Western Victoria PHN Winter Symposium 2018 …...ABS, September, 2017 5 0 100 200 300 400 500 600...
Transcript of Western Victoria PHN Winter Symposium 2018 …...ABS, September, 2017 5 0 100 200 300 400 500 600...
Western Victoria PHN Winter Symposium 2018Geelong
June 2018
“The fact that people with serious mental illness die an average of
20 years earlier than the rest of the population, the majority from preventable causes,
is one of the biggest health scandals of our time, yet it is very rarely talked about.”
Professor Sue Bailey
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Risk of premature death
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People with a psychoticdisorder
People with a mental illness
General population
Relative risk of early deathABS, September, 2017
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General Population
Mental Illness
MI and disadvantage
MI and rural
MI and male
MI and not in workforce
Percentage with physical illness
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Cancer Diabetes CardiovascularDisease
Asthma
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People with no mental health condition All people with mental health conditions
People with a psychotic disorder
Number of deaths in a 13 month period(ABS, Table 12, 2017)
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Heart failure
Dementia, including Alzheimer's disease
Diseases of the urinary system
Prostate cancer
Transport accidents
Cirrhosis and other diseases of liver
Diabetes
Cerebrovascular diseases
Blood and lymph cancer
Breast cancer
Intentional self-harm
Chronic lower respiratory diseases
Colon, sigmoid, rectum and anus cancer
Trachea, bronchus and lung cancer
Ischaemic heart diseases
Mental Health Gen pop'n
Relative risk of early death, by disease type(Percentage, ABS, Table 12, 2017)
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Percentage of total population who accessed
mental health mbs and/or pbs
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Transport accidents
Ischaemic heart diseases
Cerebrovascular diseases
Heart failure
Cirrhosis and other diseases of liver
Dementia, including Alzheimer's…
Blood and lymph cancer
Colon, sigmoid, rectum and anus…
Diseases of the urinary system
Intentional self-harm
Diabetes
Trachea, bronchus and lung cancer
Breast cancer
Prostate cancer
Chronic lower respiratory diseases
Mental Health Gen pop'n
Procedures, hospitalisations and death rates
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0 0.5 1 1.5 2 2.5 3
Schizophrenia
Affective Psychosis
Other psychosis
Personality disorders
Depression
Gen Population
Procedures Hospitalisation Death
Comorbidities
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• 80% of people living with a mental illness have a chronic physical illness (ABS,2017)
• 55% have two or more co-existing conditions(AIHW, 2017)
• 20% of people with a physical illness have a co-existing mental illness (ABS, 2015)
•Total cost $15 Billion pa
•1 % of GDP
• Interactions increases cost by 45%
(RANZCP, 2016)
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Poorer physical health costs
What is the gap in life expectancy?-that depends…
• Those with any contact with state mental health services 12 years for women,16 years for men (Lawrence et al., 2013)
• Schizophrenia 28.5 years (Suetani et al., 2015)
• Severe mental illness clients of UK mhs, 14 years (Chang et al., 2011)
• US between 13 and 30 years (depending on state) (Colton and maderschieid, 2006)
• Int’l: 15 years for women, 20 years for men (Thornicroft, 2013)
• Lawrence, review of 3500 studies – all found excess mortality (Lawrence et al., 2015)
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THE NATIONAL ALLIANCE FOR
RURAL AND REMOTE
MENTAL HEALTH
0 5000 10000 15000 20000 25000 30000
GPs
MH Nurses
Psychologists
Psychiatrists
Pharmacists
Ots
State Private Other
HWA, 2014
There are a lot of professions…and a lot of employers
Stepped Care:There are a lots of types of care provided
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A health system… or a health miasma?
There are a lot of lifestyle risks
•Smoking
•Antipsychotic medications
•Lack of exercise
•Poor diet
•Drugs and alcohol
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There are a lot of system challenges
•Diagnostic overshadowing
•Poor access
•Medication effects
•Inadequate screening and intervention
•Service coordination
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WE are here
Stakeholder interviews
Grey Literature
Review
Published literature Review
Draft
Workshop Materials
Consensus Building Workshop
AdditionalStakeholder interviews
Grey Literature
ReviewCont.Broad Consultation
Draft
Background Paper
DraftConsensusStatement
FinalConsensus
Statement and Background Paper
Endorsement by OrganisationsMental Health Drug and Alcohol
Principal Committee
EWIC
ExpertAdvisory
Group
Implementationand
collaboration
Building on a strong base
• 6 focused reports (Australian)
• 10 state and territory mental health plans
• 6 national mental health plans
• 7 Australian consensus statements
• 41 state and territories mental health/physical health clinical guidelines and related policy documents
• 8 international ph-mh statements/plans/platforms
• 125 reviews, reports, research papers.
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Working in partnership
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COMPARISON RATINGS OF 80 CONSENSUS ITEMS FOR 8 WORKSHOP GROUPINGS AND TOTAL SAMPLE N=54
Av Total sample Psychiatrist -clinician (3) Service Provider (10) National Organisation (7) Other - misc (4)
Academic Researcher (3) Professional Colleges (8) State Terrritory MH (11) Carer -Consumer (8)
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The launch of the national consensus statement
The essential elements
• A holistic, person centred approach
• Promotion, prevention and early intervention
• Equity of access
• Improved quality of health care
• Better care coordination
• Monitoring and targets
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Implementation Group
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Members
Elida Meadows, Co-Chair National Mental Health Consumer & Carer Forum
Russell Roberts, Co-Chair Charles Sturt University
Alexis Mohay Australian Government, Department of Health
Arthur Papakotsias Neami National
Carol Turnbull Ramsay Health Care, South Australia
Cate Howell Royal Australian College of General Practitioners
Grant Sara Mental Health Information Strategy Standing Committee
Janine Mohamed Congress of Aboriginal and Torres Strait Islander Nurses and Midwives
John Allan Queensland Government, Department of Health
Josh Fear Mental Health Australia
Kim Ryan Australian College of Mental Health Nurses
Libby Dunstan Brisbane North Primary Health Network
Malcolm Hopwood Royal Australian and New Zealand College of Psychiatrists
Murray Wright Safety and Quality Partnership Standing Committee
Peggy Brown National Mental Health Commission
Richard Weston Healing Foundation
EW
Resources Initiatives
Issue
Promote
Awareness
•Stakeholder database
•Coms strategy
•Website
•Digital communications
•Newsletters
•Symposium
Facilitate Collaboration
•Audit of activities
•ID commonalities
•Website
•Newsletters
•Social media
•Symposium
Resources
•Build resource repository
•Draw on audit tool
•Identify gaps
•Support resource development
Measure Progress
•Audit tool. Test-retest
•MHISSC data/targets
•ABS monitoring
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NMHCCFMHISSC
MHPC
SQPSC
Constellation model of collective impact
Implementation coordination
• Mobilising commitment • 70+ national, state and local organisations have pledged support so far
• Collating commitments • National audit of current initiatives and those planned
• Identifying best practice across Australia• Facilitating collaboration and cooperation
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Implementation coordination(continued)
• Locating, identifying and sharing the best resources for• Consumers• Carers• Clinicians• Service planners, quality and innovation managers
• Developing new resources and tools
• Showcasing best practice and innovation• National and international
• Tracking progress
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1) A common agenda
2) Shared measurement systems
3) Mutually reinforcing activities
4) Continuous communication
5) A backbone support organisation
Current policy directions
• National Consensus Statement
• The Fifth National Mental Health and Suicide Prevention Plan (and accountabilities)
• National Mental Health Commission Report Card
• ACSQHC – Health care standards – Health service standards
• Equally Well Implementation Committee
• ABS tracking and reporting (Sept 2017)
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For PHNs and LHNs….
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New projects
• ACSQHC – Health care standards – Health service standards
• Consumer and carer resource –Co-designed-broadly endorsed
• Mental Health Service Standards
• Revision of the GP redbook
• Developing national indices and national targets(Eg half the number of early deaths due to respiratory disease)
• Ongoing ABS tracking and reporting (Sept 2017)
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What can you do on Monday?Don’t just screen… intervene
• Check, screen…• Complete physical examination in last 12 months?
• Medication review – type, dose, polypharmacy?
• Smoking? Offer support and advice to help
• Community participation?
• Have a recovery focus…
• Arrange: Collaborate, initiate, advocate, expectorate!
• Join us!
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https://equallywell.org.au/
“Contact us” - Get involved!
Sign [email protected]
Commit [email protected]
Get updates/newslettershttps://equallywell.org.au/
Put the link on your webpagehttps://equallywell.org.au/
Share your innovation and evidence