Establishing a stepped care approach has been identified as a fundamental objective for mental health service planning and commissioning to be undertaken by Primary Health Networks (PHNs). Within their identified catchment, PHNs have been tasked with ensuring that services are available to provide a continuum of primary mental health services operating within a stepped care approach. It is anticipated that this system will help facilitate improved access to treatment, ensure a range of services are available to meet the needs of individuals and population groups, and make the best use of available workforce and technology.
Two key elements defining models of stepped care have been identified as:
- The use of the least restrictive or intensive treatment option available appropriate to the individual’s needs, delivered at the right time and intensity; and
- Being self-correcting, monitoring treatment outcomes to enable “step up” to a more intensive or “step down” to less intensive intervention(s) when required.
Modelling of mental health service needs and treatment requirements within the National Mental Health Service Planning Framework (NMHSPF) provides the basis for analysis of the expected level and profile of services required to inform implementation of a stepped care approach.
The Department of Health commissioned a research team within the School of Population Health at The University of Queensland to undertake research to assist them in providing advice to support the implementation of a stepped care approach to mental health care by PHNs, including:
- The spectrum of mental illness and the continuum of care for people along that spectrum;
- The place of digital mental health and low intensity face-to-face treatment in a stepped care model, including the clinical characteristics of individuals for whom digital mental health and low intensity face-to-face treatment is appropriate; and
The treatment of severe mental illness in a stepped care model including the interface with state and territory clinical mental health services and disability support services likely to be within the scope of the National Disability Insurance Scheme.