Primary response
A primary care response to a mental health crisis
I am General Manager of Commissioning for Sydney North Health Network, a Primary Health Network in Northern Sydney. I take a primary care commissioning perspective on the mental health crisis and on what a practical response to that crisis might look like.
Defining the crisis
The crisis is that suicide rates continue to trend in the wrong direction. People’s experience of the public mental health system is fragmented, short-lived, and difficult to access. It is hard to get care unless you are in acute crisis, and even then, if there is an alcohol or other drug issue, you are often bounced between services. Continuity of care is not supported. There is also a lack of support in primary care to prevent people going into crisis in the first place.
A neighbourhood health hub model
In response, Sydney North health Network is spearheading a neighbourhood health hub strategy.
This targets
- Low socioeconomic communities
- Those experiencing health inequity
- First Nations communities
- Refugee populations
- LGBTQI communities.
What the model looks like in practice
This is a model developed in other jurisdictions, including the NHS. It provides a one-stop shop for health, social care, and economic support for people experiencing mental health and addiction issues, alongside other health conditions that would otherwise lead to hospital admission.
A whole-of-system collaboration
The model is developed in partnership with the non-government sector and includes general practitioners, pharmacies, allied health providers, and primary allied health staff.
It also involves engaging with local health districts across mental health, alcohol and other drugs, and aged care, as well as the Department of Communities and Justice, particularly in relation to social housing and support for children and young people.
From prototype to scale
Sydney North Health Network is developing this model in Northern Sydney and is at the implementation stage, moving into a three-step process.
- Stage one is small teams, where we prototype, test, and learn using a minimum viable model across two sites over 12 to 18 months.
- Stage two is a team-of-teams approach, where those teams are connected and work together.
- Stage three is the full neighbourhood health hub, where we co-design, build, and sustain a facility to house these connected teams.
Reaching the third stage is expected to take three to five years.
What success looks like
Success will be seen in
- Suicide rates trending down
- Reduced demand on emergency departments for non-accidental injuries and suicide attempts
- Fewer emergency admissions to mental health units
Demand on the public system should reduce overall. There are also economic outcomes, including more people in work, reduced unemployment, and reduced homelessness.
Building the conditions for change
We are optimistic because the authorising environment is in place. There is support from the Australian Government, from the Primary Health Network, from the local health district, and from non-government organisations.
A wellbeing collaborative has been established and running for nearly a year, bringing together around 400 stakeholders, including community members, general practitioners, partners, and funders. There is also support from local politicians, alongside funding to begin the work.
It is our time to be bold if you want to get these results.
