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Stepped Care for Mental Health Program Evaluation


  • New approach to delivering primary care mental health services
  • Mixed methods formative evaluation of the first year of implementation
  • Geographical and contextual differences impacted implementation, especially for vulnerable populations.
The Challenge

One in three Australians will experience mental health issues in their lifetime, but accessing services has historically been difficult and stigmatized. As part of the National Mental Health reform, Primary Health Networks have commissioned locally designed mental health services using the Stepped Care approach. The client organisation commissioned six service streams and a centralized intake and triage service. The structure of services and the split across varying service providers and sub-regional areas was significantly different from previous years.

The Approach

Abt was asked to evaluate how the new approach in the first year affected the quadruple aims: population health and system improvement, lower costs, improved clinician experience, and improved client experience. Abt undertook a mixed methods formative evaluation, which included data analysis of the relatively new Primary Mental Health Care Minimum Data set from six service streams, five service providers, and 12 local government areas, along with stakeholder consultations of consumers, service providers, referrers, and the Primary Health Network.

The Results

The results highlighted the complexity of implementing such a large-scale change across a diverse region, from workforce capacity in regional areas to data quality, and delivery of the centralized triage and intake service. Additionally, it highlighted the importance of established services and relationships for Aboriginal and Torres Strait Islander peoples and people with severe and complex needs.  Service accessibility remained a high priority and key recommendations to support improvements have since been introduced. 

Ethics application was submitted and the project has received full approval to link PMHC-MDS with hospital and community datasets to understand patients’ journeys through the health system in this region.