Evaluation of the mental health nurse incentive program
4.2 Summary of findings: appropriateness
Table of contents
The key findings of the evaluation of MHNIP in relation to appropriateness are summarised below.
- Key Finding 1: there is a sizeable group of people in the community with severe and persistent mental illness. Expert advice suggests this is in the order of 1.2% of the adult population aged 18 to 64 years. It is estimated that a little under half of this group is the size of the MHNIP target population - 0.6% of the adult population with severe and persistent mental illness primarily reliant on assistance from GPs and psychiatrists in the private sector.
- Key Finding 2: the target group will always be bigger than realised demand under MHNIP eg some people will have exited the program because their condition has stabilised. Allowing for this, there is evidence demand exceeds the services currently available under MHNIP – an estimated 49,800 people in 2011-12.
- Key Finding 3: there is a high level of support from medical practitioners for the model of care embedded in MHNIP whereby mental health nurses, working in conjunction with GPs and psychiatrists, provide treatment and support to people with severe and persistent mental illness living in the community.
- Key finding 4: patients, carers and relevant peak bodies are also supportive of the model of care underlying MHNIP.
- Key finding 5: General Practices and Medicare Locals (formerly Divisions of General Practices) accounted for the largest proportion of MHNIP services delivered (80.9%) and mental health nurses employed (76.4%) between 1 July 2009 and 30 June 2011
- Key finding 6: there was evidence that medical practitioners are triaging patients to different Commonwealth funded programs supporting people with mental illness, based on clinical need. This included utilising MHNIP for patients with severe and persistent mental illness, and referral of patients with lower levels of disability to support from other appropriate services.
- Key finding 7: until the application of session caps in May 2012, realised demand under MHNIP was driven by supply-side factors –the number of eligible providers and credentialed nurses. These program design features were not sustainable in a period of budget restraint.
- Key finding 8: access to MHNIP services varies by jurisdiction. The supply-side driven design characteristics of MHNIP meant that service growth was not always linked to geographic areas where there was higher relative need for new services.
- Detailed finding #1: mental health nurses undertake both clinical and non-clinical activities to support their patients.
- Detailed finding #2: mental health nurses require a broad range of skills to perform their role under MHNIP.
- Detailed finding #3: the care provided by a metal health nurse was not affected by the nature of the eligible organisation.
- Detailed finding #4: mental health nurses have local knowledge of what programs, community supports, and social activities are available to support the patients they see through MHNIP. Their capacity to make these links, based on service availability, varies by geographic area and jurisdiction.
- Detailed finding #5: there is scope for greater social marketing of new programs, like Personal Helpers and Mentors Services (PHaMS) that may be of assistance to people with severe and persistent mental illness.
- Detailed finding #6: there is an opportunity to improve the pathways of patients from MHNIP to other appropriate services where their condition has improved.
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