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Mental health services
Overview
Mental health problems and mental illness cause disability reduced quality of life, and impaired productivity in our community.
The Mental Health Services RDF describes the broad spectrum of mental health services that should be accessible to people in Tasmania. Mental health services provide specialised healthcare that promotes optimal quality of life for people with mental disorders or mental health problems. These services provide assessment, diagnosis, monitoring and treatment of people who have a mental illness or disorder characterised by a clinically significant disturbance of thought, mood, perception, memory and/or behaviour.
Mental health services address the needs of a broad mix of patient types across the entire age spectrum (children and youth, adults and older persons). A person’s need for mental health services can be short, medium, long term or intermittent, and often spans various levels of care and service areas across the health service continuum.
The delivery of mental health services routinely considers and responds to the special needs that may be associated with the mental health of:
- Aboriginal and Torres Strait Islander peoples
- people of culturally and linguistically diverse backgrounds
- people living in rural and remote areas
- people in out-of-home care
- people with a comorbidity or complex needs—this may include, but is not restricted to, people with a mental health diagnosis as well as:
- an intellectual disability
- a substance-use disorder
- a cognitive illness or other brain disorder/s
- severe or complex medical problems
- a forensic history.
By national convention, the accepted term used when referring to a mental health patient is consumer, with consumers supported by their family and/or carers. However, on occasion the terms patient, people and person have been used in the module to maintain consistency with other parts of the RDF.
Delineating service system roles
The National Mental Health Services Planning Framework describes the range of services required within a comprehensive mental health system, using an agreed national taxonomy of mental health services across the spectrum of service delivery. Service areas relevant to this RDF are broadly defined as:
- Ambulatory mental health services deliver mental health care to non-admitted consumers, including primary and specialised clinical ambulatory mental health services, specialised mental health community support services, crisis or mobile assessment treatment services, and day programs. Services are streamed according to age groups.
- Acute inpatient mental health services deliver mental health care to admitted consumers, usually on a short- to medium-term and intermittent basis. Services are streamed according to age groups. Although many services are bed-based hospital or facility services, hospital-in-the-home and ‘virtual’ bed models can operate.
- Non-acute inpatient mental health services deliver mental health care to consumers over a long-term period and involve a specialist rehabilitation component to care. Previously, many of these services have been known as extended treatment/care services. Services are streamed according to age groups.
Along the continuum, mental health care may take place in several settings, including a general acute unit, a dedicated mental health unit or hospital, a residential program, an institutional facility (e.g., a prison), a community-based setting or in the person’s home.
Service networks
Although the RDF describes different levels of service based on mental health need and a defined service scope for each service providing mental health care, the Tasmanian mental health service system operates according to a networked ‘stepped care’ service model characterised by:
- Clinical pathways and service arrangements to support movement of service users between both lower and higher-level services within the network.
- Collaborative working partnerships between services providing mental health care and other organisations, support agencies and services relevant to people’s care needs.
Private sector services
Private sector mental health services provide a comprehensive range of services to people with mental health problems across the age spectrum and health service continuum.
Private sector services are delivered by individual clinicians or multidisciplinary teams of mental health clinicians. The full continuum of care ranges from intensive, admitted, overnight treatment to day hospital, outpatient and community care, and psychiatric emergency care for patients of the private mental health service system.
Private sector services complement, and often work in partnership with, public sector services. The defined service scope for each service providing mental health care in this RDF may include private sector service elements or may be wholly provided within the private sector.
This framework
The Mental Health Services RDF consists of four sections:
- Section 1: Adult Services
- Section 2: Child and Youth Services
- Section 3: Older Persons Services
- Section 4: Statewide and other Targeted Services
For the purposes of this RDF, age-specific services are generally categorised as follows:
- Child and Adolescent Services—0 to <18 years
- Adult Services - 18 to <65 years (and Aboriginal and Torres Strait Islander consumers <50 years).
- Older Persons Services ≥65 years (and Aboriginal and Torres Strait Islander consumers ≥50 years).
Consumers aged older than 14 years and older persons may access adult services where clinically and developmentally appropriate, and in line with policy and procedural documentation of the adult service.
This categorisation does not prevent services from providing mental health care to people outside the usual age range for their service, where it is safe and appropriate for the service to do so.
Adult Services
Adult ambulatory services provide non-admitted mental health care to adult consumers. Services may be authorised to provide involuntary treatment to patients.
| Level | Service Description | Service Requirements | Workforce Requirements |
|---|---|---|---|
| 1 |
Intermittent, Short-term. Risk/complexity: Low. May only be available for limited hours. Community clinic or home-based care. Delivered predominantly by one or more general health clinicians who provide local community healthcare service non specific to mental health. Basic screening. Brief and/or basic assessment. Brief and/or basic intervention. Consumer and carer education. Primary care and prevention programs. |
As per module overview, plus: Identification, initial acute assessment and brief individual and/or group interventions of uncomplicated mental health problems. Forward referrals for expert assessment / diagnosis / intervention as required. Development of care plan. Basic clinical detail collected to inform assessment / diagnosis / intervention / recovery. Limited psychoeducation. Mental health assessments / interventions conducted in consultation with mental health clinician where clinically indicated and associated with documented review process. Mental health assessments / interventions (and referrals to other mental health services) conducted by general health clinicians of service. Documented processes with Level 5 adult inpatient mental health service. |
As per module overview, plus access to one or more of following (visiting basis or outreach services): Registered medical practitioner. Registered nurse. Allied health professionals Peer workforce. Access to advocacy services. |
| 2 |
Intermittent, Short-term, Medium-term. Risk/complexity: Low. Accessible during business hours. Hospital-based outpatient clinic, community clinic or home-based care. Delivered predominantly by team of general health clinicians and visiting mental health professionals who provide a local community healthcare service (general health clinicians providing mental health service have qualifications and/or experience in mental health care). Some mental health specific services/programs provided at this level. Assessment. Interventions, including counselling. Consumer and carer education and information. Documented case review. Primary prevention programs. Consultation liaison with higher-level mental health services. |
As per Level 1, plus: Identification, initial acute assessment and interventions of mental health problems (that may be associated with simple comorbidities and/or resistance to treatment). Range of primary prevention services (e.g. stress management). Psychoeducation (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Mental health assessments / interventions conducted by general health clinicians with qualifications and/or experience in mental health and/or visiting mental health clinicians. |
As per Level 1, plus access to one or more of the following qualified and experienced mental health professionals: Registered medical practitioner. Registered nurse. Allied health professionals. Peer workforce. Access to visiting mental health professionals. |
| 3 |
Intermittent, Short-term, Medium-term, Long-term. Risk/complexity: Low, Moderate. Day programs primarily consist of block based intervention periods and may only be delivered at certain times of the year. Hospital based outpatient clinic or day program, community mental health clinic or home based care. Delivered predominantly by small team (not necessarily multidisciplinary) of mental health professionals who provide local mental health care service. Assessment by mental health professionals. Targeted interventions by mental health professionals. Consumer and carer education and information. Care coordination/case management. Documented case review. Primary and limited secondary prevention programs. Consultation liaison with higher-level mental health services. |
As per Level 2, plus: Identification, ongoing assessment, monitoring and interventions of mental health problems (that may be associated with comorbidities and/or resistance to treatment). Integrated identification, assessment and intervention of any co-occurring substance-use disorders. Development of individual mental health recovery plan. Range of primary (e.g. stress management) and some limited secondary (e.g. weight management) prevention services. Psychoeducation for consumer and family/carer (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Mental health assessments/interventions conducted by mental health clinicians of the service. If providing non ablative neurosurgical procedures, authorised mental health service under Mental Health Act 2013. |
As per Level 2, plus: Limited access to registered medical specialist with credentials in psychiatry. Access to two or more qualified and/or experienced mental health nurses. Access to allied health professionals with qualifications and/or experience in mental health. Peer workforce. Access to some visiting specialties in health and/or mental health (e.g. Community Forensic Outreach Service). |
| 4 |
Intermittent, Short-term, Medium-term, Long-term. Risk/complexity: Low, Moderate, High. Accessible during business hours. Hospital based outpatient clinic or day program, community mental health clinic or home based care. Delivered predominantly by multidisciplinary team of mental health professionals who provide local mental health care service. Multidisciplinary assessment by mental health professionals. Targeted interventions by mental health professionals. Consumer and carer education and information. Care coordination/case management. Documented regular case review. Some group programs. Primary and secondary prevention programs. Consultation liaison with lower- and higher-level mental health services. |
As per Level 3, plus: Development of comprehensive individual mental health recovery plan within 1 week of assessment. Extensive clinical detail collected to inform assessment, diagnosis, intervention and recovery. Extensive range of primary (e.g. stress management) and secondary (e.g. weight management) prevention services. Assertive outreach applicable to service and target population. Mental health assessments / interventions conducted by team of mental health professionals. May be authorised mental health service under Mental Health Act 2013. |
A per Level 3, plus: Access to registered medical specialist with credentials in psychiatry for assessment, case management and review. May have extended hours access to registered medical practitioner in psychiatry under supervision (e.g. psychiatry registrar). Access -during business hours - to registered nurse with qualifications and/or experience in mental health. Access - during business hours - to allied health professional/s with qualifications and/or experience in mental health. Peer workforce. |
| 5 |
Intermittent, Short-term, Medium-term, Long-term. Hospital based outpatient clinic, community mental health clinic, home based care, or designated hospital or community based day program. ** Delivered predominantly by multidisciplinary team of mental health professionals who provide a local mental health care service. Multidisciplinary assessment by mental health professionals. Targeted interventions by mental health professionals. Consumer and carer education and information. Care coordination/case management. Documented frequent case review. Group programs. Primary and secondary prevention programs. Consultation liaison with lower- and higher-level mental health services. |
As per Level 4, plus: Identification, ongoing assessment, monitoring and interventions of mental health problems ranging in risk and complexity (that may be associated with complex comorbidities and/or indicators of treatment resistance). Targeted clinical programs for individuals / groups / families / carers. Psychoeducation for consumers, families/carers and groups (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Separate clinical services for families/carers, if required. Mental health assessments / interventions conducted by multidisciplinary team of mental health professionals. Service based within a DoH service or part of service network that includes Level 5 or 6 adult acute inpatient mental health unit. Consultation-liaison services to local health services as required. Authorised mental health service under Mental Health Act 2013. |
As per Level 4, plus: Access -during business hours- - to registered medical specialist with credentials in psychiatry for assessment, case management and review. Access - during business hours - to registered nurse with extensive mental health experience and/or qualifications in mental health. Access - during business hours - to multidisciplinary team of allied health professionals with qualifications and/or experience in mental health. Access to psychology, social work, occupational therapy, speech pathology and dietetic services. Access to dedicated pharmacy services for mental health. Peer workforce. Access to range of visiting or local health / mental health specialties. |
| 6 |
Intermittent, Short-term, Medium-term, Long-term. Risk/complexity: Highest. Hospital based outpatient clinic, community mental health clinic, home based care or hospital or community based day program. Delivered by highly specialised multidisciplinary team of mental health professionals (medical practitioners, psychiatrists, nurses, allied health and other specialists) providing specialist mental health care service either locally and/or across service areas. Multidisciplinary and subspeciality assessment by mental health professionals. Specialised interventions by mental health professionals. Consumer and carer education and information. Care coordination/case management. Documented frequent case review. Targeted group programs. All levels of prevention. |
As per Level 5, plus: Identification, ongoing assessment, monitoring and interventions of complex mental health problems (that may be associated with most complex comorbidities and/or indicators of treatment resistance). Extensive clinical detail collected to inform assessment, diagnosis, intervention and recovery, and broader service delivery across all levels of service. Extensive range of primary (e.g. stress management), secondary (e.g. weight management) and tertiary (e.g. psychosis treatment maintenance) prevention services. Statewide clinical forums to assist dissemination of clinical expertise. Services form part of an integrated mental health service and are based in a DoH service or are part of service network that also includes Level 5 or 6 adult acute inpatient mental health unit. Assertive outreach applicable to service and target population. Specialist consultation liaison to other health and non health services/agencies for target population. May provide extensive range of additional clinical programs and service components, such as outreach service, telehealth services or extended treatment program. |
As per Level 5, plus: Extended-hours access to registered medical specialist with credentials in psychiatry for assessment, case management and review. Extended-hours access to registered medical practitioner with credentials in psychiatry (psychiatry registrar). Extended-hours access to registered nurses with extensive mental health experience and/or qualifications in mental health. Extended-hours access to multidisciplinary team of allied health professionals with mental health. Qualifications and/or experience, some with:
Peer workforce. Access to extensive range of visiting or local health / mental health specialties. |
** Service delivered by community based Acute Care Teams and Mobile Intensive Treatment Teams – or their equivalents – may be defined at this level of service.
Adult acute inpatient services provide admitted mental health care to adult patients. Services may be authorised to provide involuntary treatment to patients.
| Level | Service Description | Service Requirements | Workforce Requirements |
|---|---|---|---|
| 1 | n/a | n/a | n/a |
| 2 |
Intermittent, Short-term. Provides general healthcare and some limited mental health care 24 hours a day. Medical services provided on-site or in close proximity to provide rapid response at all times. Team of general health clinicians within a facility without dedicated mental health staff (on- site) or allocated beds. Screening. Assessment. Brief interventions and monitoring. Consumer and carer education and information. Documented case review. Consultation-liaison with higher level mental health services. |
As per module overview, plus: Identification, initial acute assessment, brief intervention and monitoring of uncomplicated mental health problems. Medication management. Forward referrals for expert assessment, diagnosis, and intervention. Development of care plan. Limited psychoeducation (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Mental health assessments and interventions conducted in consultation with mental health clinician where clinically indicated and associated with documented review process. Mental health assessments and brief interventions / monitoring (and referrals to other mental health services) conducted by general health clinicians of this service. Documented processes with Level 5 acute inpatient mental health service Additional mental health interventions may be directly provided by mental health clinicians using telehealth facilities, visiting and/or community-based workforce. |
As per module overview, plus: Admitted by registered medical practitioner. Daily care coordinated by registered medical practitioner who has access to registered medical specialist with credentials in psychiatry to assist and guide assessment, treatment, case management and case review (may be via telehealth). Medical services provided on-site or in close enough proximity to provide rapid response at all times Suitably qualified and experienced registered nurse in charge (however titled) of unit. Qualified and experienced registered nurse in charge of each shift with skills appropriate to service being provided. Other suitably qualified nursing staff working within their scope of clinical practice. Access—during business hours—to registered nurse with qualifications in mental health and/or extensive mental health experience who can provide advice, support and direction for nursing care. Access—during business hours—to allied health professionals AINs or equivalent may complement clinical team at discretion of nurse in charge. Bachelor of Nursing students (second- or third-year undergraduate) may complement clinical team at discretion of nurse in charge and under registered nurse supervision. Access to advocacy services. |
| 3 |
Intermittent, Short-term, Medium-term. Provides general healthcare and mental health care 24 hours a day. Within a general medical facility that has limited number of allocated mental health beds or may operate as mental health special care suite/area. Delivered predominantly by general and mental health professionals (on- site). Screening. Assessment by general and mental health professionals. Targeted interventions by general and mental health professionals. Consumer and carer education and information. Documented case review. Primary and limited secondary prevention programs. Consultation-liaison with higher level mental health services. |
As per Level 2, plus: Identification, acute assessment, brief intervention and monitoring of mental health problems (that may be associated with simple comorbidities and/or resistance to treatment). Development of comprehensive individual mental health recovery plan within 1 week of assessment. Limited range of primary (e.g. stress management) and secondary (e.g. weight management) prevention services. Psychoeducation (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Mental health assessments, interventions and monitoring conducted by general and mental health clinicians of this service. An infant can only be admitted with his/her mother to an adult acute mental health inpatient unit as defined in the Perinatal and Infant Services section of this module. |
As per Level 2, plus: Admitted by / under registered medical specialist with credentials in psychiatry. Daily care coordinated by registered medical specialist with credentials in psychiatry and/or registered medical practitioner who has access to registered. At least one registered nurse per shift with qualifications and/or experience in mental health. Access—during business hours—to community- or hospital-based allied health professionals with qualifications and/or experience in mental health. |
| 4 |
Intermittent, Short-term, Medium-term. Provides mental health care 24 hours a day. Within a dedicated mental health hospital or a general hospital that has dedicated mental health acute inpatient beds. Delivered predominantly by mental health professionals. Screening. Multidisciplinary assessment by mental health professionals. Targeted interventions by mental health professionals. Consumer and carer education and information. Care coordination/case management. Documented regular case review. Some group programs. Primary and secondary prevention programs. Consultation-liaison with higher level mental health services. |
As per Level 3, plus: Identification, ongoing assessment, monitoring and interventions of mental health problems (that may be associated with comorbidities and/or indicators of treatment resistance). Integrated approach to identification, assessment, and intervention of any co-occurring substance-use disorders. Extensive clinical detail collected to inform assessment, diagnosis, intervention, and recovery. Range of primary (e.g. stress management) and secondary (e.g. weight management) prevention services. Psychoeducation for the consumer and family / carer (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Mental health assessments, interventions and monitoring conducted by team of mental health professionals. Mental health assessments and interventions for adolescents conducted in consultation with child and youth mental health clinician from ambulatory service Level 4 or above, or acute inpatient service. Level 5 or above where clinically indicated and associated with documented review process. Documented processes outlining supervisory requirements to ensure safety of adolescents admitted to the unit. Documented processes with Level 4, 5 or 6 child and youth acute inpatient mental health service. If ECT services are provided, service is delivered within a hospital with procedural and recovery areas. As clinically indicated, ECT services may be facilitated and/or provided at this service level by mental health service authorised to provide ECT under Mental Health Act 2013. If providing non-ablative neurosurgical procedures, on-site Level 5 or above neurosurgical service is required. |
As per Level 3, plus: Access—24 hours—to registered medical specialist with credentials in psychiatry for assessment, treatment, case management and case review. If providing non-ablative neurosurgical procedures, surgical service provided by qualified and experienced specialist medical practitioner with credentials in neurosurgery. If providing ECT services, medical practitioner with credentials in procedural sedation. Registered nurse in charge of each shift is suitably qualified and/or experienced mental health professional. Two or more registered nurses per shift qualified and/or experienced in mental health. Access—during business hours—to community- or hospital-based allied health staff with qualifications and/or experience in adult acute mental health. Access to dedicated pharmacy services for mental health. Peer workforce. Access to some on-site and/or visiting specialties in health / mental health.
|
| 5 |
Intermittent, Short-term, Medium-term. Provides mental health care 24 hours a day. Within dedicated mental health hospital or general hospital that has dedicated mental health acute inpatient unit. Delivered predominantly by multidisciplinary team of mental health professionals (psychiatrist, nurses, allied health professionals). Screening. Multidisciplinary assessment by mental health professionals. Targeted interventions by mental health professionals. Consumer and carer education and information. Care coordination/case management. Documented regular case review. Group programs. Extensive primary and secondary prevention programs. Consultation- liaison with higher and lower level mental health services |
As per Level 4, plus: Identification, ongoing assessment, monitoring and interventions of mental health problems ranging in risk and complexity (that may be associated with complex comorbidities and/or indicators of treatment resistance). Targeted clinical programs for individuals / groups / families / carers (e.g. group therapy for consumers with Bipolar Affective Disorder). Extensive range of primary (e.g. stress management) and secondary (e.g. weight management) prevention services. Mental health assessments, interventions and monitoring conducted by multidisciplinary team of mental health professionals. Authorised mental health service under Mental Health Act 2013. May provide range of additional clinical programs and service components, such as telehealth services or a day program. |
As per Level 4, plus: May have access—24 hours—to registered medical practitioner (psychiatry registrar /principal house officer / senior medical officer / career medical officer) with credentials relevant to the discipline. Majority of registered nursing staff each shift are qualified mental health practitioners. Access to dedicated pharmacy services for mental health. Peer workforce. Access to extensive range of on-site and/or visiting specialties in health / mental health |
| 6 |
Intermittent, Short-term, Medium-term. Provides mental health care 24 hours a day. Service is highly specialised and/or statewide inpatient service delivered from large general hospital incorporating dedicated mental health unit or may be delivered from purpose-designed and built mental health facility. Demonstrates specialist expertise in delivery of mental health services to a consumer group that cannot be safely and effectively cared for in any other level of acute inpatient mental health service. Delivered by highly specialised multidisciplinary team of mental health professionals (medical practitioners, psychiatrists, nurses, allied health and other specialists). Screening. Multidisciplinary assessment by mental health professionals. Specialised interventions by mental health professionals. Consumer and carer education and information. Care coordination/case management. Documented daily case review. targeted group programs. All levels of prevention programs / services. Consultation- liaison with lower level mental health services. |
As per Level 5, plus: Identification, ongoing assessment, monitoring and interventions of complex mental health problems (that may be associated with most complex comorbidities and/or indicators of treatment resistance). Extensive clinical detail collected to inform assessment, diagnosis, intervention and recovery, and broader service delivery in all levels of service. Extensive range of primary (e.g. stress management), secondary (e.g. weight management) and tertiary (e.g. psychosis treatment maintenance) prevention services. Statewide clinical forums to assist dissemination of clinical expertise. Psychoeducation for consumers, families / carers and groups (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Separate clinical services for families / carers, if required. Service forms part of integrated mental health service and is based in a DoH Service or part of service network that also includes Level 5 or 6 adult ambulatory mental health service. Specialist consultation- liaison to other health and non-health services / agencies for target population. May provide extensive range of additional clinical programs and service components, such as outreach services, telehealth services or day programs. |
As per Level 5, plus: Access—24 hours—to registered medical practitioner (psychiatry registrar /principal house officer / senior medical officer / career medical officer) with credentials relevant to the discipline. Registered nursing staff are qualified mental health practitioners and have extensive mental health experience. Extended-hours access to community- or hospital-based allied health professionals with relevant specialist mental health qualifications and experience. Peer workforce. |
Adult non-acute inpatient services provide admitted mental health care to adult patients. Services may be authorised to provide involuntary treatment to patients.
| Level | Service Description | Service Requirements | Workforce Requirements |
|---|---|---|---|
| 1 | n/a | n/a | n/a |
| 2 | n/a | n/a | n/a |
| 3 | n/a | n/a | n/a |
| 4 |
Medium-term, Long-term. Provides daily clinical care and rehabilitation to consumers on an extended basis before they move to more independent living arrangements. Target population includes those within service identified age range who either require graduated entry back into community post hospitalisation, or require extended and intensive clinical interventions, but do not need or would not benefit from a mental health acute inpatient admission. 24 hours a day. Based in the community or may be co located with a hospital based medical/mental health service. Delivered predominantly by mental health professionals who provide supervised and structured living environment, such as that of a Community Care Unit. Multidisciplinary assessment by mental health professionals. Targeted interventions and rehabilitation by mental health professionals. Consumers and carer education and information. Care coordination/case management. Documented regular case review. Group programs. Primary and some secondary prevention programs. Consultation-liaison with lower and higher level mental health services. |
As per module overview, plus: Identification, ongoing assessment, monitoring, interventions and rehabilitation of mental health problems ranging in risk and complexity (that may be associated with comorbidities and/or indicators of treatment resistance). Integrated approach to identification, assessment and intervention of any co-occurring substance-use disorders. Targeted clinical programs for individuals / groups / families / carers (e.g. group therapy for families/carers of consumers with a psychotic illness). Forward referrals for assessment, diagnosis and intervention as required. Development of comprehensive individual mental health recovery plan within 1 week of assessment. Extensive range of primary (e.g. parenting support) and secondary (e.g. weight management) prevention services. Psychoeducation for consumer and family/carers (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Mental health assessments, interventions, rehabilitation and monitoring conducted by multidisciplinary team of mental health professionals. Additional mental health interventions may be directly provided by mental health clinicians using telehealth facilities, visiting and/or community-based workforce. Service provision occurs alongside ongoing consultation-liaison with referring service / practitioner. |
As per module overview, plus: Admitted by/ under registered medical specialist with credentials in psychiatry. Access—during business hours—to registered medical specialist with credentials in psychiatry for assessment, treatment, case management and case review. Suitably qualified and experienced registered nurse (however titled) in charge of unit. Registered nurse in charge of each shift has mental health qualifications and/or experience in mental health. Two or more registered nurses per shift qualified and/or experienced in mental health. If inpatient unit occupancy is low, only one registered nurse per shift qualified and/or experienced in mental health. Access—during business hours—to community- or hospital-based allied health professionals e.g. psychology, social work, occupational therapy, speech pathology and dietetic services. Peer workforce. Access to range of visiting or local health/mental health specialties. AINs or equivalent may complement clinical team at discretion of nurse in charge. Bachelor of Nursing students (second- or third-year undergraduate) may complement clinical team at discretion of nurse in charge and under registered nurse supervision. Access to advocacy services. |
| 5 |
Medium-term, Long-term. Provides daily clinical care and rehabilitation to targeted population of consumers (e.g. those with dual diagnosis of mental health disorder and acquired brain injury). Target population for this service includes those within service-identified age range who require extended and intensive clinical interventions (some may require high levels of security), and whose clinical needs are not able to be safely and adequately met in an adult acute inpatient mental health service. 24 hours a day. Supervised, structured and secure environment (e.g. a Medium Secure Unit). Delivered predominantly by multidisciplinary team of mental health professionals (psychiatrists, nurses, allied health). Service provision. Multidisciplinary assessment by mental health professionals. Targeted interventions and rehabilitation by mental health professionals. Consumers and carer education and information. Care coordination/case management. Documented regular case review. Group programs. Primary and secondary prevention programs. Consultation-liaison with lower and higher level mental health services. |
As per Level 4, plus: Co-located with hospital-based medical / mental health service or part of purpose- designed and built mental health facility. Identification, ongoing assessment, monitoring, interventions and rehabilitation of mental health problems ranging in risk and complexity (that may Extensive clinical detail collected to inform assessment, diagnosis, intervention and recovery. Range of additional programs and service components (e.g. partial hospitalisation, consultation-liaison services, rehabilitation programs and telehealth). Mental health assessments, interventions, rehabilitation and monitoring conducted by multidisciplinary team of mental health professionals. Authorised mental health service under Mental Health Act 2013. |
As per Level 4, plus: Access - 24 hours - to registered medical specialist with credentials in psychiatry for assessment, treatment, case management and case review. Access -24 hours - to support by registered medical practitioner/s. Access—during business hours—to multidisciplinary team of allied health professionals (relevant postgraduate training is desirable). Access to dedicated pharmacy services for mental health. Peer workforce. Access to wide range of visiting or local health / mental health specialties. |
| 6 |
Medium-term, Long-term. Demonstrates specialist mental health expertise in delivery of mental health services to members of targeted population—some of whom will present with special care needs requiring non acute extended inpatient mental health treatment and rehabilitation. 24 hours a day. Highly specialised and/or statewide extended care inpatient service. Predominantly provided by multidisciplinary team of mental health professionals (medical practitioners, psychiatrists, nurses, allied health and other specialists). Multidisciplinary assessment by mental health professionals. Specialised interventions by mental health professionals. Consumers and carer education and information. Care coordination/case management. Documented frequent case review. Targeted group programs. All levels of prevention programs/services. Consultation-liaison with lower level mental health services. |
As per Level 5, plus: Primary service site co-located with adult acute inpatient mental health unit or, alternatively, primary service site may be purpose-designed and built mental health facility. Identification, ongoing assessment, monitoring, interventions and rehabilitation of complex mental health problems (that may be associated with the most complex comorbidities and/or indicators of treatment resistance). Extensive clinical detail collected to inform assessment, diagnosis, intervention and recovery, and broader service delivery in all levels of service. Extensive range of primary (e.g. stress management), secondary (e.g. weight management) and tertiary (e.g. psychosis treatment maintenance) prevention services. Statewide clinical forums to assist dissemination of clinical expertise. Psychoeducation for consumers, families/carers and groups (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Extensive range of additional programs and service components (e.g. step-down programs, consultation-liaison services, rehabilitation programs and telehealth). |
As per Level 5, plus: Medical services provided on-site or are in close enough proximity to provide rapid response at all times. Majority of registered nursing staff qualified mental health practitioners and have extensive mental health experience. Extended-hours access to community- or hospital-based allied health professionals with qualifications and experience in mental health. Some clinicians will be specialists in specific intervention areas relevant to service being provided. Peer workforce. Access to extensive range of specialist health service providers (not all of whom are required to be on-site). |
Child and Adolescent Services
Child and adolescent ambulatory services provide non-admitted mental health care to consumers with mental health care needs. Level 4 to 6 may be authorised to provide involuntary treatment to patients.
| Level | Service Description | Service Requirements | Workforce Requirements |
|---|---|---|---|
| 1 |
Intermittent, Short-term. May only be accessible for limited hours. Community clinic or home-based care. Delivered predominantly by one or more general health clinicians who provide local community healthcare service that is non-specific to mental health. Screening. Basic assessment. Brief and/or basic intervention. Consumer and carer education. Some group programs. Primary care and prevention programs. |
As per module overview, plus: Screening, identification, initial acute assessment and brief interventions of uncomplicated mental health problems. Forward referrals for expert assessment, diagnosis and/or intervention as required. Development of a care plan. basic clinical detail collected to inform assessment, diagnosis, intervention and/or recovery. Psychoeducation (including providing information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Mental health assessments and interventions (and referrals to other mental health services) conducted by general health clinicians of this service. Mental health assessments and interventions conducted in consultation with child and youth mental health clinician, from Level 4 ambulatory service or above, where clinically indicated, and associated with documented review process. Range of primary (e.g. parenting support) and some limited secondary (e.g. weight management) prevention services. Documented processes and collaborative partnerships with schools, education networks and service providers as required. Service is based within a DoH service or is part of a service network that includes Level 5 or 6 child/adolescent acute inpatient mental health unit. |
As per module overview, plus access to one or more of following (visiting basis or outreach services): Registered nurse. Allied health professionals. Access to advocacy services. |
| 2 |
Intermittent, Short-term, Medium-term. Accessible during business hours. Community clinic or home-based care. Delivered predominantly by team of general health clinicians and visiting mental health professionals who provide local community healthcare service. General health clinicians have qualifications and/or experience in mental health care. Some mental health- specific services / programs provided at this level. Screening. Assessment. Interventions including counselling. Consumer and carer education and information. Documented case review. Some group programs. Primary and secondary prevention programs. Consultation-liaison with higher level mental health services. |
As per Level 1, plus: Identification, initial acute assessment and interventions for mental health problems (that may be associated with simple comorbidities). Limited range of primary prevention services (e.g. parenting support). Psychoeducation (including providing information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Mental health assessments and interventions conducted by one or more general health clinicians with qualifications and/or experience in mental health and/or by visiting mental health professionals. Range of primary (e.g. parenting support) and some limited secondary (e.g. weight management) prevention services. Documented processes and collaborative partnerships with schools, education networks and service providers as required. Service is based within a DoH service or is part of a service network that includes Level 5 or 6 child/adolescent acute inpatient mental health unit. |
As per Level 1, plus access to one or more of following qualified and experienced mental health professionals: Registered nurse. Allied health professionals. Access to visiting mental health professionals. |
| 3 |
Intermittent, Short-term, Medium-term. Accessible during business hours. Community mental health clinic or home-based care. Delivered predominantly by small team (not necessarily multidisciplinary) of mental health professionals who provide local mental health care service. Most clinical team members have qualifications and/or experience in child and youth mental health care. Screening. Assessment by mental health professionals. Targeted evidence-based interventions by mental health professionals. Consumer and carer education and information. Care coordination / case management. Documented case review. Some group programs. Primary and secondary prevention programs. Consultation-liaison with higher level mental health services. |
As per Level 2, plus: Identification, ongoing assessment, monitoring and interventions for mental health problems that may be associated with comorbidities. Integrated identification, assessment and brief intervention of any co-occurring substance-use disorders. Development of individual mental health recovery plans. Targeted parenting support and interventions. Documented processes and collaborative partnerships with schools, education networks and service providers as required. Mental health assessments and interventions conducted by team (not necessarily multidisciplinary) of mental health professionals, most of whom have qualifications and/or experience in child and youth mental health. |
As per Level 2, plus: Registered medical practitioner ; limited access to registered medical specialist with credentials in psychiatry and certificate in child and adolescent psychiatry (or equivalent). Registered nurses with qualifications and/or experience in child and youth mental health. Access to allied health professionals with qualifications and/or experience in child and youth mental health. Access to some visiting specialties in health and/or mental health (e.g. Child and Youth Forensic Outreach Service). May have access to school-based youth health nurse. |
| 4 |
Intermittent, Short-term, Medium-term. Accessible during business hours with exception of day programs, which are delivered primarily during school terms and consist of block-based intervention periods. Access for acute assessment limited extended hours. Hospital-based outpatient clinic or day program, community mental health clinic or through home- based care. Delivered predominantly by multidisciplinary team of child and youth mental health professionals who provide local mental health care service. Screening. Multidisciplinary assessment by mental health professionals. Targeted evidence-based interventions by mental health professionals. Consumer and carer education and information. Care coordination / case management. Documented regular case review. Some group programs. Targeted secondary prevention programs. Consultation and liaison with lower and higher level mental health services. |
As per Level 3, plus: Extensive clinical detail collected to inform assessment, diagnosis, intervention and/or recovery. Development of comprehensive individual mental health recovery plan within 1 week of assessment. Extensive range of primary (e.g. parenting support) and secondary (e.g. weight management) prevention services. Assertive outreach (non-clinic based) applicable to service and target population. Mental health assessments and interventions conducted by team of mental health professionals with qualifications and/or experience in child and youth mental health. May be authorised mental health service under Mental Health Act 2013. |
As per Level 3, plus: Access to registered medical specialist with credentials in psychiatry and certificate in child and adolescent psychiatry (or equivalent) for assessment, case management and review. Access - during business hours - to registered medical specialist with credentials in paediatrics for medical consultation-liaison. Access - during business hours - to registered nurse with qualifications and/or experience in child and youth mental health. Access—during business hours—to multidisciplinary team of allied health professionals with qualifications and/or experience in child and youth mental health. |
| 5 |
Intermittent, Short-term, Medium-term, Long-term. Accessible during business hours and consumers have access to limited extended-hours service. Day programs delivered primarily during school terms and consist of block-based intervention periods. Access for acute assessment limited extended hours. Hospital-based outpatient clinic, community mental health clinic, home- based care or hospital- or community-based day program. Delivered predominantly by multidisciplinary team of child and youth mental health professionals who provide local mental health care service. Screening. Multidisciplinary assessment by mental health professionals. Targeted evidence-based interventions by mental health professionals. Consumer and carer education and information. Care coordination / case management. Documented frequent case review. Group programs. Relapse prevention and prevention of chronicity. Consultation and liaison with lower and higher level mental health services. |
As per Level 4, plus: Authorised service under Mental Health Act 2013. Identification, ongoing assessment, monitoring and interventions for mental health problems ranging in risk and complexity (that may be associated with complex comorbidities and/or indicators of treatment resistance). Targeted clinical programs for individuals / groups / families (e.g. group therapy for families / carers of patients with psychotic illness). Psychoeducation for patients, families / carers and groups (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Statewide clinical forums to assist dissemination of clinical expertise. Separate clinical services for families/carers, if required. Consultation-liaison services to local children’s health services as required. Mental health assessments and interventions conducted by multidisciplinary team of mental health professionals with qualifications and/or experience in child and youth mental health. Service based within DoH service or is part of service network that also includes Level 5 or 6 child / adolescent acute inpatient mental health unit. Service provision may occur across a range of sites (e.g. hospital, school, home, recreational venues), and service capacity and resources must be sufficient to transport patients individually and/or as a group. |
As per Level 4, plus: Access—during business hours and limited extended hours—to registered medical specialist with credentials in psychiatry and certificate in child and adolescent psychiatry (or equivalent) for assessment, case management and review. Access—during business hours—to registered nurse with extensive experience in mental health and/or qualifications in mental health and qualifications and/or experience in child and youth mental health. Access—during business hours—to multidisciplinary team of allied health professionals with child and youth mental health qualifications and/or experience Access to peer (caregiver and/or consumer) workforce. Access to range of visiting or local health / mental health specialties. |
| 6 |
Intermittent, Short-term, Medium-term, Long-term. Accessible during business hours and extended-hours service provided. Access for acute assessment limited extended hours. Hospital-based outpatient clinic, community mental health clinic, home- based care or through hospital- or community-based day program. Delivered by multidisciplinary team of child and youth mental health professionals providing specialist mental health care service either locally and/or across DOH SERVICE or service areas. Screening. Multidisciplinary assessment by mental health professionals. Specialised evidence-based interventions by mental health professionals. Consumer and carer education and information. Care coordination / case management. Documented frequent case review. Targeted group programs. Relapse prevention and prevention of chronicity. Consultation and liaison with lower level mental health services. |
As per Level 5, plus: Identification, ongoing assessment, monitoring and interventions for complex mental health problems (that may be associated with most complex comorbidities and/or indicators of treatment resistance). Extensive clinical detail collected to inform assessment, diagnosis, intervention and/or recovery and broader service delivery in all levels of service. Extensive range of primary (e.g. parenting support), secondary (e.g. Statewide clinical forums to assist dissemination of clinical expertise. Specialist consultation-liaison to other health and non- health services / agencies for target population. Assertive outreach applicable to service and target population. May provide extensive range of additional clinical programs and service components, such as outreach service, telehealth services or extended treatment program |
As per Level 5, plus: Extended-hours access to registered medical specialist with credentials in psychiatry and certificate in child and adolescent psychiatry (or equivalent) for assessment, case management and review. Extended-hours access to registered medical practitioner in psychiatry under supervision (e.g. psychiatry registrar). Extended-hours access to registered nurses with qualifications and experience in child and youth mental health. Some of these clinicians have:
Extended-hours access to multidisciplinary team of allied health professionals with child and youth mental health qualifications and experience. Access to dedicated pharmacy services for mental health. Some of these clinicians have:
Access to peer (caregiver and/or consumer) workforce. Access to extensive range of visiting or local health / mental health specialties. |
Child and adolescent acute inpatient services provide admitted mental health care to paediatric patients. Services may be authorised to provide involuntary treatment to patients.
| Level | Service Description | Service Requirements | Workforce Requirements |
|---|---|---|---|
| 1 | n/a | n/a | n/a |
| 2 | n/a | n/a | n/a |
| 3 | n/a | n/a | n/a |
| 4 |
Intermittent, Short-term, Medium-term. Provides mental health care 24 hours a day. Within hospital that has paediatric unit or beds. Delivered predominantly by general or children’s health professionals with access to mental health clinicians. Screening. Multidisciplinary assessment. Targeted interventions and monitoring. Consumer and carer education and information. Documented regular case review. Some group programs. Consultation- liaison with higher level mental health services. |
As per Level 3, plus: Identification, ongoing assessment, monitoring and interventions for mental health problems (that may be associated with comorbidities and/or indicators of treatment resistance). Integrated approach to identification, assessment and intervention of any co- occurring substance- use disorders. Development of comprehensive individual mental health recovery plans within 1 week of assessment. May be an authorised mental health service under Mental Health Act 2013. Extensive clinical detail collected to inform assessment, diagnosis, intervention and recovery. Range of primary (e.g. parenting support) and secondary (e.g. weight management) prevention services. Psychoeducation for consumer and family / carer (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Documented processes and collaborative partnerships established with schools, education networks and service providers. |
As per Level 3, plus: Consumer admitted by / under registered medical specialist with credentials in paediatrics with access to a medical specialist in psychiatry and certificate in child and adolescent psychiatry (or equivalent). Daily care coordinated by registered medical specialist with credentials in psychiatry who has access—24 hours—to registered medical specialist with credentials in psychiatry and certificate in child and adolescent psychiatry (or equivalent) to assist and guide assessment, treatment, case management and case review (may be via telehealth). Access during business hours to a registered nurse(or other mental health professional) qualified and experienced in mental health. Access—during business hours—to community- or hospital- based allied health staff with qualifications and/or experience in mental health. Access to some on-site and/or visiting specialties in health / mental health. |
| 5 |
Intermittent, Short-term, Medium-term, Long-term***. 24 hours a day. Within hospital that has allocated mental health beds for children and/or adolescents or within dedicated child and youth mental health unit. Delivered predominantly by child and youth mental health professionals. Screening. Multidisciplinary assessment by mental health professionals. Targeted interventions by mental health professionals. Consumer and carer education and information. Documented regular case review. Group programs. Extensive primary and secondary prevention programs. Consultation-liaison with higher and lower level mental health services. |
As per Level 4, plus: Identification, ongoing assessment, monitoring and interventions for mental health problems ranging in risk and complexity (that may be associated with complex comorbidities and/or indicators of treatment resistance). Targeted clinical programs for individuals / groups / families / carers (e.g. group therapy for families/carers of patients with psychotic illness). Extensive range of primary (e.g. parenting support) and secondary (e.g. weight management) prevention services. Authorised mental health service under Mental Health Act 2013. As clinically indicated, ECT services may be facilitated and/or provided by mental health service authorised to provide ECT under Mental Health Act 2013, and under care of registered medical specialist with credentials in psychiatry and certificate in child and adolescent psychiatry (or equivalent), and in accordance with Mental Health Act 2013. May provide a range of additional clinical programs and service components, such as telehealth services or a day program. |
As per Level 4, plus: Access—24 hours—to registered medical specialist with credentials in psychiatry and certificate in child and adolescent psychiatry (or equivalent) to assist and guide assessment, treatment, case management and review. Registered nurse (however titled) in charge of unit is qualified and experienced in child and youth mental health. Qualified and/or experienced registered nurse in charge of each shift with extensive skills appropriate to service being provided. Majority of unit nursing staff have mental health qualifications and/or experience, and/or qualifications and/or experience in child and youth mental health, and/or children’s health. Access—during business hours—to community- or hospital-based allied health staff with qualifications and/or experience in child and youth mental health (postgraduate qualifications desirable). Access to psychology, social work, occupational therapy, speech pathology and dietetic services. Access to dedicated pharmacy services for mental health. Access to peer (caregiver and/or consumer) workforce. Access to extensive range of on-site and/or visiting specialties in health/mental health. May have hospital-based school teacher dedicated to mental health consumer. |
| 6 |
Intermittent, Short-term, Medium-term, Long-term. 24 hours a day. Highly specialised and/or statewide inpatient service delivered from child / adolescent hospital that incorporates dedicated mental health unit or may be delivered from purpose- designed and built mental health facility. Demonstrates specialist expertise in delivery of mental health services to a patient group that cannot be safely and effectively cared for in any other level of acute inpatient mental health service. Has statewide and/or interstate health service functions. Delivered by a highly specialised, multidisciplinary team of child and youth mental health professionals. Screening. Multidisciplinary assessment by mental health professionals. Specialised interventions by mental health professionals. Consumer and carer education. Documented daily case review. Targeted group programs. All levels of prevention programs / services. Consultation-liaison with lower level mental health services. |
As per Level 5, plus: Identification, ongoing assessment, monitoring and interventions for complex mental health problems (that may be associated with most complex comorbidities and/or indicators of treatment resistance). Extensive clinical detail collected to inform assessment, diagnosis, intervention, recovery and broader service delivery in all levels of service. Extensive range of primary (e.g. parenting support), secondary (e.g. weight management) and tertiary (e.g. psychosis treatment maintenance) prevention services. Statewide clinical forums to assist dissemination of clinical expertise. Separate clinical services for families / carers, if required. Specialist consultation- liaison to other health and non-health services / agencies for target population. Psychoeducation for consumer, families / carers and groups (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Forms part of integrated mental health service and is based in a DoH service, or is part of service network that also includes Level 5 or 6 child and youth ambulatory mental health service. May provide extensive range of additional clinical programs and service components, such as an outreach service, telehealth services or day program. |
As per Level 5, plus: Access - 24 hours - to registered medical practitioner (psychiatry registrar / principal house officer / senior medical officer / career medical officer) with credentials relevant to the discipline. Medical services provided on-site or in close enough proximity to provide rapid response at all times. As per level 5 with all staff qualified and experienced in child and youth mental health. As per level 5 with all staff qualified and experienced in child and youth mental health. Access to peer (caregiver and/or consumer) workforce. Access to extensive range of on-site and/or visiting specialties in children’s health. Access to on-site school with school teachers who can provide range of educational services dedicated to children and/or adolescents with mental illness. |
*** 4 to 6 weeks. Timeframes beyond this require specific consultation with higher level child and youth mental health acute inpatient service that will contribute in ongoing manner to case review and management.
Child and adolescent non-acute inpatient services provide admitted mental health care to children / adolescents with mental health care needs. Services may be authorised to provide involuntary treatment to patients.
| Level | Service Description | Service Requirements | Workforce Requirements |
|---|---|---|---|
| 1 | n/a | n/a | n/a |
| 2 | n/a | n/a | n/a |
| 3 | n/a | n/a | n/a |
| 4 | n/a | n/a | n/a |
| 5 |
Medium-term, Long-term. 24 hours a day. Supervised, structured and secure environment. Delivered by multidisciplinary team of child and youth mental health professionals. Multidisciplinary assessment by mental health professionals. Targeted interventions by mental health professionals. Consumer and carer education and information. Ongoing support of educational needs and documented processes with educational providers. Care coordination and case management. Documented frequent case review. Group programs. Primary and secondary prevention programs Consultation-liaison with higher and lower level mental health services. |
As per module overview, plus: Primary service site co-located with child/adolescent acute inpatient mental health unit or, alternatively, primary service site may be purpose- designed and -built mental health facility. Identification, ongoing assessment, monitoring, interventions and rehabilitation for mental health problems ranging in risk and complexity (that may be associated with complex comorbidities and/or indicators of treatment resistance). Integrated approach to identification, assessment and intervention of any co-occurring substance-use disorders. Targeted clinical programs for individuals / groups / families / carers (e.g. group therapy for families/carers of consumers with a psychotic illness). Forward referrals for assessment, diagnosis and intervention as required. Development of comprehensive individual mental health recovery plan within 1 week of assessment. Extensive clinical detail collected to inform assessment, diagnosis, intervention and recovery. Extensive range of primary (e.g. parenting support) and secondary (e.g. weight management) prevention services. Psychoeducation for consumer and family / carer (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Authorised mental health service under Mental Health Act 2013. Service provision occurs alongside ongoing consultation-liaison with the referring service / practitioner. Range of additional programs and service components (e.g. partial hospitalisation, consultation-liaison services, rehabilitation programs, telehealth). Service provision may occur across range of sites (e.g. hospital, school, home, recreational venues) and service capacity and resources must be sufficient to transport consumers individually and/or as a group. Service based within a DOH SERVICE or is part of service network that also includes Level 5 or 6 child/adolescent acute inpatient mental health unit. As clinically indicated, ECT services may be facilitated and/or provided at this level of service by a mental health service authorised to provide ECT under the Mental Health Act 2013, and under care of registered medical specialist with credentials in psychiatry and certificate in child and adolescent psychiatry (or equivalent), and in accordance with the Mental Health Act 2013. Mental health assessments and interventions are conducted by child and youth mental health clinicians of this service. Additional mental health interventions may be directly provided by child and youth mental health clinicians using telehealth facilities, visiting and/or community-based workforce. |
As per module overview plus: Admitted by / under registered medical specialist with credentials in psychiatry. Access—24 hours—to registered medical specialist with credentials in psychiatry and certificate in child and adolescent psychiatry (or equivalent) for assessment, treatment, case management and case review. Access to medical support. Access to registered medical specialist with credentials in paediatrics for medical consultation-liaison (may be via telehealth). Majority of unit nursing staff suitably qualified and experienced mental health professionals who may have postgraduate mental health qualifications. All nursing staff providing mental health care have access—during business hours—to registered nurse with extensive mental health experience and/or qualifications who can provide advice, support and direction for nursing care. Access to multidisciplinary team of allied health professionals with qualifications and/or experience in child/adolescent mental health. Access to psychology, social work, occupational therapy, speech pathology, dietetic services and dedicated pharmacy services for mental health Access to range of visiting or local health / mental health specialties and range of specialist children’s health service providers. May have program-based, qualified and registered teacher dedicated to mental health consumers. AINs or equivalent may complement the clinical team at the discretion of the nurse in charge. Bachelor of Nursing students (second or third year undergraduate) may complement the clinical team at the discretion of the nurse in charge and under registered nurse supervision. Access to advocacy services. |
Older Persons Services
Older persons ambulatory services provide non-admitted mental health care to consumers aged 65 years and over. Services may be authorised to provide involuntary treatment to patients.
| Level | Service Description | Service Requirements | Workforce Requirements |
|---|---|---|---|
| 1 |
Intermittent, Short-term. May only be available for limited hours. Community or home-based care, including residential aged care. Delivered predominantly by one or more general health clinicians who provide local community healthcare service that is non-specific to mental health. Screening. Brief and/or basic assessment. Brief and/or basic intervention. Consumer and carer education. Consultation with higher level mental health and dementia services. |
As per module overview, plus: Identification, initial acute assessment and brief interventions of uncomplicated mental health and dementia-related problems. Forward referrals for expert assessment, diagnosis and intervention. Basic clinical detail collected to inform assessment, diagnosis, intervention and recovery. Mental health and dementia assessments and interventions (and referrals to other mental health services) conducted by general health clinicians. |
Access to one or more of following: Registered medical practitioner. Registered nurse. Allied health professionals. Access to peer (caregiver and/or consumer) workforce. Access to advocacy services. |
| 2 |
Intermittent, Short-term, Medium-term. Accessible during business hours. community or home-based care, including residential aged care. Delivered predominantly by team of general health clinicians and visiting mental health professionals who provide local community healthcare service (general health clinicians providing mental health service have qualifications and/or experience in mental health care). Screening. Assessment. Interventions, including counselling. Consumer and carer education and information. Consultation with higher level mental health and dementia services |
As per Level 1, plus: Identification, initial acute assessment and interventions of mental health problems and dementia. Provision of information about available health and aged services and supports. Mental health and dementia assessments and interventions conducted by one or more general health clinicians and/or visiting clinicians with expertise in mental health care. |
A team of general health clinicians and / or visiting mental health professionals that may include: Registered medical practitioner. Registered nurse. Allied health professionals. Access to peer (caregiver and/or consumer) workforce. Access to visiting mental health professionals. |
| 3 |
Intermittent, Short-term, Medium-term, Long-term. Accessible during business hours. Community or home-based care, including residential aged care. Delivered predominantly by small team (not necessarily multidisciplinary) of mental health professionals who provide local older persons mental health care service. Screening. Assessment by mental health professionals. Targeted interventions by mental health professionals. Consumer and carer education and information. Psychoeducation. Care coordination / case management. Case review. Individual programs. May provide some group programs. Primary and limited secondary prevention programs. Consultation with higher level mental health and dementia services. |
As per Level 2, plus: Identification, ongoing assessment, monitoring and interventions of dementia and mental health problems that may be associated with comorbidities and/or indicators of treatment resistance. Development of individualised management plan. Psychoeducation for patient and family / carer (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Mental health assessments and interventions conducted by team (not necessarily multidisciplinary) of mental health clinicians with experience in older persons mental health care. |
A team including one or more of the following types of health professionals: Registered medical practitioner with credentials in mental health. Registered nurse with qualifications in mental health. Access to allied health professionals with qualifications in mental health. Access to peer (caregiver and/or consumer) workforce. Access to some visiting specialties in health and/or mental health. |
| 4 |
Intermittent, Short-term, Medium-term, Long-term. Accessible during business hours. Hospital-based, community or home-based care, including residential aged care. Delivered predominantly by multidisciplinary team of mental health professionals who provide local older persons mental health care service. Screening. Multidisciplinary assessment by mental health professionals. Targeted interventions by mental health professionals. Consumer and carer education and information. Psychoeducation. Care coordination / case management. Documented regular case review. Individual and some group programs. Primary and secondary prevention programs. Consultation-liaison with lower and higher level mental health and dementia services. |
As per Level 3, plus: Conduct comprehensive, multidisciplinary patient assessment. Development of comprehensive individualised management plan. May provide assertive outreach to target population groups. Mental health assessments and interventions provided by multidisciplinary team of mental health professionals based on service capacity. May be authorised mental health service under Mental Health Act 2013. |
A per Level 3, plus: Registered medical specialist with credentials in psychiatry. Access to registered medical specialist with credentials in geriatric psychiatry. Registered nurse with qualifications in mental health. Access to registered nurse with qualifications and/or experience in older persons mental health. Access—during business hours—to multidisciplinary allied health professional team. Access to peer (caregiver and/or consumer) workforce. Access to visiting specialties in health and/or mental health. |
| 5 |
Intermittent, Short-term, Medium-term, Long-term. Accessible during business hours and may provide limited extended hours service. Hospital-based outpatient clinic, community or home-based care, including residential aged care. Delivered predominantly by multidisciplinary team of specialist older persons mental health professionals. Screening. Multidisciplinary assessment by older persons mental health professionals. Targeted interventions by older persons mental health professionals. Consumer and carer education. Psychoeducation. Education and support for primary and community providers. Care coordination/case management. Documented regular case review. Individual and group programs. Primary and secondary prevention programs. Consultation-liaison with lower and higher level mental health and dementia services. |
As per Level 4, plus: Conduct comprehensive, multidisciplinary patient assessment ranging in risk and complexity (that may be associated with complex comorbidities and/or indicators of treatment resistance). Facilitates access to targeted clinical programs for individuals / groups / families / carers (e.g. patients with dementia and associated complex behaviours). Psychoeducation for patients, families / carers and groups (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Mental health assessments and interventions conducted by multidisciplinary team of specialist older persons mental health professionals. Service based within DoH service or part of service network that includes Level 5 or 6 older persons acute inpatient mental health unit. Provides assertive outreach to target population groups. Authorised mental health service under Mental Health Act 2013. |
As per Level 4, plus: Registered medical specialist with credentials in geriatric psychiatry. Access—during business hours—to registered nurse with qualifications and/or extensive mental health experience who has qualifications and/or experience in older persons mental health. Access—during business hours—to multidisciplinary team of allied health professionals with qualifications and/or experience in older persons mental health. Access to psychology, social work, occupational therapy, speech pathology and dietetic services. Access to dedicated pharmacy services for mental health. Access to peer (caregiver and/or consumer) workforce. Access to range of visiting or local health / mental health specialties. |
| 6 |
Intermittent, Short-term, Medium-term, Long-term. Accessible during business hours and extended hours service provided. Hospital-based outpatient clinic, community or home-based care, including residential aged care. Delivered by specialised multidisciplinary team of older persons mental health professionals. Screening. Multidisciplinary assessment by older persons mental health professionals. Specialised interventions by older persons mental health professionals. Consumer and carer education. psychoeducation. Education and support for primary and community providers. Care coordination / case management. Documented frequent case review. Targeted individual and group programs. All levels of prevention. Consultation-liaison with lower level mental health and dementia services. |
As per Level 5, plus: Identification, ongoing assessment, monitoring and interventions for complex mental health problems and dementia of the highest risk and complexity, including subspecialist services. Statewide clinical leadership and support to lower level services. Specialist consultation and/or liaison to other health and non-health services / agencies for target population. Services form part of integrated older persons mental health service, is based in DoH service or are part of service network that also includes Level 5 or 6 older persons acute inpatient mental health unit. |
As per Level 5, plus: Registered medical specialists with credentials in geriatric psychiatry. Extended-hours access to registered medical practitioner with credentials in psychiatry (psychiatry registrar). Extended-hours access to registered nurses with mental health qualifications and extensive experience in mental health including older persons mental health care. Extended-hours access to multidisciplinary team of allied health professionals with mental health qualifications and experience in older persons mental health, some of who have:
Access to peer (caregiver and/or consumer) workforce. Access to extensive range of visiting or local health / mental health specialties. |
Older persons inpatient services provide admitted dementia and mental health care to people aged 65 years and over. Services may be authorised to provide involuntary treatment to patients.
| Level | Service Description | Service Requirements | Workforce Requirements |
|---|---|---|---|
| 1 | n/a | n/a | n/a |
| 2 | n/a | n/a | n/a |
| 3 | n/a | n/a | n/a |
| 4 |
Intermittent, Short-term. 24 hours a day. Within a general medical facility with allocated geriatrics or mental health beds or may have older persons mental health special care suite/area within a community facility. Delivered by general health clinicians. Access to specialist older persons mental health clinicians for consultation and support. Screening. Assessment by general and / or mental health professionals. Targeted interventions by general and mental health professionals. Consumer and carer education and information. Documented case review. Individual programs. Primary and limited secondary prevention programs. Consultation with higher level specialist older persons mental health services. |
As per module overview plus: Identification, ongoing assessment, monitoring and interventions of mental health problems and dementias. Documented processes and established collaborative partnerships with aged care services and agencies. May be authorised to provide services according to the Mental Health Act 2013 and Guardianship and Administration Act 1995. As clinically indicated, ECT services may be facilitated and/or provided at this service level by mental health service authorised to provide ECT. |
As per module overview plus: Admitted by registered medical practitioner. Daily care coordinated by registered medical practitioner who has access to registered medical specialist with credentials in old age psychiatry to assist and guide assessment, treatment, case management and case review (may be via telehealth). Registered nurses with specialist qualifications and / or experience in mental health. Access to psychology, social work, occupational therapy, speech pathology and dietetic services. Access to pharmacist. Access to peer (caregiver and/or consumer) workforce. Access to range of visiting or local subacute (palliative care, GEM, rehabilitation), general medicine, geriatrics and acute medicine subspecialties as required. |
| 5 |
Intermittent, Short-term, Medium-term. 24 hours a day. Hospital with dedicated older persons inpatient unit or supervised, structured and secure community facility. Delivered predominantly by multidisciplinary team of older persons mental health professionals. Screening. Multidisciplinary assessment by older persons mental health professionals. Targeted interventions by older persons mental health professionals. Consumer and carer education and information. Care coordination/case management. Documented regular case review. Individual programs. Primary and secondary prevention programs. Consultation-liaison with higher and lower level older persons health and aged. |
As per Level 4, plus: Multidisciplinary identification, ongoing assessment, monitoring and interventions for dementia and mental health problems. Supports access to targeted clinical programs for individuals / groups / families / carers (e.g. family/carers of patients with dementia and associated complex behaviours). Assessments, interventions and monitoring conducted by multidisciplinary team of older persons mental health professionals. Authorised to provide services according to the Mental Health Act 2013 and Guardianship and Administration Act 1995. Where ECT services are provided, service is delivered within a hospital with procedural and recovery areas. Where non-ablative neurosurgical procedures are provided, on-site Level 5 or above neurosurgical service is required. |
As per Level 4, plus: Admitted by / under registered medical specialist with credentials in old age psychiatry. Daily care coordinated by registered medical specialist with credentials in old age psychiatry. Access to registered medical specialists with credentials in geriatrics. Registered nurses with specialist qualifications and / or experience in older persons mental health. Access to psychology, social work, occupational therapy, speech pathology and dietetic services with experience in dementia care and older persons mental health (postgraduate training desirable). Access to pharmacy services. Access to peer (caregiver and/or consumer) workforce. Access to range of visiting or local subacute (palliative care, GEM, rehabilitation), general medicine, geriatrics and acute medicine subspecialties as required. |
| 6 |
Intermittent, Short-term, Medium-term, Long-term. 24 hours a day. Is highly specialised service delivered within purpose-designed and built older persons mental health facility. Services delivered by highly specialised, multidisciplinary team of older persons mental health professionals. Screening. Multidisciplinary assessment by older persons mental health professionals. Targeted and specialised interventions by older persons mental health professionals. Consumer and carer education and information. Care coordination/case management. Documented daily case review. Individual and targeted group programs. Primary, secondary and tertiary prevention programs. Consultation- liaison with lower level older persons health and aged services. |
As per Level 5, plus: Identification, ongoing assessment, monitoring and interventions for complex dementias and mental health problems that may be associated with most complex comorbidities and/or indicators of treatment resistance, including patients with co-morbid mental illness, severe BPSD, neuropsychiatric symptoms, complex psychosocial sequelae from the dementia, or complex psychosocial vulnerability due to the dementia. Primary (e.g. stress management), secondary (e.g. falls prevention) and tertiary (e.g. psychosis treatment maintenance) prevention services. Separate clinical services for families / carers, if required. Specialist consultation and/or liaison to other health and non-health services / agencies including subspecialist support for priority populations including patients with Parkinson’s and Huntington’s-associated care needs. Psychoeducation for consumers, families / carers and groups (including information about available dementia-specific and mental health services, mental health problems and illnesses, indicated treatment options and support services). Provides assertive outreach services, telehealth services and day programs. |
As per Level 5, plus: Extended hours access to registered medical specialists with credentials in old age psychiatry. Extended hours access to registered medical specialists with credentials in geriatrics. Majority of registered nursing staff qualified mental health practitioners and have extensive older persons mental health experience. Extended-hours access to allied health professionals with relevant specialist older persons mental health qualifications and experience. Access to dedicated pharmacy services for mental health. Access to peer (caregiver and/or consumer) workforce. Access to range of visiting or local subacute (palliative care, GEM, rehabilitation), general medicine, geriatrics and acute medicine subspecialties as required. |
Statewide and Other Targeted Services
- The Wilfred Lopes Centre (WLC) is Tasmania’s only secure forensic mental health facility, specialising in the inpatient management of patients with serious mental disorder with complex forensic treatment needs and/or a need for therapeutic security.
- Patients present with a range of psychiatric and forensic treatment needs, and are managed by a specialised forensic multidisciplinary team in a purpose built forensic mental health facility.
- There are a number of pathways to WLC admission outlined in Part 5 of the MHA, including the admission of patients involved with the criminal justice system who have been found unfit to stand trial and/or not guilty by reason of insanity and made subject to a restriction order under the Criminal Justice (Mental Impairment) Act 1999 (CJMIA), patients under supervision orders apprehended under s31 of the CJMIA, patients admitted from custody under s36A of the Corrections Act, admissions under s134 of the Youth Justice Act, and civil patients admitted under s63 of the MHA where ongoing admission to an approved hospital is considered ‘untenable’.
| Level | Service Description | Service Requirements | Workforce Requirements |
|---|---|---|---|
| 1 | n/a | n/a | n/a |
| 2 | n/a | n/a | n/a |
| 3 | n/a | n/a | n/a |
| 4 | n/a | n/a | n/a |
| 5 | n/a | n/a | n/a |
| 6 |
Intermittent, Short-term, Medium-term, Long-term. Choice: Voluntary, Involuntary. All ages. Acute and subacute inpatient components of this service providing inpatient mental health care 24 hours a day. WLC, located in Risdon Vale, is currently the only secure forensic inpatient facility in Tasmania. MDT consisting of psychiatrists, psychiatric registrars, social worker, occupational therapist, nursing staff, and care assistants. Psychology services are currently provided on a sessional basis only, which is a recognised service gap. Access to WLC is by referral and formal intake processes, and subject to legislation. Comprehensive multidisciplinary assessment, including specialised forensic risk and needs assessments. Targeted specialist interventions by mental health professionals. Consumer and carer education. Care coordination / case management. Targeted individual and group programs. All levels of prevention programs / services. Comprehensive risk assessment and risk management planning, and utilisation of procedural, environmental, and relational security approaches. Some limited consultation-liaison to non-forensic service to support inpatient management of consumers with forensic or risk issues who do not meet criteria or are waitlisted for admission to WLC., or advice on inpatient violence risk management. Medico-legal reporting. Psychiatric input to prison. |
As per module overview, plus: Inpatient care for consumers meeting admission criteria for admission to WLC are who are unable to be adequately or safely cared for within non-forensic inpatient mental health services. Identification, ongoing assessment, monitoring and interventions of complex mental health problems (that may be associated with most complex comorbidities and/or indicators of treatment resistance and specific treatment needs requiring specialist forensic intervention). Medication management. Extensive clinical detail collected to inform assessment / diagnosis / intervention / recovery, and broader service delivery in all levels of service. Range of primary (e.g. stress management), secondary (e.g. weight management) and tertiary (e.g. psychosis treatment maintenance) prevention services. Clinicians providing mental health services participate in clinical practice supervision with clinician/s qualified and experienced in forensic mental health. May provide extensive range of additional clinical programs and service components, such as an outreach service, telehealth services or an extended treatment program. |
Level 6 Inpatient. Consumer admitted by / under registered medical specialist with credentials in psychiatry. Access - 24 hours - to registered medical specialist with credentials in psychiatry and relevant specialist qualifications and experience in forensic assessment, treatment, case management and review. Medical services provided on-site or are in close enough proximity to provide rapid response at all times. Access to general practice services. Suitably qualified and experienced registered nurse in charge (however titled) of unit. Registered nurse in charge of each shift is suitably qualified and experienced mental health professional. Majority of nursing staff on each shift have required qualifications and experience in mental health, some with additional qualifications/experience in forensic mental health. Access during business hours to multidisciplinary team of allied health professionals with qualifications and experience in forensic mental health including psychology (in reach from CFMHS), social work (1.0), occupational therapy (2.0). In the future, would ideally have dedicated psychology resources for WLC, and capacity to support reflective practice. Access to pharmacy services. People with lived experience of mental illness are engaged with aspects of service delivery. Access to range of local health / mental health specialties (may be on a visiting basis or by outreach services) both in public private sector. Inpatient care is supported by ‘care assistance’, rostered with nursing staff. OT assistance support OT-led rehabilitative interventions. Ancillary staff include cleaners, cooking staff. Security staff. Access to advocacy services. Access to other allied health and medical services (e.g., podiatry, dietitian, dental). The FMHS interfaces with NDIS-funded service providers. Access to Indigenous-specific supports. |
- Highly specialised forensic mental health service operating on a hybrid model providing forensic case management of suitable consumers and consultation-liaison services to non-forensic mental health services, correctional services, courts, and other services.
- Court Liaison Services.
- Tasmanian Fixated Threat Assessment Centre (TFTAC).
| Level | Service Description | Service Requirements | Workforce Requirements |
|---|---|---|---|
| 1 | n/a | n/a | n/a |
| 2 | n/a | n/a | n/a |
| 3 | n/a | n/a | n/a |
| 4 | n/a | n/a | n/a |
| 5 | n/a | n/a | n/a |
| 6 |
Intermittent, Short-term, Medium-term, Long-term. Choice: Voluntary, Involuntary. 18 years and above. Younger people may be considered for service access on a case by case basis. Ambulatory mental health care is provided during service defined hours of business. Delivered from a range of sites across the state; however, statewide coordination and governance of these services are centralised. The MDT consists of psychiatrists, psychologists, nurses and social workers, some of whom fulfil specific roles as case managers and court liaison officers. The CFMHS provides primary case management of suitable consumers with major mental disorder and/or complex forensic treatment needs. This includes consumers placed under the care of the Chief Forensic Psychiatrist (and managed by CFMHS under delegation) through the imposition of a supervision orders by the Supreme Court, typically following the commission of a serious offence. Suitable ‘civil’ patients at high risk of offending or with specific forensic treatment needs may also be accepted for case management by the CFMHS. Consumers with intellectual disability in the absence of major mental illness subject of supervision orders are also currently managed by the CFMHS. Consultation-liaison services include specialist forensic risk assessments and advice to relevant services about risk and management issues. Court Liaison Service which provides mental health assessment, liaison, advice and referral in relation to people in contact with the mental health system with, or suspected of having, mental health issues, including diversion to appropriate mental health services, where appropriate. Lower level services for adult forensic mental health consumers are delivered as part of core business associated with ambulatory, acute inpatient and non-acute inpatient services, as defined in the Adult Services and Older Persons Services sections of this module. Access to forensic mental health services is by referral and formal intake processes. Comprehensive multidisciplinary assessment, which includes specialist forensic risk and needs assessments. Targeted specialist interventions by mental health professionals, which includes both primary case management, and consultation-liaison activities include primary and secondary consultation and provision of advice and support to other services. Educational sessions for non-forensic mental health services, correctional services, prison services, and others. Consumer and carer education. Care coordination / case management. Documented frequent case review via weekly MDT and in depth formal review of each case managed consumer at least once a year. Targeted individual and group programs. All levels of prevention programs / services. Consultation-liaison with non-forensic mental health services. Court Liaison Services. Consultation to Correctional Services. Medico-legal reporting. |
As per module overview, plus: Identification, ongoing assessment, monitoring and interventions of complex mental health problems (that may be associated with most complex comorbidities and/or indicators of treatment resistance). Medication management. Extensive clinical detail collected to inform assessment / diagnosis / intervention / recovery, and broader service delivery in all levels of service. Extensive range of primary (e.g. stress management), secondary (e.g. weight management) and tertiary (e.g. psychosis treatment maintenance) prevention services. Statewide clinical forums to assist dissemination of clinical expertise. Services delivered by a highly specialised team that provide mental health care to target population/s, some of whom present with special care needs. Specialist mental health assessments and interventions conducted by mental health clinicians and health workers of this service. Specialist consultation-liaison to other health and non-health services/agencies for target population. Clinicians providing mental health services participate in clinical practice supervision with clinician/s qualified and experienced in forensic mental health. May provide extensive range of additional clinical programs and service components, such as an outreach service, telehealth services or an extended treatment program, as required. |
Level 6 Ambulatory. Access—during business hours—to registered medical specialist with credentials in psychiatry and relevant specialist qualifications and experience in forensic assessment, case management and review. The CFMHS operate on a hybrid case-management and consultation-liaison model, including multiple disciplines. The Team Leader is a senior clinician within the service (currently a nurse). Access - during business hours - to registered nurses with qualifications in mental health and/or mental health experience in forensic assessment, case management and review. Access - during business hours - to multidisciplinary team of allied health professionals with qualifications and/or experience in forensic mental health. People with lived experience of mental illness are engaged with aspects of service delivery. Access to extensive range of local health / mental health specialties (may be on a visiting basis or by outreach services). The CFMHS interfaces with NDIS-funded service providers. Access to Indigenous-specific supports. |
Services provide ambulatory and admitted mental health care to patients. Services may be authorised to provide involuntary treatment to patients.
| Level | Service Description | Service Requirements | Workforce Requirements |
|---|---|---|---|
| 1 | n/a | n/a | n/a |
| 2 | n/a | n/a | n/a |
| 3 | n/a | n/a | n/a |
| 4 | n/a | n/a | n/a |
| 5 | n/a | n/a | n/a |
| 6 |
Intermittent. Choice: Voluntary, Involuntary. 18 to 85 years.* Inpatient service 24 hours per day. Day program and community clinics during business hours. Services will be delivered from a range of sites across the state; however, this service is centrally coordinated. Acute inpatient service components at this level are co-located with a Level 5 or 6 adult acute inpatient mental health service (consumers meeting admission criteria for acute inpatient component present with problems defined as highest risk/complexity and these consumers are unable to be adequately or safely cared for within their local acute inpatient mental health service) and Level 5 CAMHS. Delivered by multidisciplinary team of highly specialised clinicians / mental health professionals. Ambulatory service components may include statewide consultation-liaison service, outpatient assessment and treatment recognition services, specialist outpatient therapy and/or intensive outpatient program (consumers referred to ambulatory service components present with problems ranging from low to highest risk/complexity, some of whom may demonstrate most extreme comorbidities and/or indicators of treatment resistance). Lower level services for mental health consumers with an eating disorder are delivered as part of core business associated with ambulatory, acute inpatient and non-acute inpatient services – these service areas are defined in the CAMHS, Adult Services and Older Persons Services sections of this module. Comprehensive multidisciplinary assessment. Targeted specialist interventions by mental health and medical health professionals. Consumers and carer education. Care coordination. Documented frequent case review. Targeted group programs. All levels of prevention programs / services. Consultation-liaison with lower level mental health services. |
As per module overview, plus: Authorised service under Mental Health Act 2013. Identification, ongoing assessment, monitoring and interventions of complex mental health problems (that may be associated with most complex comorbidities and/or indicators of treatment resistance). Integrated approach to identification, assessment and intervention of any co-occurring substance-use disorders. Targeted clinical programs for individuals / groups / families / carers. Medication management. Forward referrals for assessment / diagnosis / intervention as required. Development of comprehensive individual mental health recovery plan within 1 week of assessment. Referral to community mental health clinicians on hospital discharge, as appropriate. Extensive range of primary (e.g. stress management), secondary (e.g. re-feeding syndrome) and tertiary (e.g. treatment maintenance) prevention services. Psychoeducation for consumers, families/carers and groups (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Separate clinical services for families / carers, if required. Specialist mental health assessments / interventions conducted by clinicians of this service. Specialist consultation-liaison to other health and non-health services / agencies for target population. Current policy and procedure documentation informs the processes of consultation-liaison with lower‑level services who provide an eating disorders mental health service. Documented processes and collaborative partnerships with key stakeholders associated with eating disorder treatment, research and education (e.g. Eating Disorders Association). Clinicians providing mental health services participate in clinical practice supervision with clinician/s qualified and experienced in eating disorders and mental health. May provide extensive range of additional clinical programs and service components, such as an outreach service, telehealth services or a day program. As clinically indicated, ECT services may be facilitated and/or provided by mental health service authorised to provide ECT under Mental Health Act 2013. Statewide clinical forums to assist dissemination of clinical expertise. Extensive clinical detail collected to inform assessment / diagnosis / intervention / recovery and broader service delivery in all levels of service. |
Level 6 Ambulatory As per module overview, plus:
Level 6 Inpatient As per module overview, plus:
|
* Adolescent consumers older than 16 years may access this service, where clinically and developmentally appropriate, and in line with policy and procedural documentation of the eating disorders service. Younger consumers will be seen by CAMHS Eating disorder clinicians; embedded in CAMHS but a key component of TEDS.
Perinatal and infant services provide ambulatory and admitted mental health care to parents and infants. Services may be authorised to provide involuntary treatment to patients.
| Level | Service Description | Service Requirements | Workforce Requirements |
|---|---|---|---|
| 1 | n/a | n/a | n/a |
| 2 | n/a | n/a | n/a |
| 3 |
Intermittent, Short-term, Medium-term, Long-term. Timeframe for ambulatory perinatal mental health service delivery ranges from preconception to child’s second birthday (24 months) – women in perinatal period experiencing moderate to severe mental health difficulties requiring mental health assessment may access range of mental health perinatal services, as can women who have had miscarriage, stillbirth, neonatal death or termination. Target population is not individuals with a [pre-existing mental health presentation who become pregnant. Rather the focus is on mental health disorders that specifically relate to the perinatal period e.g. postnatal depression. Expected majority of consumers are female; however, some fathers may access range of perinatal mental health services. Timeframe for ambulatory infant mental health service delivery generally ranges from preconception to 12 months.
Hospital-based outpatient clinic, community mental health clinic or home-based care. Delivered predominantly by multidisciplinary team of mental health professionals who provide local, community mental health care service specifically for target population. Note: Lower level services for ambulatory consumers presenting with perinatal and/or infant mental health problems are delivered as part of core business associated with ambulatory mental health services. Screening. Multidisciplinary assessment by mental health professionals. Targeted interventions by mental health professionals. Consumer and carer education and information. Care coordination/case management. Documented regular case review. Some group programs. Primary and secondary prevention programs. Consultation with higher level mental health services. |
As per module overview, plus: Identification, ongoing assessment, monitoring and interventions of mental health problems (that may be associated with comorbidities and/or indicators of treatment resistance). Integrated approach to identification, assessment and intervention of any co-occurring substance-use disorders. Forward referrals for assessment, diagnosis and/or intervention as required. Clinical detail collected to inform assessment, diagnosis, intervention and recovery. Development of comprehensive individual mental health recovery plan within 1 week of assessment. Range of primary (e.g. stress management) and secondary (e.g. mother–infant therapy) prevention services. Psychoeducation for consumers and family/carer (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). May be authorised mental health service under Mental Health Act 2013. Policy - supporting multidisciplinary approach to pregnancy, birth and early postnatal care—is in place for women who are planning pregnancy or who are pregnant, outlining communication channels between mental health and maternity teams. Policy outlining communication channels between mental health and maternity carers is in place where pregnant women are receiving care at this service level. Where appropriate, documentation of care is contained within pregnancy handheld record to promote communication and information between the woman and mental health and maternity care teams. Documented processes with Level 5 or 6 acute inpatient mental health service (child and youth, adult and/or perinatal and infant) capable of perinatal and infant mental health care. Service based within DoH service or part of service network that also includes Level 5 or 6 acute inpatient mental health unit (child and youth, adult and/or perinatal and infant) capable of perinatal and infant mental health care. Mental health assessments and interventions conducted by mental health clinicians of this service. |
As per module overview, plus: Access to registered medical specialist with credentials in psychiatry (with training / experience in perinatal and/or infant mental health) for assessment, case management and review. Access - during business hours - to registered nurse who has qualifications in mental health and/or extensive mental health experience, in addition to training and/or experience in perinatal and/or infant mental health. Access - during business hours - to multidisciplinary team of allied health professionals with training / experience in perinatal and/or infant mental health Consultation may be available from visiting specialties in mental health, maternity and child health and other areas of health. Access to advocacy. |
| 4 |
Short-term. May be provided for mothers and their infants when admission to an inpatient unit is most clinically appropriate and safe service for the individual case, and when transfer to higher level adult acute inpatient unit or perinatal and infant mental health inpatient service is not feasible or clinically necessary. Provide inpatient mental health care for mothers and their infants (from third trimester of pregnancy until infant becomes mobile) where mother exhibits signs and/or symptoms of serious mental illness that have not responded adequately to less intensive interventions in the community, and/or safety and treatment needs of dyad/family warrant admission. Infants will only be admitted if it can be clearly determined during assessment that the mother can safely care for the infant. 24 hours a day. Parenting support unit. Delivered predominantly by multidisciplinary team of mental health professionals. Service may operate on demand and is delivered via a hospital that incorporates an acute inpatient mental health unit or via purpose-designed and built mental health facility. Note: Lower level services for inpatients presenting with perinatal and/or infant-related mental health problems delivered as part of core business associated with acute inpatient mental health services. Screening. Multidisciplinary assessment by mental health professionals. Targeted interventions by mental health professionals. Consumer and carer education and information. Care coordination/case management. Documented frequent case review. Some group programs. Primary and some secondary prevention programs. Consultation with higher level mental health services. |
As per Level 3, plus: Wide range of primary (e.g. stress management) and some secondary (e.g. mother infant therapy) prevention services. If infant admitted with mother, following requirements are to be met: Consultation-liaison initiated immediately and maintained with higher level perinatal and infant mental health service throughout the admission Mother and infant provided with single, ensuite room that must have clear observation paths for nursing staff at all times and is within close proximity to: Nursing station (room should be able to be locked from outside and be key accessible only by nursing staff) Infant monitors, either connected to nurses’ station or able to transmit while mobile, in use at all times in order for infant’s wellbeing to be monitored. |
As per Level 3, plus: Consumer admitted by / under registered medical specialist with credentials in psychiatry. Access - 24 hours - to medical practitioner Suitably qualified and experience registered nurse (however titled) in charge of unit. Registered nurse in charge of each shift suitably qualified and has extensive mental health experience. Unit nursing staff, two or more of whom each shift are registered nurses and have qualifications in mental health and/or extensive mental health experience. If inpatient unit occupancy is low, only one nurse per shift need have qualifications in mental health and/or extensive mental health experience. Enrolled nurses may complement nursing team. If infant admitted with mother, registered nurse with qualifications in mental health and/or extensive mental health experience provides 24-hour care and observation for mother and infant throughout admission. Access to psychology, social work, occupational therapy, speech pathology and dietetic services (postgraduate training desirable). Access to dedicated pharmacy services for mental health. access to peer workforce. AINs or equivalent may complement clinical team at discretion of nurse in charge. Bachelor of Nursing students (second or third year undergraduate) may complement clinical team at discretion of nurse in charge and under registered nurse supervision. Access to range of on-site and/or visiting specialties in health / mental health / maternity / child health. |
| 5 |
Intermittent, Short-term, Medium-term. As for Level 4 Who require more care than can be provided in a parent support inpatient unit and require admission to a adult mental health inpatient unit and no mother-baby psychiatric facility is available. 24 hours a day. Service delivered as one component of Level 5 or Level 6 adult acute inpatient mental health unit that comprises limited number of designated mother–infant beds. Delivered via a hospital that incorporates an acute inpatient mental health unit or via purpose-designed and built mental health facility. Delivered predominantly by multidisciplinary team of mental health professionals providing acute inpatient mental health service. Screening. Multidisciplinary assessment by mental health professionals. Targeted interventions by mental health professionals. Consumer and carer education and information. Care coordination/case management. Documented frequent case review group programs. Primary and secondary prevention programs Consultation with higher level mental health services. |
As per Level 4, plus: Identification, ongoing assessment, monitoring and interventions of mental health problems ranging in risk and complexity (that may be associated with complex comorbidities and/or indicators of treatment resistance). Medication management. Targeted clinical programs for individuals / groups / families. Extensive clinical detail collected to inform assessment, diagnosis, intervention and recovery. Extensive range of primary (e.g. stress management) and secondary (e.g. mother infant therapy) prevention services. Assertive outreach applicable to service and target population. Psychoeducation for consumers, families/carers and groups (including information about available mental health services, mental health problems and illnesses, indicated treatment options and support services). Separate clinical services for families/carers, if required. Consultation-liaison services to local health services as required. Clinicians providing mental health services participate in clinical practice supervision with clinician/s qualified and/or experienced in perinatal and infant mental health. Mental health assessments and interventions conducted by multidisciplinary team of mental health professionals. Authorised mental health service under Mental Health Act 2013. As clinically indicated, ECT services may be facilitated and/or provided to an adult by mental health service authorised to provide ECT under Mental Health Act 2013. |
As per Level 4, plus: At least one registered nurse per shift with qualifications and experience in child health and/or perinatal/infant mental health. Access to peer workforce. Access to extensive range of on-site and/or visiting specialties in health / mental health / maternity / child health. |
| 6 |
Intermittent, Short-term, Medium-term. May have special care needs. On occasion, mother may be admitted in third trimester of pregnancy. Father may rarely be admitted in his own right, along with his infant. Offers assessment and intervention for range of perinatal and infant mental health disorders and relationship disturbances at highest level of risk and complexity, especially those that require admission of several family members. May include most complex cases where there is combination of mental illness, personality disorder, substance abuse, infant distress or disorder, and child safety concerns. 24 hours a day. Highly specialised statewide inpatient service delivered via dedicated mother–infant mental health unit co-located with Level 5 or 6 acute inpatient mental health unit. If physical environment permits, this service can operate as parent–infant inpatient service with physical layout designed to safely meet needs of older infants and their families, including family rooms and outdoor play spaces (allowing for admission of infants up to age of 36 months as well as sibling groups where all are younger than 36 months at time of admission). Service demonstrates specialist expertise in delivery of perinatal and infant mental health services to targeted population and is delivered by multidisciplinary team of mental health professionals with expertise in perinatal and/or infant mental health. Screening. Multidisciplinary assessment by mental health professionals. Specialised interventions by mental health professionals. Consumer and carer education. Care coordination/case management. Documented daily case review. Targeted group programs. All levels of prevention programs/services. Consultation-liaison with lower level mental health services.
|
As per Level 5, plus: Identification, ongoing assessment, monitoring and interventions of complex mental health problems (that may be associated with most complex comorbidities and/or indicators of treatment resistance). Extensive clinical detail collected to inform assessment, diagnosis, intervention and recovery, and broader service delivery in all levels of service. Extensive range of primary (e.g. stress management), secondary (e.g. mother infant therapy) and tertiary (e.g. psychosis treatment maintenance) prevention services. Statewide clinical forums to assist dissemination of clinical expertise. Specialist mental health assessments and interventions conducted by multidisciplinary team of mental health professionals with specialist qualifications and experience in perinatal and/or infant mental health. Specialist consultation-liaison to other health and non-health services / agencies for target population. |
As per Level 5, plus: Access - 24 hours - to registered medical specialist with credentials in psychiatry and qualifications and experience in perinatal psychiatry. Registered nurses, majority of whom have qualifications in mental health and/or extensive mental health experience or qualifications and/or extensive experience in perinatal and/or infant mental health. Extended-hours access to community- or hospital-based allied health professionals with relevant specialist mental health qualifications and experience. Access to peer workforce. |
* Consumers presenting with low to moderate risk and/or complexity can be admitted to this level of service as is clinically appropriate and relevant to individual consumer needs.
