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Using the stepped care services in your community

Maintain a good understanding of the mental health services in your area (eg mental health care providers, agencies, referral pathways). This will help you make better decisions about appropriate care for your consumers, including whether to step their level of care up or down.

Ideally, you should know and be familiar with:

  • local mental health care providers and each one’s eligibility criteria
  • other mental health care agencies
  • referral pathways
  • evidence-based treatments
  • workplace employee assistance programs (EAPs)
  • services available at local organisations (eg schools, universities, councils, community groups, authorities).
As defined by the DoHDA, therapies and treatments not considered to be appropriate for a stepped care approach are those that:
  • are not supported by empirical evidence
  • fall outside the scope of primary mental health care, specifically:
    • services principally targeted at providing social support, with the exception of suicide prevention activities
    • bed-based services
  • duplicate or replace existing services provided by other organisations, including state and territory government services
  • are not supported by the funding guidelines for the primary mental health flexible funding pool.

You need to be familiar with the roles of different health professionals in your area so that you can provide appropriate referrals. This also decreases the need for the consumer to explain their situation to multiple health professionals.

When referring a consumer:

  • ensure that the training completed by theproposed service provider qualifies them to deliver the appropriate level of care (eg tele-coaches, GP providers of FPS, provisionally qualified psychologists, clinical psychologists and mental health workers have quite different qualifications)
  • be aware of the responsibilities for escalation of care when you are sharing care with other providers, because you may need to quickly and effectively manage consumers who present with severe and persistent mental health symptoms.

While you might not talk to your consumers about the Stepped Care Model specifically, you should discuss the stepped care services that are available and might be effective options for them.

A basic principle of the Stepped Care Model is that you do not default to the same approach for mental health care (eg psychological services) when there are other services that would better suit the consumer’s needs and circumstances.

As part of providing a consumer-centred service, your discussions with the consumer need to include:

  • the information the consumer needs about their treatment options
  • the treatments they feel most comfortable with
  • the treatments that the consumer has the ability to access
  • the role of the carer in the consumer’s treatment and care.

When working with Aboriginal and Torres Strait Islander peoples, consider:

  • yarning approaches
  • community consultation
  • culturally safe communication practices
  • the importance of choice regarding AHWs or ACCHO involvement9.

Depending on what is commissioned by the PHN, stepped care services may not be suitable for consumers with:

  • acute psychosis or suicidality
  • intellectual disability
  • chronic illness or physical disability.

In these situations, use established referral pathways and networks to access the most appropriate care, based on the consumer’s needs.

 

Downloads

GPMHSC-Guide-Stepped-care-model.pdf