Is headspace making a difference to young people’s lives?
Evaluation-of-headspace-program Evaluation-of-headspace-program
Appendix B not take into account competing and complementary services, and this limitation must be considered when interpreting these findings. However, the current formula for centre allocation, which assumes that all young people have access to a headspace centre if they live within an SA4 or SA3 area that contains a headspace centre, may not provide equitable access. For example, these regions vary substantially in both geographic size and youth population. As a result, the distance required to travel to a headspace centre may be too great to facilitate access for all young people residing in certain SA4 or SA3 areas despite there being a headspace centre somewhere within the area. In areas with large youth populations, or a high prevalence of youth mental health problems, access may also be limited by the capacity of a single headspace centre to service the demand. These issues are considered in the following chapter. If the allocation of sites is governed by factors other than weighted youth population (such as competing and complementary services and lead agency financial resources), these factors need to be made more explicit in the centre allocation model. DoH and hNO also need to give consideration to the costs and benefits of a system which records lead agency financial contribution. Lead agency contribution to occasions of service (as recorded in the hCSA) seems quite low. However, we have no information about the costs associated with lead agency funded occasions of service as costs of occasion of service are not recorded on the hCSA. As well as adding cost of service information to the hCSA, we recommend that the Department and hNO investigate lead agency contributions to the headspace service model beyond that which is observed in hCSA. This will provide a better understanding of the overall contribution of non-headspace funds to the service model than is achievable under the data access limitations of this evaluation. Evaluation of the current model of centre expansion Background The previous section described the potential for national coverage of headspace and the funding requirements (see Appendix G) to achieve this under the Department of Health’s current allocation model. This chapter provides an evaluation of the effectiveness of the current centre allocation model to provide access to headspace services The current definition of access to a headspace centre, as defined by the current centre allocation model, and the costs associated with achieving national coverage under this model are described in Part One, Centre Expansion under the Current headspace Centre Allocation Model. The current centre allocation model does not take into account factors such as the geographic size of the area, the travel times associated with accessing headspace centre services, and the number of young people who require mental health services within the area. In addition, the current funding arrangement of headspace grants for individual headspace centres places limits on the extent to which centres can vary their service type and service volume to meet client demand. The headspace grant amount is fixed for the period of the grant agreement (typically 3 or 4 years), and includes set amounts for centre establishment in Year One and normal operations thereafter. When nearing completion of the grant term the Lead Agency enters negotiations with the Department and hNO for contract renewal. If successful, the process repeats itself, without establishment funding. This funding arrangement effectively places a cap on individual centre resources as the headspace grant amount is agreed in advance and is fixed in contract across the grant term. As described in Part One, there is some flexibility provided by leveraging headspace services off Lead Agency contributions, but these contributions are likely to be variable across sites and Lead Agencies. For reasons described in Part One, information about the size and nature of Lead Agency contributions is unavailable to the evaluation team. These features of the current centre allocation model limit equity of access to headspace centres. Hence the need to investigate what may be possible in terms of youth access to headspace services under a range of alternative centre allocation models. Social Policy Research Centre 2015 headspace Evaluation Final Report 130
Appendix B The concept of access as it relates to headspace and the evaluation of headspace services headspace has been established to provide access to mental health and related support services for young people aged 12-25 years in Australia. The concept of access, as it applies to headspace, has implications for the conduct and outcomes of the evaluation. There are five key inter-related considerations underpinning the access concept as it applies here: • distance from client’s home to the nearest headspace centre • demand for services within the geography of interest • capacity of a headspace centre to service client demand • level of funding available to support a given headspace centre, and • availability of other mental health services. Variation in any one of these will affect the level and quality of access for an individual young person, and therefore will impact on estimates for any alternatives to the existing centre allocation model. The current definition of headspace centre access is incorporated into the current centre allocation model, as utilised for the hypothetical centre expansion modelling undertaken for Part One. There are shortcomings with current definition of access that has implications for headspace centre utilisation for young people in Australia. Part Two is designed to unpack those shortcomings, consider some alternative access definitions, and provide a basis for a series of alternative centre allocation models in the following Part Three. We do this by utilising administrative headspace data and independent survey data combined with ABS statistical geographies and sophisticated mapping techniques to investigate a number of key access parameters as they apply to existing headspace centres. The definition of access underpinning the headspace service model has direct implications for the cost of the program, the acceptable area coverage, the measurement of patronage, and the potential of the service to maximise impact on youth mental health. Evaluation of current Model of Centre Allocation The existing model of headspace centre allocation is based on the following definition of access: a young person living in an SA4 or SA3 area that contains a headspace centre is deemed to have access to headspace services. This definition is evaluated in the section that follows, by considering evidence regarding: • travel distance of clients to obtain headspace centre services • distribution of need, or potential demand, for mental health services • centre service capacity • level of funding available to centres under the current model. Distance to nearest headspace centre Rationale The geographic units used in the current definition, and in particular SA3s in regional and remote areas, can cover vast geographic areas. Furthermore, these administrative boundaries are not designed with the primary aim of capturing functional communities and may not represent optimal catchment areas for service use by young people. Therefore, in order to determine a more realistic definition of likely travel distance to access mental health services, data from Young Minds Matter (YMM), the headspace Centres Services Application (hCSA) and the Census were used to determine the relationship between use of headspace services and proximity to a centre. Social Policy Research Centre 2015 headspace Evaluation Final Report 131
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Appendix B<br />
The concept of access as it relates <strong>to</strong> <strong>headspace</strong> and the evaluation of <strong>headspace</strong><br />
services<br />
<strong>headspace</strong> has been established <strong>to</strong> provide access <strong>to</strong> mental health and related support<br />
services for <strong>young</strong> people aged 12-25 years in Australia. The concept of access, as it applies<br />
<strong>to</strong> <strong>headspace</strong>, has implications for the conduct and outcomes of the evaluation. There are five<br />
key inter-related considerations underpinning the access concept as it applies here:<br />
• distance from client’s home <strong>to</strong> the nearest <strong>headspace</strong> centre<br />
• demand for services within the geography of interest<br />
• capacity of a <strong>headspace</strong> centre <strong>to</strong> service client demand<br />
• level of funding available <strong>to</strong> support a given <strong>headspace</strong> centre, and<br />
• availability of other mental health services.<br />
Variation in any one of these will affect the level and quality of access for an individual <strong>young</strong><br />
person, and therefore will impact on estimates for any alternatives <strong>to</strong> the existing centre<br />
allocation model.<br />
The current definition of <strong>headspace</strong> centre access is incorporated in<strong>to</strong> the current centre<br />
allocation model, as utilised for the hypothetical centre expansion modelling undertaken for<br />
Part One. There are shortcomings with current definition of access that has implications for<br />
<strong>headspace</strong> centre utilisation for <strong>young</strong> people in Australia.<br />
Part Two is designed <strong>to</strong> unpack those shortcomings, consider some alternative access<br />
definitions, and provide a basis for a series of alternative centre allocation models in the<br />
following Part Three. We do this by utilising administrative <strong>headspace</strong> data and independent<br />
survey data combined with ABS statistical geographies and sophisticated mapping techniques<br />
<strong>to</strong> investigate a number of key access parameters as they apply <strong>to</strong> existing <strong>headspace</strong> centres.<br />
The definition of access underpinning the <strong>headspace</strong> service model has direct implications for<br />
the cost of the program, the acceptable area coverage, the measurement of patronage, and the<br />
potential of the service <strong>to</strong> maximise impact on youth mental health.<br />
Evaluation of current Model of Centre Allocation<br />
The existing model of <strong>headspace</strong> centre allocation is based on the following definition of access:<br />
a <strong>young</strong> person living in an SA4 or SA3 area that contains a <strong>headspace</strong> centre is deemed <strong>to</strong> have<br />
access <strong>to</strong> <strong>headspace</strong> services. This definition is evaluated in the section that follows, by considering<br />
evidence regarding:<br />
• travel distance of clients <strong>to</strong> obtain <strong>headspace</strong> centre services<br />
• distribution of need, or potential demand, for mental health services<br />
• centre service capacity<br />
• level of funding available <strong>to</strong> centres under the current model.<br />
Distance <strong>to</strong> nearest <strong>headspace</strong> centre<br />
Rationale<br />
The geographic units used in the current definition, and in particular SA3s in regional and remote<br />
areas, can cover vast geographic areas. Furthermore, these administrative boundaries are not<br />
designed with the primary aim of capturing functional communities and may not represent optimal<br />
catchment areas for service use by <strong>young</strong> people. Therefore, in order <strong>to</strong> determine a more realistic<br />
definition of likely travel distance <strong>to</strong> access mental health services, data from Young Minds Matter<br />
(YMM), the <strong>headspace</strong> Centres Services Application (hCSA) and the Census were used <strong>to</strong> determine<br />
the relationship between use of <strong>headspace</strong> services and proximity <strong>to</strong> a centre.<br />
Social Policy Research Centre 2015<br />
<strong>headspace</strong> Evaluation Final Report<br />
131
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