Abstract
Harvey Whiteford
The Council of Australian Governments (COAG) mental health reforms are being driven by the need to address two main problems in the mental health sector. The first is that many Australians, especially those with high prevalence anxiety and depressive disorders, are not receiving treatment. While the Commonwealth Better Access initiative has almost certainly increased the treated prevalence of common mental disorders, we do not know much about the quality of the services provided. The second problem being addressed by the COAG reforms is the far from optimal outcomes gained by those with complex and persistent disorders. The failure to adequately integrate health, accommodation, rehabilitation and disability services for this group is a major deficiency. This paper will discuss the role mental health outcomes can and must play in addressing these two critical areas.
Sarah Gordon
Tāku Reo, Tāku Mauri Ora: My Voice, My Life is a new measure that has been developed for the primary purpose of supporting mental health consumers/tāngata whai ora to reflect and communicate on their own mental health outcomes.
Over the past three years we have worked to produce what appears to be a good measure which, if supported with similarly appropriate and robust systems and processes for implementation and use, will serve to provide an effective and efficient measure of mental health outcomes for both consumers and other stakeholders.
This presentation will profile the new measure together with the results of the piloting associated with the development project, highlight some key aspects of that project which have served to result in such a significant development, and explore the approach proposed for the implementation and use of Tāku Reo, Tāku Mauri Ora: My Voice, My Life.
Michael Lambert
About 8% of clients who enter psychotherapy leave treatment more dysfunctional than when they entered and an additional 30% show no treatment benefit. Clinicians are overly optimistic and their appraisal of their own work and degree of patient benefit, especially in regard to detecting treatment failure. Methods and their effects on reducing treatment failure are presented based on six clinical trials. These include the use of a brief measure of symptomatic disturbance, interpersonal problems, and social role functioning, that is given on a weekly basis via the use of OQ-Analyst software and handheld computers. Expected treatment response (based on the course of 11,000 patients) is used to identify individual patients who are deviating significantly from a positive change trajectory. This information is provided to therapists as a “signal alarm” and the effects of giving this feedback and problem solving Clinical Support Tools are contrasted to treatment as usual.
Alastair Macdonald
I will describe the development of a RCOM programme in a UK NHS Trust from the early 1990s in one corner of an older adults mental health service to its present stage attempting to cover services for children and adolescents, working-age and older adults and psychological therapies across much of SE London. I hope to cover: the advantages and disadvantages of carrot (feedback to clinical and management teams) and stick (performance management), dependency on IT systems and their vagaries, issues in training issues in extraction, analysis (including evolving attempts to show change meaningfully), and feedback to clinical and management teams the issue of interventions, the positive and less positive contributions of academic psychiatrists and psychologists and, depending on how depressed I am, the impact of government initiatives on these processes.