Is headspace making a difference to young people’s lives?
Evaluation-of-headspace-program Evaluation-of-headspace-program
7. Conclusion for youth mental health is complex and fragmented. While individual headspace centres can and do mitigate some of these issues locally, there are significant structural barriers to providing a holistic and continuous service to vulnerable young people. The evaluation identified a number of ways that the service delivery model could be enhanced to better meet the needs of young people and their parents. Many parents and carers would like to be more engaged with their young person’s treatment and wanted more help to learn how to effectively support their young person. Further, evaluation data indicates that there is a need for headspace to provide family-based therapy. Many staff at centres acknowledged this need and would like to be better able to support families as a unit. Another way that the service delivery model could be enhanced to better meet the needs of young people is to increase the capacity of centres to provide outreach services to engage young people who are reluctant to engage in centre based care. While eheadspace and engagement with schools have attempted to address these issues, there are still large groups of young people not accessing headspace. The evaluation highlights some workforce challenges, particularly the need for more GPs and psychiatrists in headspace centres or attached to them. Although further evidence is required, headspace should consider and address the reasons why many GPs are not willing to refer young people to headspace. A strategy to actively engage GPs may be required to boost awareness and develop trust. The data collected from GPs suggests that alternative forms of collaboration between centres and GPs should be considered. Online and telephone treatment methods may be of assistance to help not only increase scale, but to support young people with low needs as well as young people unable to leave their homes or travel to headspace centres. The economic evaluation The economic analysis indicates that the average cost of a headspace occasion of service is $339 (2013/14 dollars) 37 . Considerable variation in average costs per occasion of service at the centre level exists and can range from $136 to above $1,000, taking into account the headspace grant only. Substantial surpluses also exist in terms of the headspace grant within the 2013/14 financial year. It is recognised that legitimate impediments may reduce the ability of some centres to realise operational efficiencies, particularly in certain areas throughout Australia. However, it is recommended that centre level operational efficiencies are examined in order to make better use of finite resources. This could involve a number of measures, including: • review of funding grant allocation relative to historical and predicted need at the local area level • targeted assistance to particular centres to ensure operational efficiencies are optimised • performance indicators and targets linked to grant funding. Each of these initiatives would need to be carefully considered and implemented to ensure that unintended consequences for the headspace program did not materialise and that headspace can continue to reach its objectives in improving the social, emotional and mental health of young Australians. In terms of the government investment, the mental health of headspace clients improves moderately relative to other matched control groups. It should also be noted that headspace provides a number of benefits such as community engagement and awareness which are difficult to cost but which have raised the profile of youth mental health in Australia. 37 There is no similar program with which to directly compare and benchmark headspace program costs, however, this occasion of service cost compares closely to ambulatory services which nationally averaged $303 per treatment day in the 2012-13 financial year (excluding Victoria). Ambulatory care services (a form of community based mental health services) are provided by outpatient clinics (hospital or clinic based), mobile assessment and treatment teams, day programs and other services dedicated to assessment, treatment, rehabilitation and mental health care (SCRGSP, 2015). Social Policy Research Centre 2015 headspace Evaluation Final Report 114
7. Conclusion Overall the evaluation found a significant need for early intervention for young people with mental health, substance misuse, social/emotional and sexual/physical health problems. headspace is making some headway to address the service need and has had some success, especially in mental health. The cost of headspace treatment appears comparable to community mental health care. Further, if headspace did not exist, it is likely that large numbers of young people would not access services or would access them at a much later stage in the development of their disorders, potentially incurring significant costs to the government as well as difficulties for the young people and their families. Nevertheless, the evaluation has identified a number of ways in which headspace could improve its service delivery model and its access and engagement processes to better serve young Australians. Implications for future research The evaluation identified a number of additional studies that, if undertaken, would make a valuable contribution to a better understanding of headspace and youth mental health care in Australia. A significant proportion of headspace clients receive only one or two occasions of service. The evaluation is unable to explain this high rate of single service use as administrative data does not explain why they disengaged, and young people who had left the service early were not interviewed. It is suggested that a longitudinal study be undertaken that monitors the service use of early leavers. As the evaluators were only working with one year’s data, we were unable to see if these people return after a period of time. Further, interviewing single service users would provide valuable information on the needs and motivations of young people who do seek help but disengage early from support services. Also, the logic behind headspace is that as an early intervention service, it will minimise the impact of mental illness over the lifetime of clients. Given the data limitations, the evaluation was unable to establish if this is the case. It is suggested that further work be done in this area as more long-term data collected via the hCSA becomes accessible to researchers. To confirm the efficacy of early intervention in youth mental health, research will require access to other datasets such as MBS and hospital admission data. Social Policy Research Centre 2015 headspace Evaluation Final Report 115
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7. Conclusion<br />
Overall the evaluation found a significant need for early intervention for <strong>young</strong> people with mental<br />
health, substance misuse, social/emotional and sexual/physical health problems. <strong>headspace</strong> is<br />
<strong>making</strong> some headway <strong>to</strong> address the service need and has had some success, especially in mental<br />
health. The cost of <strong>headspace</strong> treatment appears comparable <strong>to</strong> community mental health care.<br />
Further, if <strong>headspace</strong> did not exist, it is likely that large numbers of <strong>young</strong> people would not access<br />
services or would access them at a much later stage in the development of their disorders, potentially<br />
incurring significant costs <strong>to</strong> the government as well as difficulties for the <strong>young</strong> people and their<br />
families. Nevertheless, the evaluation has identified a number of ways in which <strong>headspace</strong> could<br />
improve its service delivery model and its access and engagement processes <strong>to</strong> better serve <strong>young</strong><br />
Australians.<br />
Implications for future research<br />
The evaluation identified a number of additional studies that, if undertaken, would make a valuable<br />
contribution <strong>to</strong> a better understanding of <strong>headspace</strong> and youth mental health care in Australia.<br />
A significant proportion of <strong>headspace</strong> clients receive only one or two occasions of service. The<br />
evaluation is unable <strong>to</strong> explain this high rate of single service use as administrative data does not<br />
explain why they disengaged, and <strong>young</strong> people who had left the service early were not interviewed.<br />
It is suggested that a longitudinal study be undertaken that moni<strong>to</strong>rs the service use of early leavers.<br />
As the evalua<strong>to</strong>rs were only working with one year’s data, we were unable <strong>to</strong> see if these people<br />
return after a period of time. Further, interviewing single service users would provide valuable<br />
information on the needs and motivations of <strong>young</strong> people who do seek help but disengage early<br />
from support services.<br />
Also, the logic behind <strong>headspace</strong> is that as an early intervention service, it will minimise the impact<br />
of mental illness over the lifetime of clients. Given the data limitations, the evaluation was unable <strong>to</strong><br />
establish if this is the case. It is suggested that further work be done in this area as more long-term<br />
data collected via the hCSA becomes accessible <strong>to</strong> researchers. To confirm the efficacy of early<br />
intervention in youth mental health, research will require access <strong>to</strong> other datasets such as MBS and<br />
hospital admission data.<br />
Social Policy Research Centre 2015<br />
<strong>headspace</strong> Evaluation Final Report<br />
115
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