Is headspace making a difference to young people’s lives?

Recommendations

Info

5. Service Delivery Model Develop a long-term, sustainable funding approach with multiple funding streams The economic evaluation highlighted that headspace operates with multiple funding streams, however, is overwhelmingly reliant on government funding. Delivery of services at headspace centres are partly funded by the Australian Government Department of Health through the Youth Mental Health Initiative. This grant payment covers site costs such as rent, infrastructure and some staff salaries. In addition, multiple funding streams are leveraged through headspace to pay for direct services. These funding streams comprise the Medicare Benefits Scheme (MBS), Access to Allied Psychological Services (ATAPS), the Mental Health Nurse Incentive Program (MHNIP), and the Rural Primary Health Services (RPHS). In addition, services are funded by centre lead agencies and consortium members who are required to co-contribute to the running costs of headspace centres. This is typically managed through the provision of in-kind support and staffing to increase service capacity. The economic evaluation highlights great diversity in unit costs across centres and this suggests that more efficient use of government funds may be achievable. One way to achieve greater efficiency and less variation in unit costs could be the organisational development and implementation of performance targets or service goals. A small number of centre manager survey respondents (n=5) suggested other ways that they believed would make the funding model more equitable across centres. Suggestions included allocating funds based on client numbers and/or occasions of service provided, as well as taking into account characteristics of the region to be serviced by the centre (such as remoteness, local cost of living, and workforce availability). Evaluation data suggests then that headspace is yet to develop a long-term, sustainable funding approach. A few stakeholders suggested that this will require greater equity in funding across centres. The rating of importance given by centre managers to alternative sources of income suggests that they understand that a diversification of funding sources, particularly an increase in the contribution of private funding to headspace (through for example philanthropy, social investment and business partnerships) is required for long-term sustainability. 5.2 To what extent is model fidelity important? Model fidelity may be defined as the extent to which the delivery of an intervention or program adheres to the protocol or program model as originally developed (Mowbray et al, 2003). Fidelity measurement, which is increasingly used in program evaluations, is difficult to apply in this context as the centre-based headspace program model is not clearly prescribed or manualised. Rather, each centre operates differently to meet the needs of the local community, and the composition and expertise of the centre consortiums. Evaluation data highlights diversity in the implementation of the service model across headspace centres. During interviews with staff, variation in model implementation was attributed to multiple factors, in particular local community needs, available resources and differing Lead Agencies. A small number of staff valued the flexibility in the service model: Having some from such a long history in the public mental health sector, the adjustability of the headspace model is really quite good. It’s not rigid with layers of bureaucracy (Psychologist) However, not all viewed this as a potential strength that enabled services to fit local community needs. Rather, a small number of stakeholder respondents viewed this diversity as problematic: Headspace has been developed as a one size fits all and this limits its capacity to be flexible around different needs both from a locality perspective and a client’s perspective (Survey Response No. 8) [Need to be] more clear about model of care (Survey Response No. 169) Little clarity of headspace program and service delivery focus (Survey Response No. 17) headspace National Office is taking steps towards ensuring greater consistency and quality in service delivery. headspace National Office is undertaking a large project to identify and document a best practice headspace model. An outcome of this project has been the development of the Social Policy Research Centre 2015 headspace Evaluation Final Report 76
5. Service Delivery Model headspace Best Practice Framework. This framework identifies four key outcome areas, along with a set of objectives and implementation indicators which enable the provision of appropriate service responses for young people. In the organisational strategic plan (headspace, 2012), headspace specifies that the key elements of the centre-based program are: • clinical service delivery • delivery of vocational and other youth services • services targeted for 12-25-year olds and delivered in a youth friendly environment • local referral network, and • mental health promotion. For the purposes of this evaluation, we have used these key elements to assess implementation of the service delivery model (refer question 5.1 above). These elements are too broad to be operationalised as criteria for assessing model fidelity; however, the development of the headspace Best Practice Framework suggests that the organisation is moving towards further specification of the service model. The elements are also too broad to support an analysis that links key service elements with client outcomes. Evaluation data indicates that all elements were implemented at centres but it does not support an assessment of the extent to which service components impact the outcomes of young people. 5.3 What are the risk and protective factors for headspace sustainability? The evaluation has highlighted a number of factors that enhance and threaten headspace’s long-term sustainability. These factors are described below: Risk factors As previously stated, headspace operates with multiple funding streams; however, there is a heavy reliance on government funding. This reliance on government funding is a potential risk to long-term sustainability as any cutbacks to headspace funding streams could impact service provision. The mental health service system competes for finite funding and a reduction in the total amount could negatively impact headspace service delivery. The economic evaluation also highlighted much variation in unit costs across centres. The analysis identified a number of centres that have very high headspace grant investment with relatively low occasions of service. It was out of the scope of the evaluation to assess operations at individual centres so we are not able to provide an explanation for this diversity in unit costs. It is suggested that centres established during rounds 1-4 with significantly high unit costs be investigated to identify any operational inefficiencies that may exist. The headspace service model relies upon collaboration between the centre’s lead agency, consortium partners and other local service provider organisations that refer young people to centres and/or receive referrals from headspace. Collaboration is therefore crucial to centre-based services. The evaluation highlighted mixed results regarding collaboration with services at the community level. Evaluation data suggests that only a small proportion of young people (3-5%) are referred to other services within the community. This suggests that the headspace model is effective in holistically meeting the needs of young people. Collaboration of headspace centres across the national network is not supported by a database holding contact information. As discovered during the recruitment phase of the Professional Stakeholders Survey, there is no centrally held database of headspace lead agencies and their related consortium organisations. The Department of Health and headspace National Office holds contact information on all lead agencies, but not on consortium partners. It is suggested that such a database of lead agencies and their partners be developed. Such a database would need to be updated regularly given the high turnover of staff within the sector. Results from the subsample of general practitioners (n=45) who participated in the Professional Stakeholders Survey suggest that greater engagement of this stakeholder group is required not only Social Policy Research Centre 2015 headspace Evaluation Final Report 77
Page 1 and 2:
Is headspace making a difference to
Page 3 and 4:
Authors This report was written by
Page 5 and 6:
5. Service Delivery Model 73 5.1 Wh
Page 7 and 8:
Table 6.1 Table 6.2 Table 6.3 Main
Page 9 and 10:
Figure 4.9 Figure 4.10 Figure 4.11
Page 11 and 12:
Executive Summary headspace 1 aims
Page 13 and 14:
Executive Summary or very high leve
Page 15 and 16:
Executive Summary through mental he
Page 17 and 18:
value to society of the improvement
Page 19 and 20:
1. Introduction people in Australia
Page 21 and 22:
2. Evaluation Methodology 2.1 Aims
Page 23 and 24:
2. Evaluation Methodology Evaluatio
Page 25 and 26:
2. Evaluation Methodology Table 2.3
Page 27 and 28:
2. Evaluation Methodology Represent
Page 29 and 30:
3. Access and Engagement with Centr
Page 31 and 32:
Page 33 and 34:
Page 35 and 36: 3. Access and Engagement with Centr
Page 51 and 52: 4. Outcomes of headspace Clients Th
Page 53 and 54: 4. Outcomes of headspace Clients 35
Page 55 and 56: 4. Outcomes of headspace Clients Ch
Page 57 and 58: 4. Outcomes of headspace Clients No
Page 59 and 60: 4. Outcomes of headspace Clients Th
Page 61 and 62: 4. Outcomes of headspace Clients Fi
Page 63 and 64: 4. Outcomes of headspace Clients A
Page 65 and 66: 4. Outcomes of headspace Clients Ta
Page 67 and 68: 4. Outcomes of headspace Clients nu
Page 69 and 70: 4. Outcomes of headspace Clients No
Page 71 and 72: 4. Outcomes of headspace Clients Ta
Page 73 and 74: y three percentage points, and 2.1
Page 75 and 76: 4. Outcomes of headspace Clients So
Page 77 and 78: 4. Outcomes of headspace Clients I
Page 79 and 80: 4. Outcomes of headspace Clients in
Page 81 and 82: 4. Outcomes of headspace Clients Wh
Page 83 and 84: 5. Service Delivery Model For the a
Page 85: 5. Service Delivery Model the provi
Page 89 and 90: 5. Service Delivery Model services,
Page 91 and 92: 5. Service Delivery Model services
Page 93 and 94: 5. Service Delivery Model Further,
Page 95 and 96: 5. Service Delivery Model that we
Page 97 and 98: 5. Service Delivery Model is a cons
Page 99 and 100: 5. Service Delivery Model connectio
Page 101 and 102: 5. Service Delivery Model Table 5.2
Page 103 and 104: 5. Service Delivery Model Table 5.3
Page 105 and 106: 5. Service Delivery Model I don’t
Page 107 and 108: 5. Service Delivery Model group is
Page 109 and 110: 5. Service Delivery Model Figure 5.
Page 111 and 112: 6. The Costs of headspace One of th
Page 113 and 114: 6. The Costs of headspace Table 6.1
Page 115 and 116: 6. The Costs of headspace In-scope
Page 117 and 118: 6. The Costs of headspace Revenue/
Page 119 and 120: 6. The Costs of headspace Other gov
Page 121 and 122: 7. Conclusion The evaluation of hea
Page 123 and 124: 7. Conclusion treatment); however,
Page 125 and 126: 7. Conclusion Overall the evaluatio
Page 127 and 128: Appendix A Evaluation scope areas h
Page 129 and 130: Appendix B The current model of hea
Page 131 and 132: Appendix B and each SA3 in non-capi
Page 133 and 134: Appendix B chapter 39 . To determin
Page 135 and 136: Appendix B While there is an overal
Page 137 and 138:
Appendix B Figure B3 describes the
Page 139 and 140:
Appendix B Figure B5 Cost per young
Page 141 and 142:
Appendix B The concept of access as
Page 143 and 144:
Appendix B Figure B7 Heard of heads
Page 145 and 146:
Figure B10 Proportion of headspace
Page 147 and 148:
Appendix B Table B5 Females 18-25 y
Page 149 and 150:
Appendix B following section. Figur
Page 151 and 152:
Appendix B and less access to mains
Page 153 and 154:
Appendix B Figure B17 Estimated pre
Page 155 and 156:
Appendix B Figure B18 SA1s within 1
Page 157 and 158:
Figure B20 Hypothetical allocation
Page 159 and 160:
Appendix B The current model of cen
Page 161 and 162:
Appendix B Current centre funding m
Page 163 and 164:
Appendix B Evaluation of the curren
Page 165 and 166:
Appendix B Level of funding availab
Page 167 and 168:
Appendix B provide a method for ide
Page 169 and 170:
Appendix B centres and Localities i
Page 171 and 172:
Appendix B for greater flexibility
Page 173 and 174:
Appendix B Additional consideration
Page 175 and 176:
Appendix B of achieving more effici
Page 177 and 178:
Appendix B • Used the simulation
Page 179 and 180:
Appendix C information relating to
Page 181 and 182:
Appendix C Regarding gender, in bot
Page 183 and 184:
Appendix C Figure C5 Total number o
Page 185 and 186:
Appendix C Table C1 Information Sum
Page 187 and 188:
Appendix C Data Cleaning and Analys
Page 189 and 190:
Appendix C groups. The age and sex
Page 191 and 192:
Appendix C Figure C8 Demographic ch
Page 193 and 194:
Appendix C The KeySurvey software s
Page 195 and 196:
Appendix C different client groups.
Page 197 and 198:
Appendix D Round State Centre Name
Page 199 and 200:
Appendix E Characteristics HS clien
Page 201 and 202:
Table E4 Cell Sizes for Figure 3.4
Page 203 and 204:
Appendix F Figure F1 Changes in K10
Page 205 and 206:
Appendix F three SEIFA quintiles. A
Page 207 and 208:
Appendix F Occasion of service inte
Page 209 and 210:
Appendix F Table F1 Cell sizes for
Page 211 and 212:
Page 213 and 214:
Page 215 and 216:
Appendix G Supplementary material f
Page 217 and 218:
Appendix G Table G3 Round 3 (10 cen
Page 219 and 220:
Appendix G Table G7 Round 7 (10 cen
Page 221 and 222:
State (youth population) a headspac
Page 223 and 224:
Page 225 and 226:
Appendix G Table G12 Round 11(16 ce
Page 227 and 228:
Table G16 Additional youth populati
Page 229 and 230:
Round Region State Additional youth
Page 231 and 232:
Page 233 and 234:
Page 235 and 236:
Appendix G Figure G1 Percentage of
Page 237 and 238:
Page 239 and 240:
Page 241 and 242:
Page 243 and 244:
Appendix G Table G22 Australians 18
Page 245 and 246:
Appendix G Synthetic small area est
Page 247 and 248:
Appendix G Figure G16 Estimated pre
Page 249 and 250:
Page 251 and 252:
Page 253 and 254:
Appendix G Figure G22 SA1s within 1
Page 255 and 256:
Page 257 and 258:
Page 259 and 260:
Appendix G Table G25 Centres alloca
Page 261 and 262:
References Atkins, D.C., Bedics, J.
Page 263:
References Smith, E., Jones, T., Wa
show all

Is headspace making a difference to young people’s lives?

Create successful ePaper yourself

Delete template?

Save as template?