, PhD, FAPS, Professor, Mental Health Services Research
School of Population Health, University of Queensland, Richlands, QLD.
David A Perkins, PhD, Director
Centre for Equity and Primary Health Research in the Illawarra and Shoalhaven, School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW.
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©Aust Health Rev 2005 www.aushealthreview.com.au PRINT ISSN: 0156-5788 ONLINE ISSN: 1449-8944