Historically, mental health care in Australia has been highly medicalised, under-funded, and fragmented across settings and services. There are gaps in treatment pathways, with low-moderate needs mostly being addressed by General Practitioners (GPs), and more acute presentations and persistent mental ill-health being managed through secondary and tertiary care settings through psychiatry. The current structure of the mental health care system sees long wait times to receive care, substantial out of pocket costs, and limited to no specialist services in some regions.  The system is not adequately designed to support people with distress or mental ill-health beyond the capacity of GPs to treat, but not of sufficient severity or acuity to be seen by specialist services.

As a response to these needs, the commonwealth government has funded 8 pilot Head to Health adult mental health services to “provide a safe and welcoming space for adults, their family and friends, who may be in distress or crisis, or need help finding the right mental health services for their individual needs.” (https://beta.headtohealth.gov.au/head-to-health-services)

There was one pilot Head to Health service established in each state and territory. Of these, five are run by Neami and their partners in 5 diverse Australian communities. These are Darwin, Penrith, Townsville, Geelong and Adelaide. Service provision commenced around the end of 2021.  Currently the Head to Health Service model is expanding with new services being funded across the country, with the exception of Victoria which is developing a state-based adult mental health model as a response to the Royal Commission into Victoria’s Mental Health System.

The ALIVE National Centre has partnered with Neami National to conduct an implementation co-evaluation of the five Head to Health services they manage.

This project covers the establishment of a baseline understanding of the implementation, ongoing discussions with stakeholders on the progress of the evaluation, and an intensive three-month period of data collection from a range of stakeholders to inform the co-evaluation. This project aims to identify implementation facilitators and barriers and develop recommendations that will inform the implementation process of participating services and guide the implementation of new services using innovative models of care. The whole project will be conducted over a 12-month period.

What have we learned so far in this project?

• Innovative models of mental health care are being developed and implemented using multidisciplinary teams of clinicians and peer workers.
• Early evaluation of these programs allows the development of implementation recommendations to strengthen staffing models and service delivery; improve definitions of roles and scope of practices; add to professional development and supervision; and develop education.
• Services are in an ongoing evolution and development process to meet the needs of their communities and innovative and longer term evaluative approaches are needed to reflect this.
• With the ongoing implementation of Head to Health and Victorian Mental Health and Wellbeing hubs, there is a need to conduct wide-ranging evaluations of the services informed by co-design that can lead to iterative and ongoing improvements to the service models and care provided.

Research Team:

Matthew Lewis, Michelle Banfield, Mark Loughhead, Jennifer Bibb, Phil Orcher, Hayley Purdon, Catherine O’Donnell, Ian Muchamore, Joshua Moorhouse, Anna Lampugnani, Pippa Featherstone, Dianna Smith, Melissa Petrakis, Konstancja Densley, Elise Dettmann, Caroline Tjung, Priscilla Ennals, Emily Castagnini, Victoria J Palmer.