Early Psychosis work in AustraliaService and workforce developmentHeather StavelyNational Program ManagerSkills and Knowledge Division

Heather.Stavely@orygen.org.auwww.orgygen.org.au/Skills-Knowledge

Orygen The National Centre of Excellence in Youth Mental Health

• Workshops

• Online modules

• webinars

Training

• Grad Cert

• Diploma

• Master degree

Award programs

• Service development

• Implementation and start-up

Consulting

• Research bulletins

• Practice points

• Online learning

Campus

• International linkages

• Interest groups

• Conferences

Networking

Skills and Knowledge division

S&K manages Orygen’s workforce training and service development offerings

orygen.org.au/Skills-Knowledge

History……

“An air of desolation more calculated to fix than remove”

EPPIC Model – core functions

Objective

Enable young person to maintain / regain social, academic and career trajectory during critical period of first 2 – 5 years following onset of psychotic illness

EPPIC Model – core components

Linkages for YMH and EP

National approach – headspace centres across Australia

Some headwinds for Early Psychosis programs

EPPIC National Support Program (ENSP)

Core Functions of ENSP:

o Technical and expert advice, assistance to Australian federal government

o Technical and expert advice to headspace national office (hNO) and headspace sites for implementing and scaling up and model fidelity

o Service development consultancy to hNO and headspace Youth Early Psychosis Program (hYEPP)

o Wide ranging workforce development strategies and advice

What would you do?

If you were asked to roll out something

similar in New Zealand how would you approach:

Service development

o What would be the key service development issues?

o How closely do you think you could / should emulate the EPPIC 16 core components?

Workforce development

o What additional or different skillsets would your workforce need?

o How would you equip the workforce with these skills?

Service Development

Service Development Implementing the EPPIC Model and overcoming challenges

• Building a youth-centric optimistic service

• Supporting youth engagement

Being youth friendly

• Relationship building with other services

• staff specifically assigned to liaise with other services

Building service networks

• Avoiding a clinic-centric care model

• Promoting a culture of working with YP at home

Offering home-based care

• Young people and families have access to comprehensive range of interventionsComprehensive

• Appropriate and timely

• Responsive clinical pathwaysEase of access

RESOURCE

Implementing the EPPIC ModelSuccess enablers

Service Development Organisational issues

Service Development Implementation

Caseload capping

Service Development Modelling tool

1. Workforce development

2. Workforce planning

3. Evidence-based core competencies

4. Staffing profile / skillset

5. Registration and practice standards

6. Position descriptions

7. Orientation, mentoring, supervision

8. Peer support

9. Education and training

Service Development Workforce development guide

Service Development Service development model - steps

Service Development headspace clinical pathway - 1

Service Development headspace clinical pathway - 2

headspace Youth Early Psychosis Program (hYEPP) centre headspace centre

Service Development headspace hYEPP sites

o Strong collaborative implementation committee

o Understand contextual issues- state government/local

o High priority –workshop/model briefing/fidelity

o One Lead agency and parity of workforce with State

o Change management/Integration in primary setting

o Pick up referrals ASAP (MATT team)

Service Development Learnings

Service Development Fidelity

Service Development Consulting and site visit activity

Workforce Development

Workforce Development Key domains

o How to best deliver content and congruency with evidence

o Flexibility and responsiveness to local sites

o Best range training options (to embed knowledge and skills)

o Nature of workforce (multi-disciplinary/level/learning style)

o Different levels of knowledge in workforce (prior/current)

o Core topics

Workforce Development Key issues

o Focus on local context and particular workforce needs and characteristics

o Specialist roles (family work, peer support)

o Complex and large scale

o Workforce of between 350 - 400

Workforce Development Translation

Used a multifaceted approach (blended learning) of:

o Direct face to face workshops

o Written resources (manuals/CPP’s)

o A Learning Management System (LMS)

o Online interactive modules

o Community of Practice

o Webinars

o Resource Library

o E-newsletter

Workforce Development Training framework

Manuals Clinical Practice Points

Workforce Development published learning resources

Workforce Development Learning Management System (LMS)

Reports on individual and each site:

o Access

o Time spent

o Completed

o Certificate (CPD points)

o Knowledge gain

Workforce Development LMS activity reports

Five core packages with adaptation to local site needs

Orientation Package 1 Package 2 Package 3 Package 4

Introduction to

Early Psychosis

and the EPPIC

model

(philosophy, youth

friendly principles,

core components)

Assessment

CAARMS

Home based care

Case formulation

Engagement

Introduction to CBT

UHR interventions

Family Work

CAARMS revision

Functional

recovery

Vocational

recovery

Crisis response

and risk

management

Working with

psychological

interventions

Workforce Development Face to Face onsite training

Workforce Development Reports –LMS modules

0

1

2

3

4

5

6

7

8

9

10

mod1 mod2 mod3a mod3b mod4a mod4b mod5 mod6 mod7 mod8 mod9 mod10 mod11 mod12 mod13 mod14 mod15 mod16 mod17

mea

n s

core

Knowledge test pre and post mean scores

pre post

Workforce Development Reports

ACT0%

NSW19%

Vic34%

QLD15%

SA4%

WA23%

NT5%

PARTICIPATION BY STATE AND TERRITORY

Workforce Development Reports

Social Worker26%

Occupational Therapist

15%

Psychologist29%

Non-clinical6%

Other medical 2%

Psychiatry registrar1%

Psychiatrist3%

Nurse18%

PARTICIPANT PROFESSIONS

Workforce Development Reports -face to face training

0 2 4 6 8 10 12 14 16

Competence workshop1

Competence workshop 2

Competence workshop 3

Competence workshop 4

Competence workshop 5

mean change in self-assessed competence

Workforce Development Reports –face to face training

0 2 4 6 8 10 12 14 16 18

Confidence workshop 1

Confidence workshop 2

Confidence workshop 3

Confidence workshop 4

Confidence workshop 5

mean change in self-assessed confidence

o Any WFD (or SD) strategy open to local innovative practices

o Over extended period 1yr+ provide group seminars, forums or conferences

o 1-2 days seminars at start of large group trainings (set scene)

o LMS to be the centre-point for majority of learning

Workforce Development Learnings

o Choose champion or co-facilitator at each site/Leadership

o Modules – vary length and activities

o Introduce early varied leaning modalities (webinars/CoP)

o CoP to commence at start and reinforce with site supervision

o Provide foundational set manuals then CPP’s (PDF or e-pubs)

o Do self rated knowledge quizz

Workforce Development Learnings

Workforce Development Training pedagogy

Future