A mixed methods evaluation of an integrated adult mental health service model.

ABSTRACT: BACKGROUND:The Floresco integrated service model was designed to address the fragmentation of community mental health treatment and support services. Floresco was established in Queensland, Australia, by a consortium of non-government organisations that sought to partner with general practitioners (GPs), private mental health providers and public mental health services to operate a 'one-stop' mental health service hub. METHODS:We conducted an independent mixed-methods evaluation of client outcomes following engagement with Floresco (outcome evaluation) and factors influencing service integration (process evaluation). The main data sources were: (1) routinely-collected Recovery Assessment Scale - Domains and Stages (RAS-DS) scores at intake and review (n?=?108); (2) RAS-DS scores, mental health inpatient admissions and emergency department (ED) presentations among clients prospectively assessed at intake and six-month follow-up (n?=?37); (3) semi-structured interviews with staff from Floresco, consortium partners, private practitioners and the local public mental health service (n?=?20); and (4) program documentation. RESULTS:Interviews identified staff commitment, co-location of services, flexibility in problem-solving, and anecdotal evidence of positive client outcomes as important enablers of service integration. Barriers to integration included different organisational practices, difficulties in information-sharing and in attracting and retaining GPs and private practitioners, and systemic constraints on integration with public mental health services. Of 1129 client records, 108 (9.6%) included two RAS-DS measurements, averaging 5 months apart. RAS-DS 'total recovery' scores improved significantly (M?=?63.3%, SD?=?15.6 vs. M?=?69.2%, SD?=?16.1; p?

SUBMITTER: Beere D 

PROVIDER: S-EPMC6791005 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature