Service Needs analysis

needs; of the PIR clients during this period 85% were unemployed or not in the labour force and their main source of income came from pensions or government benefits. For country South Australia, PIR is only functioning in the Country North region, leaving a significant gap in the Murray Mallee, Riverland, and South East.

Identified Need Service needs across mental health, suicide prevention and alcohol and other drugs sectors Key Issue

Generally, there is a workforce shortage across the region, particularly within programs designed to minimise costs for eligible patients. Psychologists are in high demand and yet are limited particularly in rural and remote areas. Where psychologists are available, large gap payments prevent consumers from attending their services or extended waiting periods exist.

Psychological Therapy service provision rates are lower than the state average across all regions, indicating an imbalance with service provision in the metropolitan area despite equal or greater need in many rural areas. Service is not provided at all in some areas, particularly for youth. Neither Psychological Therapies nor Clinical Care Coordination services are consistently provided within all regions, despite most having some level of need, this is directly dependent on workforce availability in rural regions. Once more, where services are provided, consumers are subject to high waiting periods.

Description of Evidence

∙ Leading issue in priority matrix ∙ Recurring themes in ATAPS provider needs assessments ∙ DoH District of Workforce Shortage ∙ Drug and Alcohol Stakeholder Survey ∙ NCETA – Patterns and Prevalence & At-Risk groups AOD 2017 ∙ ATAPS referral rates ∙ CSAPHN ATAPS Provider evaluation report, 2016 ∙ Drug and Alcohol Stakeholder Survey, CSAPHN - 2016 ∙ SA Health Hospital Separations 2015-15 ∙ Estimated resident population 2014. ∙ MBS mental health providers ∙ ATAPS – DoH

Areas with high rates of hospitalisation for mental health and low service capacity need resources to minimise the risk of both ‘well’ populations and ‘at risk’ populations, from requiring higher level services through unmet lower level need. Currently clients’ needs go unmet while waiting for

Service Needs analysis

Identified Need Service needs across mental health, suicide prevention and alcohol and other drugs

sectors - continued

Key Issue

services, leading to progression in illness in most cases. Further analysis to determine if the service capacity needs to increase or is inappropriate would assist in closing this gap.

A substantial benefit for the region, is its selection as one of the National Suicide Prevention Sites. This achievement will bring considerable funding and resources into the region with the sole purpose of addressing prevention and aftercare of suicide.

Other areas in need of improvement or further analysis to improve the sector include: ∙ Range and coordination of services to better address different stages and severities of mental illness along the continuum ∙ Service appropriateness - areas with high female mental health admissions, and/or high Aboriginal and Torres

Strait Islander female mental health issues require more specific services for females and Aboriginal and Torres

Strait Islander females ∙ Lack of coordination for drug and alcohol co-morbid conditions such as mental health and suicide prevention ∙ Lack of service continuity for rural patients from acute to community care to facilitate a stepped care model ∙ A structured stepped care approach is limited and fragmented due to limited access, lengthy waiting periods and often excessive travel required for care. For residential treatment, rural patients have no option but to relocate to metro areas for treatment. see above…

Description of Evidence

Service Needs analysis

Identified Need Service needs across mental health, suicide prevention and alcohol and other drugs

sectors - continued

Key Issue

Alcohol and other drugs

Service gaps and comorbidity of mental health conditions with drug and alcohol is evident in the hospital separations for each region, correlating as high for both. Furthermore, client needs go unmet while waiting for services; ∙ Stakeholder consultation indicated extensive waiting times – clients are unlikely to be re-motivated after waiting., resulting in clients continuing to use illicit substances while they wait for a service. ∙ Extensive waiting lists indicate service capacity unable to meet need.

Aboriginal and Torres Strait Islander clients in more remote, dry zones have to travel to regional areas which aren’t dry to withdraw/sober up. Stakeholders indicate this can cause issues, particularly when clients return to their areas post rehabilitation. Clients are then lacking in follow-up and outreach back in the community.

Areas with low service capacity and/or no outreach service, require additional hours or more providers to bring waiting times down, especially in areas where there are higher rates of drug and alcohol admissions, as well as mental health admissions. see above…

Description of Evidence