Abstracts for concurrent sessions Conference day two · Abstracts for concurrent sessions...

Abstracts for concurrent sessions Conference day two

Friday 13 November 2015

Concurrent session three 9.25am – 11.50am Stream one – Training

Innovations to improve outcomes collection and utility.

Presenter and author:

Helene Stols, Bay of Plenty DHB, Tauranga, New Zealand. [email protected]

This presentation will reflect on a variety of strategies within a whole of systems manner that were applied in one DHB in NZ over the past 5 years to improve and maintain outcomes data collection compliance and to promote outcomes measurements utility. The multimodal approach included software system improvements; rationalisation of training and training packages, monitoring and feedback about team and DHB performance and using outcomes measurements in project initiatives such as transferring of consumers on Clozapine treatment to the primary sector and inclusion of outcomes measurement in a DHB/NGO Shared Support Plans Project. It is anticipated to energise and inspire the audience to think about options to improve outcomes measurement collection compliance, training options and clinical utility of outcomes measurement in partnerships with consumers and other health care providers.

Developing an e-learning outcomes refresher training.

Presenter and author: Mark Smith, Te Pou o Te Whakaaro Nui, Hamilton, New Zealand. [email protected]

This paper will provide an overview of an e-learning refresher module which Te Pou have developed. The presentation will have a demonstration of how the module works in practice. The module has two audiences: one is for trainers of outcome measures the other is all clinicians working in mental health services in NZ.

Currently refresher training for clinicians lacks consistency across the country. This training will provide a standardized approach which will improve national consistency. The module will also have evaluation built in and we will share how it has been received so far and whether it is achieving the original objectives of the project.

Training 21st Century therapists: The use of feedback informed treatment (PCOMS) within an international student population setting.

Presenter and author: Steve Taylor, National Tertiary Education Consortium (NTEC), Auckland, New Zealand. [email protected]

‘The world’ is an apt description for the 2500-strong international student population that attends the National Tertiary Education Consortium (NTEC), a 4 campus, 5 Faculty private training education provider located in Auckland, Hastings, Tauranga and Christchurch. In May 2014, under the guidance and management of the Head of Faculty (Counselling & Family Therapy), NTEC launched the International Student Counselling Centre (ISCC) in response to the growing need for pastoral and Counselling support for the international student population at NTEC in Auckland. This service

mailto:[email protected]



was quickly networked with satellite campuses around New Zealand via Skype. The primary service client and outcome measure for the ISCC is Feedback-Informed Treatment, via the use of the Outcome Rating Scale (ORS), the Session Rating Scale, and the ASIST Outcome Measurement Tool. An interim review of client service outcomes, client drop-out rates, and comparative therapist performance was conducted in November 2014 - and what was revealed via the use of Feedback Informed Treatment methodology within a multi-cultural, international adult student population is the key theme of this presentation, and will include the challenges faced within this cutting-edge industry initiative.

Stream two - Co-existing problems

Lack of data about people who have co-existing problems: Let’s discuss problems, consequences and solutions?

Presenters and authors:

Ashley Koning, Matua Raḵi, Wellington, New Zealand. [email protected].

Suzette Poole, Te Pou o Te Whakaaro Nui, Hamilton, New Zealand. [email protected]

The Ministry of Health (2010) estimated that tangata whai ora with co-existing mental health and addiction problems (CEP) accounted for about a third to half of the people accessing mental health services, and a half to two-thirds of the people accessing addiction services (Ministry of Health 2010). However recorded diagnosis rates do not reflect these estimates. Having information about the complexity of the diagnoses that people have who access mental health and or addiction services is vital to designing a responsive model of care, with services that have the right skill mix and developing a workforce capable of responding to people with CEP. This presentation will outline information about the prevalence of mental health and addiction problems gleaned from the literature. Known barriers to recording diagnostic data will be discussed. Some possible consequences of lack of accurate prevalence rates of CEP will be suggested and a discussion on improving the collection and use of information will be opened up. Results from this discussion will assist in informing the CEP joint workforce programme of work.

Mental health information and dual diagnosis.


John Dillon, Queensland Health, Townsville, Australia. [email protected]

The capturing of substance use on scale 3 of the Health of the Nation Outcomes Scale (Problem drinking or drug taking) was investigated with comparisons across both settings and jurisdictions as well as the likelihood of clinical significance translating into an accompanying F10-F19 diagnosis (Mental and behavioural disorders due to psychoactive substance use). In North Queensland, the matching of HoNOS 3 ratings with either a primary or secondary diagnosis has been monitored over 5 years. Specialist clinicians have undertaken initiatives to educate and support both staff and consumers in the identification and treatment of co-morbid mental health and substance use issues. Over this period there is evidence of an improvement in the overall recording of secondary diagnoses to reflect case complexity and particularly those related to substance use. This incremental change has been relatively slow but the improvement has been sustained over consecutive quarters.




There remains a need to develop further strategies that enhance both the quality of ratings on scale 3 of the HoNOS and the associated diagnoses that reflect the issues that consumers present with. Progress continues with a specific program in an inpatient unit, as well as resources for community clinicians including clinical guidelines, screening tools and a ready reckoner to assist with ICD10 diagnosis codes.

What does implementation science tell us about maximising use of outcome measures?


Simon Davies, Child and Adolescent Health Services, Department of Health and Adjunct Snr. Lecturer, Murdoch University, Perth, Australia. [email protected]

In any organisation, there are people, acts, and activities that exercise a disproportionate influence on performance. To achieve high fidelity use of outcome measures in CAMHS WA, we turned to implementation theories, models and frameworks to not only better understand what those factors are but undertake active steps to implement empirically supported practices to fill gaps, address hindrances, and leverage enablers.

Stream three - Information and recovery

Effective and meaningful: Measuring outcomes in the alcohol and drug sector using the visual ADOM-R©.

Authors:

Dr Susanna Galea, Dr Virginia Farnsworth, Dr David Newcombe

Presenter: Susanna Galea, Waitematā DHB, Auckland, New Zealand. [email protected]

Outcome measurement evaluates the effectiveness of treatment and recovery interventions through careful exploration of an individual’s journey and experience. Often organisations invest in ensuring that outcome-tool compliance targets are met but may fail to ensure that an understanding of such data reaches the clinical practice realm – that is, to have a ‘meaning’ at the point of care. This presentation discusses the importance of bridging the knowledge obtained through measurement of outcomes into patient-centred clinical practice. It describes the development, and psychometric testing of the Visual ADOM-R© which was aimed at answering the effectiveness question but also aimed at taking measurement a step further by making measurement meaningful for clients. The Visual ADOM-R© measures outcome pictorially, enhancing client and clinician engagement and making measurement a value process for client, clinician, as well as services.

This presentation with discuss the importance and value in incorporating pictorial approaches to engage clients in the process of health care outcome measurement.



Maintaining recovery at the heart of practice: The collaborative recovery model within Neami National.


Kerry Stringer, Neami National, Victoria, Australia. [email protected].

Marina Ngaha, Neami National, Victoria, Australia. [email protected]

The Collaborative Recovery Model (CRM) was developed over a number of years by the University of Wollongong and was adopted as a whole of organisational practice framework by Neami National in 2009. The model is consistent with the values of the recovery movement and meets the Australian government’s criteria for a Recovery Oriented Practice. In 2014 Neami National undertook a research project, utilising lived experience researchers to explore the implementation of the Collaborative Recovery Model (CRM). A key outcome of the research relates to consumer experiences and perspectives, with 90% of consumer feedback indicating that CRM practices are either important or very important towards supporting recovery. This presentation will share some of the complexities with translating outcome data into meaningful insights that can inform successful change management strategies as a requisite to embedding the model within the culture and practices of Neami National. I’m constantly struck by how different the atmosphere and the culture is within our organisation, and I think that is due to not just the sort of work we do in the community, but the way we do it, which is through CRM, I think it colours the way we work and it influences who we attract to the organisation in terms of recruitment of Neami Workers.

The Benevolent Society's mental health outcomes framework: developing an outcome focused approach to the way we work with consumers.

Authors:

Lucy Corrigan and Cherie Nay

Presenter: Lucy Corrigan, The Benevolent Society, Sydney Australia. [email protected]

The development of outcome frameworks is in line with a shift at The Benevolent Society to standardise outcomes, processes and practices to support consistent service delivery for consumers across the life span. It also reflects a funding shift to not only reporting service outputs (how much did we do?) but also consumer and community outcomes (is any one better off?). Ultimately the development of outcome frameworks across The Benevolent Society’s main service streams will ensure that the organisation is responding to the voices of consumers and communities by delivering services according to the best available evidence on what works. This presentation will detail the process The Benevolent Society has undertaken to develop a mental health outcomes framework for the PHaMs, Partners in Recovery and headspace programs. Key elements in its development include the establishment of clear governance structures including a Consumer Reference Group, engaging staff and consumers in the development of program logics, an extensive review of the literature, and external consultations with government, peak bodies, academics and other organisations. This process lead to the identification of six high level outcomes and associated indicators and the development of an outcomes tool which will guide ongoing service delivery and improvement processes. Critical success factors and lessons learnt throughout this process will be shared from a research, service delivery and consumer perspective.




Stream four - Outcomes integration

Integrating for outcomes.


Luke Rowe, Clinical Psychologist, Palmerston North, New Zealand. [email protected].

Since 1994 Te Tai Whenua o Heretaunga growth has occurred on an ad hoc basis resulting from responding to fragmented funding opportunities targeted at working with high needs populations. The organisation has evolved to one that collectively delivers services but operates in a number of independent divisions. Integration across services has been mainly opportunistic and informal in most cases, being more formal where contracts have obviously aligned. As a result innovation and efficiencies have been more vertical within services and divisions. The opportunities for shared innovations and broader efficiency gains across the organisation has been impacted by rigid service descriptions and policies prescribed by entities not connected to the realities of servicing our client population. Te Tai Whenua o Heretaunga has subsequently spent the last two years transforming and more intensively managing a change process to better serve the needs of whānau whilst ensuring a sustainable organisation that provides quality services and meets and exceeds standards of care. The transformation journey has utilised approaches of Lean and the Toyota Production System resulting in the deployment of a new operating management system leading to increased access rates and responsiveness, and also improved patient experience.

Outcomes and knowing more, exploring the national impact.

Authors:

George Furstenberg, Belinda Walker & Michael O’Connell

Presenter: George Furstenberg, Lakes DHB, Rotorua, New Zealand. [email protected]

Feedback-Informed Treatment (FIT) is a pan theoretical approach, for evaluating and improving the quality and effectiveness of behavioural health services. It involves routinely and formally soliciting feedback from consumers regarding the therapeutic alliance, and outcome of care, and using the resulting information to inform and tailor service delivery. Utilizing a FIT approach implies capturing data regarding a number of treatment outcome and treatment alliance variables for each clinical contact. This results in vast array of data that can be summarised and compared in innumerable configurations. Central to the Fit approach is the graphic representation of a consumer’s progress (treatment outcome) and their perception of the quality of their relationship with treatment providers. Data can however also be configured and summarized to depict individual clinicians treatment outcome trends, and makes it possible to track team and services performance. The intent of the FIT approach is to use outcomes data and alliance data to enhance the treatment relationship with consumers, which is seen as central to improving outcomes. The availability of this data potentially also results in qualitative changes in various other relationships, between individual clinicians and their teams, and teams/services and their funder. This study explores the relational implication of keeping and reviewing real time outcomes data for consumers, clinicians, and service managers/funders. This is done through briefly describing the development of a primary mental health service based on a FIT approach, and the sharing of example of meaningful consumer, clinician and service outcomes trends. An exploration of the perceived impact of improved access to real-time outcomes data on the triangular relationship between consumers, clinicians and manager is at the core of this presentation.



Whaiora online: An ‘outcomes focused post discharge’ story.

Presenters and authors: Dallas Hibbs, He Waka Tapu, Christchurch, New Zealand. [email protected]. Tanith Peterson, He Waka Tapu, Christchurch, New Zealand. [email protected]

Whaiora Online (WO) is an online platform that captures outcomes. WO focus is on the service user’s experience transitioning from treatment to supported independence to independence from the whaiora’s perspective. WO utilses much of the functionality of an online community, with the added benefit of visually tracking progress across health and wellbeing goals. WO has responded to our ‘user experience’ focus to simultaneously be:

• beautiful and functional • easy to use • monitored and moderated by a health provider and regulated by service users

At the backend of this tool we can colate the service users experience – ‘pursuit of wellness’, and ‘progress’ alongside the treatment data colated by clinicians. We know this will deliver multiple benefits to the key stakeholders as we look to better understand ‘attribution’ – what makes a difference, motivation – what is peculier to the whaiora, and responsiveness – how the support community responds to the needs of whaiora.

Stream five - Outcomes informing services

Outcomes - more than confirming what we know!


Rob Warriner, WALSH Trust, Auckland, New Zealand. [email protected]

WALSH Trust is a community organisation that since 1988 has offered a range of mental health support services in West Auckland. Beginning with a single house offering supported accommodation, WALSH Trust, through a number of contracts, now offers housing and recovery services, mobile community support, training, peer support and employment services. The chorus for outcomes represented in meaningful and relevant measures has never been louder. Since 2003, applying US philosopher Ken Wilber’s integral framework, WALSH Trust has explored a broad and holistic approach to strategic planning and the assessment of organisational outcomes. At the same time there has been a quantum leap in the sophistication and content of our digital information systems particularly due to the introduction of PRIMHD. In 2015 while we can regard ourselves as information rich, we are challenged to convert this information into knowledge and understanding that is accessible, of what is being achieved both across the organisation and in service delivery. Shifting consideration of outcomes as a discrete project to business as usual remains perhaps our greatest challenge. This presentation will describe the framework and its introduction, the impact such an approach has had on organisational culture and work practices, and the tools and measures that have been utilised. Also discussed will be some of the results (WHOQoL and LSP 16) and challenges in implementing and considering outcomes.




Making outcomes information our ‘CORE’ business.


Lucy Chang, Sydney South West Area Health Service, Sydney, Australia. [email protected].

Kevin Brown, Sydney South West Area Health Service, Sydney, Australia. [email protected]

Sydney Local Health District prides itself on adhering to its CORE values. This stands for Collaboration, Openness, Respect, and Empowerment. In this discussion we will explore the experiences of Croydon Mental Health, a community mental health service. We will look at how it was transformed and able to embrace a new model of care guided by these values. We will cover the following components of the CORE model: C- Collaboration: We engaged with NGO, Private, and Primary services to share information, work more collaboratively and achieve better outcomes for our consumers. O- Openness: We are becoming more transparent with our information sharing between clinicians, carers and consumers. This enables them to see both our achievements and gaps in the service. The sharing of performance data promotes healthy competition between clinicians. R- Respect: It is vital that our Code of Conduct is followed, everyone’s opinions are valued and we ensure professional standards are maintained. E- Empowerment: We enabled clinicians to support consumers in their personal recovery and have dignity of risk. Data has shown discharging people from community mental health services back to GP level care has decreased our re-admission rates by 7%. By up skilling our workforce and implementing efficient systems we meet the needs of our consumers. This presentation will highlight how the use of data and the implementation of robust models of care can improve community mental health services.

Testing the Bridge: Evaluation to improve programme delivery.

Authors:

Julien Gross, Tess Patterson, Emily Macleod, Richard Egan, Claire Cameron, Linda Hobbs, & Mary Davies

Presenters: Mary Davies, Bridge Programmes, The Salvation Army New Zealand, Fiji & Tonga Territory [email protected]. Julien Gross, PhD, University of Otago, Christchurch, New Zealand. [email protected]

In 2011, the University of Otago entered into a partnership with The Salvation Army New Zealand, Fiji & Tonga Territory to examine the services that The Salvation Army provides through its nationwide social programmes. The Salvation Army prioritised an evaluation of their Bridge Model of Treatment for harmful substance abuse as the starting point for the partnership. The Salvation Army wanted measures of outcomes that would reveal the strengths and the weaknesses of the programme and identify what could be improved on. The study began in November 2013 and took place over a 12-month period. We collected client data on entry to the Bridge Programme, at end of treatment, and at a 3-month follow-up period, when clients were back in





the community. We measured substance use as well as health, social and vocational functioning, quality of life, and criminality. We also examined the role of spirituality in treatment outcome. Participants who completed a therapeutic dose of treatment (n = 225) had significant reductions in substance use, and significant improvement in physical and mental health, family and social functioning, spiritual well-being, and quality of life. There was also a reduction in criminal activity and in negative consequences related to substance use. Importantly, all of these improvements were maintained at follow-up. These findings provide evidence for the effectiveness of the Bridge Model of Treatment. The presenters will discuss the evaluation and how The Salvation Army are using the recommendations that came out of the evaluation to guide them on the future direction of the Bridge Programme.

Conference day two Friday 13 November 2015

Concurrent session four 1.45pm - 3.15pm Stream one - Alcohol and Drug Outcome Measure (ADOM)

ADOM, useful at all levels. Symposia


Paul Hanton, Te Pou o Te Whakaaro Nui, Hamilton, New Zealand. [email protected]

Is the Alcohol and Drug Outcome Measure useful? Who is it useful to and does it reach new heights in the New Zealand Addiction sector in terms of being a useful tool for the trinity of service user, service practitioner and service leader? In our short symposium, open to all conference participants and particularly useful for practitioners and service managers, we aim to have a brief 360 overview of ADOM since it went live in July 2015. The intent of the tool has been to demonstrate utility at three levels; for the service user and practitioner to be able to see real time outcome information to support the treatment and recovery journey; for team leaders and managers to inform service effectiveness planning and on a national level, in time, as aggregate data for information and planning purposes. The journey from ADOM development to ADOM national use will be briefly covered; validation of the service user led recovery questions, training of the workforce and implementation of ADOM will be mentioned. Finally we hope to show that NZ leads the way in a collaborative ADOM feedback wheel that puts the service user at the heart of information as a tool to map their journey. Stream two - Outcomes and NGOs

The story so far: Changes in subjective quality of life and service use.


Sarah Andrews, Emerge Aotearoa, Auckland, New Zealand. [email protected]

Emerge Aotearoa is one of 14 NGO providers in New Zealand using the World Health Organisation Quality of Life 26 item short form scale, the WHOQOL-BREF, to assess the subjective quality of life of service users and use it to increase the effectiveness of personalised planning. At the aggregate level, WHOQOL-BREF data can also support service evaluation and development, but only if we really understand what it represents, and how we can apply the learning. This presentation shares some of that learning to date related to the aggregate changes in subjective quality of life over episodes of support. The focus is to learn about the WHOQOL-BREF facets most sensitive to change during engagement of the service user with the NGO. Ratings on satisfaction for each of the 26 facets of the WHOQOL-BREF generic scale were collected on entry and exit from people using a range of non-clinical community support services and the data compared. Findings indicate the value of analysing change at more specific facet level. We have identified some facets



that are significantly more sensitive to change than others, and found patterns of change that indicate where interventions may have the greatest potential impact on quality of life. Additionally, the interpretation of those changes from the perspectives of academics, staff and clients is considered as we build our capacity to use this information.

Outcome measurement and information use in the non-government world.

Presenter and author: Steve Catty, PACT, Dunedin, New Zealand. [email protected]

Pact is a national non-government organisation that provides long-term community-based support services across a diverse range of settings and locations throughout the country. In order to measure what difference our services make to the people we support, we developed and implemented a functional outcomes assessment tool that measures clients quality of life across eight life-domains. The tool is a structured conversation between support workers and clients that provides key information to guide support to our clients at all levels of the organisation. This presentation will detail our experience in developing and implementing the tool, how we report on outcomes to stakeholders, and how we have used the information for service evaluation and development.

Mobile technology in the mental health sector.

Presenters and authors: Chris Carter, Pathways Health Ltd, Hamilton, New Zealand. [email protected]. Dan Crozier, Pathways Health Ltd, Auckland, New Zealand. [email protected]

Background: Pathways are a large mental health and addiction NGO provider delivering services across New Zealand. Two years ago, Pathways reached a critical business juncture as a number of commissioned services moved away from FTE contract requirements to hourly based contracts with high expectations of a percentage of staff time spent in direct delivery. We had to find a more efficient means to deliver to this new requirement. Hamstrung by the high costs of mobile systems, we faced a fundamental challenge to our core business. Pathways Mobile the Genesis: This presentation will outline how using iPad minis together with novel information systems resulted in Pathways Mobile, a game-changing low-cost Activity recording system. A Pilot Flies: We will outline the development process, working closely with frontline teams to build this grass-roots information system. We explore how the pilot soared around Pathways, from two starter teams to virtually all of our mobile teams nationwide where we now have over 170 users of the mobile solution. Pathways Mobile How it Works: This showcases our innovative mobile system, with its emphasis on user-friendly technology. We illustrate how formerly tech-shy staff got up and running within half an hour. It wasn’t all plain sailing however and we detail the triumphs and pitfalls of the Pathways Mobile launch.




Stream three - Children and adolescents

Baby steps: The transformation of CAMHS in South Australia.

Presenters and authors: Tania Geyer, Central Adelaide, Local Health Network, Adelaide, Australia. [email protected]. Liz Prowse, Central Adelaide, Local Health Network, Adelaide, Australia. [email protected]

The last few years have been a challenging period for Child Adolescent Mental Health Service in South Australia. Two CAMHS services based in the north of the state and the south of the state developed with completely separately with different identities, different cultures and different practices, and in late 2012, a decision was made to merge. The two different CAMHS were asked to form one state-wide service, in a very quick process with minimal support. Highlighting the stark difference between the two services were their different histories but also their use of mental health information and information systems. This paper tracks the difficult and sometimes painful merge of the two CAMHS through their information use, including national benchmarking, outcome measurement, performance indicators and data analysis. We look at some of the various change processes including radical redesign, and the baby steps now being taken as a single state-wide CAMHS.

Outcome measurement across lifespan: Development of the Health of the Nation Outcome Scale for children and infants (HoNOSCI).

Authors:

Nick Kowalenko, Gordana Culjak, Peter Brann, CAMHIDEAP Working Group [email protected]

Presenter: Peter Brann, Eastern Health Child Youth Mental Health Service, Melbourne, Australia. [email protected]

Although there are some high quality mental health outcome measures available for routine use in the care of children, adolescents and adults, there is a gap for those aged less than 3 years. This paper investigates the availability and feasibility of measures for infants to build a suite of outcome measures for the entire lifespan.

The authors conducted a review to investigate the utility of measures for infants within the parameters of the current National Mental Health Outcomes and Classification Framework. The aim was to identify which psychometric tools can be used under which circumstances. The outcomes of this review and its recommendations were presented at outcome conferences previously. Of the psychometric tools available to date and assessed in the review, serious limitations of existing measures were noted. Therefore, it was identified that a combination of tools is needed; one recommendation was to develop the HoNOSCI.

Following initial work in New Zealand, the Australian Child Adolescent Mental Health Information Development Expert Advisory Panel, in consultation with the public mental health sector, developed a draft version of the HoNOSCA for use in routine clinical practice with 0-47 month old infants (HoNOSCI). Clinicians were given a copy of HoNOSCI and definitions for each of the 15 scales, for consistency. They were asked to use the instrument on a number of separate clinical cases and then complete a user survey consisting of both quantitative and qualitative questions. The development process and preliminary results will be presented.






The voice of young adults, their parents, partners and other folk: A young adult version for the Strengths and Difficulties Questionnaire.


Peter Brann, Eastern Health Child Youth Mental Health Service, Melbourne, Australia. [email protected]

Over the last decade, the traditional neglect of youth mental health has begun to be addressed. As well as the long term connection between young people and their family, there is a general trend for young people to stay at home longer, and for those experiencing serious mental health problems to be more connected, through the good and the bad, with their family. All Australasian mental health services engage in routine outcome measurement. But there has not been a consensus about a relevant instrument for young people and for their families. Many countries including Australia use the Strength and Difficulties Questionnaire (SDQ) with children, adolescents and their families. This paper will present the results of an adaptation of the SDQ from its adolescent versions (self and parent/carer reports) to a young adult version (self and parent/partner/friend reports). Having thrown the young adult SDQ (SDQ-YA) into routine use with all the traditional lack of support that occurs in real world services, the results for young adults and for adolescents are compared. It appears that the SDQ-YA functions similarly to the adolescent version. While the SDQ is just one contender for a useful instrument, the capacity of existing infrastructure to accommodate the SDQ removes a major barrier to having the voices of young adults and the voices of their parents, partners, and important others routinely heard in the outcome space. Stream four – Recovery

Client and family rated recovery.


Rachel Barbara-May, Alfred Child & Youth Mental health Service, Melbourne, Australia. [email protected].

Dr Paul Denborough, Alfred Child & Youth Mental health Service, Melbourne, Australia [email protected]

There is a worldwide movement to involve consumers in mental health care in order to improve the outcome and value of services. hYEPP in the southern region of Melbourne is striving to become an Outcome Informed Youth Mental Health Service by drawing on a large international evidence base that has consistently shown certain extra-therapeutic factors (such as social context) and intra-therapeutic factors (such as therapeutic relationship) are most likely to influence outcome. hYEPP has designed its services in a way that incorporates this evidence. hYEPP service delivery uses regular session-by-session measurement of outcome and therapeutic alliance to improve outcomes, reduce DNAs and dropout rates through improved therapeutic efficiency. This work focuses on the goal of producing positive change for people whilst decreasing the chances of clients getting stuck with an intervention that is of no long-term benefit. At the same time, it ensures that the consumer’s opinions and choices are always respected. This paper will discuss the integration of the use of these measures into clinical practice at hYEPP and in the single session family consultation program, and by doing so demonstrate how meaningful clinical engagement in client rated outcomes not only improves the effectiveness of services being delivered, but transforms services into recovery orientated services that are delivered in partnership with clients and families.




Swell: The online recovery toolkit in mental health and addiction.


Mary O’Hagan, O’Hagan McCook Weir, Wellington, New Zealand. [email protected]

Swell is peer-informed, whole of life service delivery integrated tool. Its aim is to help inform and structure service workers interactions with services users and provide people with lived experience easy to use activities and resources to explore, share and overcome challenges. It has the potential to be a rich source of information on people’s challenges and recovery outcomes. Mary O’Hagan and colleagues early version of Swell, for mental health service workers in English speaking countries, focuses on 60 life and health challenges that are important to clients. Swell will provide succinct information on what works in overcoming each challenge and in having a conversation about them, will include a peer recovery story for each challenge and can be read on a website or downloaded as a pdf and shared with clients. Once the content for workers has been completed developers will adapt the content and create activities for people with lived experience as well as build a mobile app with greater interactive and collaborative functionality for both workers and service users. The talk will conclude with a tour of the Swell website and a prototype of the mobile app for people with lived experience.

Social inclusion: An important indicator of recovery.

Authors:

Tim Coombs and Cheryl Reed.

Presenter: Tim Coombs, South East Sydney and Illawarra Area Health Service, Sydney, Australia. [email protected]

Social inclusion is widely recognised to be central to mental health (Wilson, 2006) and an important indicator of recovery (Slade 2009). Social exclusion can contribute to poor mental health and poor recovery from mental illness, while mental health problems can systematically promote exclusion through stigma and discrimination, loss of self-esteem and social competence. However, there is no agreed definition of social inclusion (Coombs 2012). The current paper will describe the development of a social inclusion measure that looks at employment, education, social participation, accommodation, physical health, control and the consumer’s voice. This measure has been created for use in routine clinical practice, to support the engagement and assessment process and provide useful information for reporting the performance of mental health services and the social outcomes of care. Results of field trials of the measure and its psychometric properties will be presented along with information regarding its further development.



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