2.The Centre Transition Process

Contents

1.Background

2.The Centre Transition Process

3.The Submission Process

4.EOI Evaluation Criteria

5.Conditions of Lodgment

6.List of Attachments

© 2016headspace National Youth Mental Health Foundation Ltd. This document is protected by copyright. All rights reserved. Apart from any use permitted under the Copyright Act 1968, no part of this document may be reproduced, copied, scanned, stored in a retrieval system, recorded or transmitted in any form or by any means without the prior written consent of headspace.

1.Background

1.1Our Business

headspace centres are currently fundedin 95 locations across Australia, with the initial 10 centres being established in 2006. These centres employ a range of youth-friendly health professionals who provide general health, mental health, education and employment, and alcohol and other drugservices to 12-25 year olds. Centres also proactively promote awareness and understanding of youth mental health issues in the broader community and work to build and maintain a local network of services to effectively facilitate access to and acquisition of care for young people in need.

On 26 November 2015, the Commonwealth announced a change to thefunding arrangements for headspace centres from 1 July 2016, whereby funding will channel through Primary Health Networks (PHN) as part of their broader commissioning role in primary care. In response to this change, the commissioning of headspace centres will be conducted jointly by hNO and PHNs as appropriate and feasible. This will include identifying lead agencies for new centres to be established in 2016 (Round 8), centres that are currently led by PHNs and need to be transitioned to a new lead agency per Commonwealth directive, and in any other circumstances where a new lead agency needs to be appointed.

hNO will continue to operate and support the headspace centre network after PHNs assume contract management for headspace centres. The detail underpinning the role of hNO is currently being scoped, however will encompass an ongoing focus on raising awareness, research, evaluation and driving service innovation in youth mental health, national data collection and reporting, quality and continuous improvement, and partnering with centres to build their capacity to consistently deliver high quality care in alignment with the headspace model.

1.2What do we stand for?

headspace National Office (hNO) and the national network of headspace centres work together to build the resilience of young people and the future potential of Australia by delivering effective youth mental health services in partnership with young people, their families and their local communities.

We believe all young people are important and deserve the best care possible. Both hNO and centre staff listen to and seek to understand the needs of young people so they can help them achieve better health and wellbeing. We work with other mental health and community agencies to improve the lives of young people.We give young people a voice and continually try to influence government, key stakeholders and opinion leaders on their behalf at national, state, regional and local levels. headspace alsoacknowledges the unique place and historical context of Aboriginal and Torres Strait Islander communities within Australia and the need to ensure services are welcoming and responsive to these communities.

In providing our services we will be:

• Innovative – We have the courage to explore new ideas and take new approaches
• Collaborative – We bring the right people together to get the best result
• Inclusive – We respect and value diversity and believe everyone counts
• Passionate – We are dedicated to making a difference in the lives of young people and their families
• Responsive – We listen to community needs and deliver on expectations to achieve great results

1.3Historical context for the establishment of headspace

Mental health is the single biggest health issue facing young Australians. Adolescence and young adulthood represent a critical period in the prevention and treatment of mental disorders, with 50% of mental disorders developing before the age of 14 and 75% by the age of 24.

In Australia, one in four young people aged 16-24 years of age will experience mental ill health in any given year. Despite their high levels of need, young people with mental health issues typically do not seek help and fail to gain access to care. Currently only one in four young people experiencing mental health problems actually receive professional help. Even when young people do access services, they often disengage before completing their treatment. Detecting and treating mental illness early is critical to preventing these problems from becoming more serious later in life.

Why don’t young people seek help?

Young people are reluctant to seek help and stay engaged in mental health treatment for a range of reasons, including:

•A lack of awareness and understanding of mental illness

•Stigma associated with mental illness

•A lack of age-appropriate, youth friendly mental health services

•Concerns about confidentiality and embarrassment in disclosing health concerns

•Doubts about the effectiveness of the treatment available

•A lack of affordable services and inadequate transportation to service locations

The gap in the current system

Compounding these negative help-seeking behaviours, mental health systems are not typically resourced to work with young people who have mild to moderate mental health issues like depression and anxiety. It is instead focused on treating children or adults with diagnosed, complex mental health problems.

Young people with emerging mild to moderate mental health issues have difficulty finding timely treatment and receiving a service that can respond to their needs. Where support is available, young people rarely receive holistic services even though mental health problems often coexist with other physical, social and emotional problems.

The need for a new approach

Given this combination of young people’s reluctance to seek help and the inadequacy of available services, it is not surprising that young people’s access and engagement with traditional mental health services is poor.

Getting help for young people early is important to help prevent mental health issues from becoming more serious and longer lasting. Developing services which are responsive and able to offer early treatment is essential along with raising the awareness of young people, their family and friends, on where to go to seek help.

All of these factors highlight that a new stream of youth mental health care is needed to tackle the issues which stand in the way of young people’s access to appropriate health services.

Responding to the identified need

headspace has been shown to have had a significant impact on facilitating earlier help-seeking amongst the 12-25 year group. Ongoing program evaluation confirms that the program is achieving on its objective of providing a highly accessible mental health program for Australia’s young people.

The service components of the headspace model are designed to respond to the factors that contribute to the problem of high need for and low access to mental health services by young people. The table below provides a summary of the challenges associated with addressing these major concerns along with the strategies that headspace is implementing to overcome these hurdles.

• Mental health and related substance use disorders are responsible for a major component of Australia’s burden of disease.
• The incidence and prevalence of these disorders is highest in adolescence and young adulthood.
• Comorbidity is very common – many young people experience multiple simultaneous difficulties, especially co-occurring mental health and substance use disorders.
• Promoting early identification, evidence-based treatment and increased treatment options among this age group will contribute to a significant reduction in the current and future burden of disease.

• Young people (and their supporters; friends, families and carers) do not always recognise and/or seek help for these problems.
• Even when young people seek help, access to appropriate services may be limited or the services are experienced as not being “youth friendly.”
• Service providers are not always able to correctly identify or manage these disorders early or effectively.
• The transition from young person to young adult is often difficult to negotiate for many service providers, hence those aged 18 to 25 often miss out or have limited access to services.
• A comprehensive, multidisciplinary, team-based approach to treatment is often required yet is not readily available.
• A lack of coordination and integration of existing services (especially drug and alcohol and mental health services) is a significant problem.

• establishing an evidence base about interventions that can assist with different stages and types of mental illness and substance use;
• community awareness initiatives which increase early help-seeking through assisting people to understand and recognise these problems and feel more comfortable, confident and capable of seeking help;
• education and training strategies that improve recognition, early diagnosis and better treatment of these problems by health service providers; and
• service system reforms which promote access to evidence-based interventions delivered by primary care and specialist providers working together within a unified, accessible and integrated service framework that ensures better coordination of service delivery.

• advocacy for and a focus on addressing youth mental health issues;
• resources and expertise in the areas of community awareness and service provider education;
• funding for service system reform to communities that demonstrate their capacity to improve mental health and substance use service delivery through better integration and coordination of service delivery, and effective partnerships involving a range of primary care and specialist service providers and related support services; and
• information and resources for the establishment of headspace centres, including information on evidenced-based practice for youth mental health.
• All funding recipients are expected to meet funding requirements and work towards a specific set of regional and national outcomes.

• An evaluation process will occur that will require the continuous collection and provision of data and other information by funded services.
• There will also be other strategies provided to services to assist them with implementing locally based evaluation activities.

1.4Using the headspace Model – headspace centres

headspace was created in response to calls from experts in the mental health sector for a new approach to service delivery. In 2005, the Australian Government allocated funding for a new nation-wide youth mental health service and then established and launched headspaceaccordingly in 2006.

headspaceis designed to improve the mental, social and emotional wellbeing of young people in Australia. The national network of headspacecentres provide a holistic, youth friendly, primary mental health service for young people aged between 12-25 and are delivered in a “one stop shop.” The headspacecentre model has an early intervention orientation and comprises four core service streams: mental health, physical / sexual health, drug and alcohol and educational / vocational services.headspace centres operate with a “no wrong door approach,” making services accessible to all young people in need. Each local headspace centre is led by a lead agency and advised by a Consortium which is made up of a diverse range of local youth service providers that collaborate with the centre on the integrated delivery of care for young people.

The objectives of headspace, as outlined by the Department of Health, are to:

•Promote early help seeking by young people 12-25 years old

•Contribute to an increase in the mental health literacy of young people

•Facilitate access to best practice treatment for young people with mental health problems, including those with associated drug and alcohol problems

•Enable better access to allied health services for young people

•Support local, integrated approaches to meeting the needs of young people, particularly those with co-morbid mental health and drug and alcohol problems

•Build the skills and confidence of general practitioners and other key providers of care and support in the community, in order to provide effective and appropriate mental health services to young people

While each headspace centre is unique and designed to meet the specific needs of its local community, all centres are underpinned by the following principles:

Accessible:At headspace centres, accessibility is a function of community awareness raising, engagement and open intake policies and procedures. The aim is to increase help-seeking behaviour, health literacy, awareness of headspaceas a place to obtain help, formation of strategic partnerships, service networks and reliable referral pathways between local service providers for seamless, rapid and optimal use of local resources.

Acceptable: acceptability is a function of youth-friendly environmental design, organisational culture, fully integrated youth participation and family inclusive practices in every aspect of service design, delivery and evaluation.

Appropriate: appropriateness is a function of the primary healthcare platform providing early interventions across fully integrated service streams to address young people’s mental health, physical health, sexual health, AOD and vocational needs.

Sustainable:sustainability is a function of headspace-specificworkforce, unique ICT systems, hybrid funding models, and adaptive governance structures tailored to local context within a strong national network of headspace service providers.

hNO provides centres with the resources, training and ongoing technical support to ensure the successful implement of the headspace model across the network. Centres are also assessed annually by hNO through use of the headspace Centre Functional Assessment, which evaluates their functioning and fidelity to the headspace model, identifies strengths as well as areas that require improvement, and drives continuous improvement in the delivery of care across the national network.

1.5What headspace centres do

headspace centres are unique in their orientation, the range of services they provide, and the youth-friendly environment in which they deliver care to young people in need. Their brief is ambitious and data collected at centres across the country proves the effectiveness of the headspace model and the novel approach centres implement in the delivery of care to young people. Specifically, headspace centres are tasked to:

• Bridge the gaps between primary care and specialist care, and the gaps between Federal and State/Territory initiatives.They reorient and maximise their use of existing resources, ensuring that new service developments link closely with existing programs and strategies funded by Federal and State/Territory governments;
• Plan and oversee the delivery of community awareness campaigns to their local constituency in order to enhance the help-seeking behaviour of young people and the capacity of local service providers and others to identify early any emerging mental health concerns and respond appropriately;
• Create specialist, youth and carer friendly spaces that ensure that young peoples’ needs are met with a coordinated and integrated response. One option to enhance service integration may be through visiting arrangements of mental health, drug and alcohol, primary care and education, training and employment and other providers to form a specialist youth-focused service under a centralised management and clinical governance framework. However, it is expected that headspace centres will employ a range of strategies to ensure effective case coordination depending on local needs and priorities. These will include a common client management system, multidisciplinary case conferencing and a clearly defined case management model;
• Develop cost-effective and sustainable models of service delivery for young people with mental health and related substance use disorders. Accordingly, these youth services will draw on funding streams such as the Medicare Benefits Schedule items for GPs, allied mental health professionals and psychiatrists introduced on 1 November 2006 under the Better Access to Psychiatrists, psychologists and general practitioners through the Medicare Benefits Schedule initiative and the access to psychological services available under the Better Outcomes in Mental Health Care Program to provide assistance to increased numbers of young people;
• Promote training and professional development opportunities among providers at the centre. Each headspace centre plans and implements local orientation, training and education programs to support the use of evidence-based treatments at the centre. Trainings provided by hNO are included in the routine offerings for centre staff;
• Participate innationalheadspace evaluation projects and support local research initiatives so that all centres are able to learn from and support each other; and
• Establish a clear process for engaging young people, families and carers in the planning, development and review of both their community awareness campaign and their headspace service platform.

1.6Key elements for a successful headspace centre model

Successful headspace centre have demonstrated the following key elements:

• The development of a youth-specific service response which, in most cases, involves utilisation of resources from existing services to create a new youth service network and platform which addresses identified unmet needs in the local community;

• Strategies for the provision of accessible, youth-friendly services, which take into account cost, privacy, appointment scheduling and physical environment, as well as the attitudes and behaviours of all staff. This implies, wherever possible, a focal physical location or platform which promotes access and engagement and that is open for service delivery during times that are convenient for young people and their families, i.e., evenings and weekends. Ideally, centres also establish a community platform for awareness building and local continuing professional education. Capacity to provide outreach services is also a consideration;

• Increasing the capacity of service delivery, where practicable, through the engagement of private practitioners, including GPs and allied health providers that are eligible to claim for services provided under MBS. Some also include additional state funds available for service delivery through the headspace platform;

• Integration of services. This involves an adjustment of age ranges for service access, the introduction of shared care support systems, and visiting arrangements with providers of primary care, drug and alcohol, specialist mental health, vocational assistance and other service providers, centralised clinical management structures and/or other system changes that support integrated and coordinated care;

• Strategies for establishing the early identification, engagement, assessment and treatment of young people aged 12-25, and support to their families/carers. This typically involves community awareness strategies, service provider education and training, a common intake and assessment process, and working with schools and other first-to-know agencies to increase their capacity for early identification and referral. Consideration is also given to addressing the needs of particular population groups relevant to the region, i.e.,Aboriginal and Torres Strait Islander young people and young people from culturally and linguistically diverse backgrounds;

• Comprehensive assessment and short-to-medium term multidisciplinary intervention which aims to progressively link young people into appropriate longer-term care arrangements (if necessary) in a planned and coordinated manner;

• Coordinated care, which includes centralised case management, multi-disciplinary case discussions, group supervision, and the use of a common client management tool;

• Strategies for promoting social recovery, in addition to symptomatic recovery. This includes engaging providers to assist with identifying and accessing education, training and employment opportunities, establishment of accommodation options and identification of other opportunities for connection with their community;

• Provision of support and training opportunities for the specialist mental health and drug and alcohol workforce, general practitioners and other primary care workers, school counsellors, youth workers and others;

• Involvement of young people and their families/carers in the development of service models and their ongoing review;

• Rigorous financial management practices that ensure the funding provided for headspace is spent appropriately and acquitted correctly; and,

• A budget that demonstrates value for money.

1.7Primary Health Care & headspace

headspace is a public health initiative with a strong early intervention focus. It draws on not-for-profit NGO, public sector and private sector inputs. The headspace model is based on the assumption that new and existing resources need to be directed to young people and arranged in a manner that creates an easy-to-use service that works in an integrated way to meet the needs of young people who have developed a disruption of their physical, emotional and/or social wellbeing.