One in five Australians in any given year will experience a mental health issue and almost half of the population will experience a mental health issue at some stage of their life.
In 2017, mental health disorders accounted for 9% of the total disease burden and cost the Australian community $33.6 billion in health care and lost productivity.
Mindgardens Model of Care
The Mindgardens model of care is built around an “integrated system of care” to address physical, mental health, drug and alcohol and neurological disorders concurrently. This will be achieved through Apex Clinics, community hubs, and technology services across geographical regions.
Within this overarching model of care, and subject to funding, Mindgardens will address mental health issues through a number of reforms:
The establishment of a psychosis service to provide new integrated approaches to care. The focus is on creating a service that provides holistic and comprehensive care, including the use of novel approaches for treatment resistance, the use of neurostimulation, cognitive remediation and clozapine, integrated with assertive management and monitoring of risk factors such as smoking, drug and alcohol use (with a particular focus on methamphetamine), diet modification, exercise physiology and dental care. Patient engagement will be enhanced using social prescribing and other holistic approaches, and potentially incorporating arts-based translational activities. This Apex clinic will link to clinical trials of improved therapies and investigation of immune related biomarkers to offer a unified approach to psychosis management and will comprise the most up to date service of its kind for patients in Australia.
The expansion of depression services to assess, treat and develop novel treatments for the ‘missing middle’ – the large number of people with chronic depression and associated co-morbidities (including drug and alcohol) who require more complex care than a GP can provide, but do not require inpatient treatment. The Apex clinic will link strongly with general practice and Integrated Hubs. This has three components:
Collaborative care where management decisions are shared among the GP, PHNs mental health specialists and patients.
True integration of patients’ physical, social and mental health needs with programs of physical activity, diet modification and social prescribing, alongside more traditional pharmacological and psychological approaches.
Use of technology to aid communication between partners in collaborative care and support use of e-health interventions. Integrated and practical delivery of evidence-based treatment information, frameworks and models across Australia using Information and communication technology (ICT) platforms delivering education, community education and online psychological therapies e.g. through online web programs.
All of this is coupled with capacity building for GPs, specialist clinicians, consumers and researchers in specialist mental health skills.
Crisis Care Services
The establishment of the crisis care services: a pilot of a safe house and drop-in recovery centre for people in suicidal crisis. This initiative will address the lack of after-hours services, and the need for alternate, non-clinical community pathways, for people in suicide crisis. Through the crisis care service we will establish the feasibility, and clinical and cost effectiveness of a ‘safe house’ for those in suicide crisis. Operating 24/7 and staffed by both mental health professionals and a peer-led workforce, the service will link emergency and aftercare services with housing and community care hubs. It will introduce clinical trial methodology to assess outcome effectiveness. Additionally, we will also pilot and evaluate a ‘safe haven’ approach, a drop-in centre providing non-clinical, peer support for people that require more than phoneline support to get them through a suicide crisis. Data driven analysis by Black Dog Institute identifies the Mindgardens catchment as a hot spot for suicide with higher rates than other Local Health Districts, likely given its proximity to trains; high-rise low-cost housing; drug and alcohol; and clifftops. As such, alternate pathways to crisis management are required in this region.
The establishment of routine clinical trials to advance understanding of the causes of mental health disorders, including those to:
- Accelerate knowledge of new treatments for depression through basic neuroscience, creating the right conditions for new discovery and collaboration
- Re-purposing of current therapeutic models from other behavioral conditions to support the treatments of depression and anxiety.
- Identification of clinical and biological (e.g. genetic and brain imaging) features which predict high risk of the later onset of conditions such as psychotic or mood disorders.