Mental health

About one in five Australians experience mental illness in any year. It can affect people across the lifespan, but mental illness experienced as an adult often has its onset in childhood or adolescence. Demographic characteristics and experiences make some people particularly vulnerable. Diagnoses, symptom intensity, duration, and impact vary, but people with a mental illness are also more at risk of experiencing a range of adverse social, economic and health outcomes. While attitudes to, and understanding of mental illness have improved, there is still stigma around having a mental illness and people can be unwilling to seek help.

Governments fund mental health inpatient and outpatient services, child and adolescent mental health services and subsidise access to psychological services. Policy has changed much in recent decades, with an increasing focus on reducing stigma and increasing social inclusion, delivering services in community settings, and providing recovery-oriented care.

Strategies include campaigns and programs to raise awareness and understanding of mental illness, screening for perinatal depression, and prevention and early intervention initiatives for children and young people. There has also been a focus on improving access to and continuity of care, ensuring service quality and accountability, and coordinating service delivery to provide more holistic support.


Project examples

Click on any of the following projects for more information.

Monitoring system for Families Mental Health Support Services

(Department of Social Services, 2014)

Monitoring system for Families Mental Health Support Services

(Department of Social Services, 2014)

Families Mental Health Support Services aims to improve mental health outcomes for children and young people, and their families. ARTD was engaged to develop a performance framework and monitoring system for the family mental health early intervention program. We designed and implemented an online data transfer and reporting system for all funded services. Initially, the Department used the system to monitor progress with implementation; later to establish outputs and client outcomes. As it was designed to be flexible, the system allowed DSS to effectively monitor the new program with emergent models of service delivery.

Evaluation of the Recovery and Resources program for people with a mental health problem

(Mental Health and Drug & Alcohol Office, 2014)

Evaluation of the Recovery and Resources program for people with a mental health problem

(Mental Health and Drug & Alcohol Office, 2014)

The Recovery and Resources Program aimed to increase the capacity of non-government organisations to support people with a mental illness to access mainstream opportunities and vocational and educational services. ARTD conducted a process and outcomes evaluation of the program. We used a mixed-method design, including an analysis of monitoring data, semi-structured interviews with 9 senior program stakeholders, an online survey of 46 program staff and 66 referral agency staff, and case studies of 9 sites (which included semi-structured interviews with 33 consumers, 28 program staff, 18 referral agency staff). The evaluation provided evidence for decisions about the future funding of the program.

Monitoring system for the families and carers mental health program

(Mental Health and Drug and Alcohol Office, 2008-14)

Monitoring system for the families and carers mental health program

(Mental Health and Drug and Alcohol Office, 2008-14)

The Family and Carer Mental Health Program aims to improve the knowledge and skills of families and carers to help them cope with caring for people with a mental illness. ARTD designed and piloted a monitoring and reporting system for the program, and was subsequently engaged to implement and maintain it from 2009 until 2014. The design, implementation, stabilisation and operation of the system has provided the Ministry of Health, Local Health Districts and services with the necessary data to assess the adequacy of support for carers of people with a mental illness and monitor improvements to service delivery.

Evaluation of framework for data collection from mental health consumers

(NSW Consumer Advisory Group - Mental Health Inc., 2012-13)

Evaluation of framework for data collection from mental health consumers

(NSW Consumer Advisory Group - Mental Health Inc., 2012-13)

The MH-CoPES Framework was developed to support NSW inpatient and community mental health services collect feedback from consumers for service improvement. ARTD evaluated the initial two-year implementation period to assess its effectiveness from service and consumer perspectives and inform future directions. We used a staged, mixed-methods approach to data collection. The first step was an online survey of all participating mental health services in NSW. Based on the findings, we purposively selected eight services as case study sites. At these services, we interviewed service managers, staff, consumer workers and consumers to understand enablers and barriers to implementation and outcomes. We also consulted with the Statewide Implementation Group and other key stakeholders. The final report made recommendations for improving the framework and its implementation.  We presented the findings to the NSW Mental Health Program Council and the final report was published on the NSW Consumer Advisory Group website.

Monitoring for mental health support program

(Mental Health and Drug & Alcohol Office, 2011-13)

Monitoring for mental health support program

(Mental Health and Drug & Alcohol Office, 2011-13)

The Recovery and Resource Services program supports people with a mental illness by improving access to community social, leisure, recreational opportunities, and vocational services. ARTD designed and piloted a data collection framework and monitoring system for the program, then went on to oversee implementation of the system and provide six-monthly reporting at the individual service and statewide level. Our reporting supported ongoing management of the program.

Evaluation of perinatal depression screening in NSW

(Mental Health Kids, NSW Department of Health 2011-13)

Evaluation of perinatal depression screening in NSW

(Mental Health Kids, NSW Department of Health 2011-13)

The National Perinatal Depression Initiative 2008–13 aimed to improve the prevention and early detection of perinatal depression through screening, and to improve support for new and expectant mothers who are experiencing perinatal depression. ARTD conducted a two-year evaluation of perinatal depression screening in NSW to identify the factors that contribute to successful implementation of screening for depression and psychosocial risk among pregnant women and new mothers. The evaluation assessed the extent to which perinatal depression screening has been implemented in NSW Maternity Units and Child and Family Health Services. The focus of the assessment was: use of the Edinburgh Depression Scale (EDS) and SAFE START psychosocial assessment questions; taking a multidisciplinary approach to supporting women identified as at risk; implementation of Multidisciplinary Case Discussion meetings; and coordinated care planning and follow-up to support vulnerable women.  We conducted an online survey of antenatal and child and family health teams implementing the screening across NSW, site visits to 16 antenatal and child and family health services, and interviews with key stakeholders and service providers. The findings were disseminated to stakeholders and used to review guidelines for screening for depression and psychosocial risk in NSW.

Evaluation of online crisis support trial

(Lifeline Australia, 2011)

Evaluation of online crisis support trial

(Lifeline Australia, 2011)

The Online Crisis Support Chat sought to replicate Lifeline’s 13 11 14 telephone crisis support service in an online environment. ARTD evaluated the processes and effectiveness of the trial using a mixed-methods design. We interviewed and held focus groups with mangers and volunteer counselling staff at the three trial sites and analysed post-training survey data to understand their perceptions about processes and the new model. We analysed administrative data on wait times, chat times and changes in mood for those receiving the service, and quantitative and qualitative data from a follow-up survey of people who made contact with the service. We selected a random sample of 100 chat transcripts to assess the extent to which chats followed Lifeline’s practice model. Our report assessed the recruitment, training and supervision processes for counsellors, the reach of the online service and the extent to which it was able to meet demand, fidelity of implementation, and user satisfaction. 

 

Monitoring for housing and support initiative for people with mental health conditions

(NSW Ministry of Health, 2006-11)

Monitoring for housing and support initiative for people with mental health conditions

(NSW Ministry of Health, 2006-11)

ARTD Consultants was engaged to develop an Evaluation Framework for the Housing and Accommodation Support Initiative; a program providing people with mental health conditions in NSW access to stable housing, clinical mental health services and accommodation support. Based on the Framework, ARTD was engaged in 2006 to develop and pilot a performance monitoring system for the program, which involved collecting systematic data on all clients from all service providers. Following the pilot, ARTD continued to analyse and produce quarterly data reports for the Ministry, Area Health Service and funded services. Program managers used the reports to monitor the program and Area Health Services used them for milestone reporting. In 2011, ARTD partnered with the Social Policy and Research Centre of University of NSW to evaluate the program.

Between 2009 and 2010, we worked to develop the capacity of the Ministry to take over the monitoring of the system. We consulted with service providers about their capacity to capture and process program data, interviewed a purposive sample of service system users and IT system specialists, and then developed and piloted electronic data capture tools. The project developed options for the future development of the HASI monitoring and reporting system.

Dementia risk reduction pilot projects

(NSW Ministry of Health, 2011)

Dementia risk reduction pilot projects

(NSW Ministry of Health, 2011)

The Dementia Risk Reduction Awareness Campaign project and the General Practitioner Dementia Risk Reduction Education project were two complementary pilot projects delivered in the Illawarra and Shoalhaven regions. They aimed to increase awareness of the link between hypertension and dementia and encourage regular heart rate checks and actions to avoid or reduce the risk of hypertension. ARTD was engaged to work with staff to strengthen the planned internal evaluation of the two pilots and identify how the processes or data collection could be linked. We reviewed documentation and drafted a logic model for each project. We then conducted a workshop with staff from both pilots to refine the logic models, and identify common objectives, potential data collection methods, and risks and mitigation strategies. Our report provided guidance for the internal evaluations and identified potential elements of an external evaluation that would be required to determine the value in rolling out the pilots more widely.

Evaluation of Lifeline national telephone crisis support service

(Lifeline Australia, 2010)

Evaluation of Lifeline national telephone crisis support service

(Lifeline Australia, 2010)

Lifeline’s 24-hour crisis telephone counselling service (through 13 11 14,) aims to make short-term crisis support and suicide intervention more accessible to people across Australia. In 2007, Lifeline received funding to expand and enhance its telephone counselling service through the Coalition of Australian Government’s Mental Health Project. ARTD conducted a retrospective evaluation of the expansion, primarily using existing Lifeline data on delivery of telephone support, training and accreditation. The project began with the development of a performance framework for the crisis support service. We then compiled and analysed key service data sets to provide a basis for benchmarking and service improvement. We produced an evaluation report which Lifeline presented to the Department as part of meeting accountability requirements for national funding.

Analysis of interviews with Aboriginal women with drug and alcohol and mental health problems

(Drug Health Services RPAH, 2010)

Analysis of interviews with Aboriginal women with drug and alcohol and mental health problems

(Drug Health Services RPAH, 2010)

The South Coast Medical Service Aboriginal Corporation conducted interviews with Aboriginal women living in the south and far south coast of NSW who had both drug and alcohol and mental health problems (n=30), the women’s families (n=15), and service providers (n=15). ARTD was commissioned by the University of Sydney to analyse the transcripts from these interviews. We developed a coding framework and used qualitative analysis software to code interviews for thematic analysis. We provided a detailed report of themes, including the women and their families’ experiences with co-morbidity services and suggestions for improving these, and services’ experiences working with women with drug and alcohol and mental health problems. The report was to inform and improve service delivery in the area.