Headspace an innovative approach

Presentation First Author: 
Chris Tanti

Across the western world, governments, policy makers, managers and clinicians congratulated themselves at the speed at which they closed institutions in order to provide services in the community. Inpatient units were mainstreamed and a web of communitybased services emerged to support people with mental illness live fulfilling lives. As a young clinician, I, like many others bought into the vision because I could visualise the enormous benefits that would flow to patients. We now know that not everything we hoped for happened. In spite of our best efforts, people with mental ill health are now more than ever before over represented in our homeless populations and our prisons and have difficulty accessing assistance for even severe health problems. The extent of the changes fell short of reforms in other areas of health, such as in physical and intellectual disability where the emphasis on vocational and housing options was maintained. Worse still, as a result of funding constraints, what was in scope in terms of treatment also narrowed to the point where only the most complex and at risk presentations received the limited range of services on offer. Then something happened in Australia that would have profound effects on the way we think about mental ill health. A vision began to emerge to create a single and simple entry point that was integrated with key community supports and provided them and their families with a clinically robust and easily accessible alternative to what was on offer previously. The evidence to do something different was compelling. We knew mental health problems accounted for close to half of the burden of disease and three quarters of adults with mental ill health had felt its onset before the age of 24. As a result was almost inevitable. When headspace first started in 2006 its brief was simple - establish 30 youth mental health one stop shops across Australia. This vision was funded by the Commonwealth Government, which in itself was a clear departure from the usual practice of state funding for mental health services. headspace had an initial budget of $55 million over four years to set up an early intervention youth mental health service that hadnt been attempted anywhere else in the world on that scale. Little more than seven years later, headspace has a budget of $500 million, 55 centres on the ground, growing to 90, an expanded brief to work with young people with first onset psychosis, a national online counselling service for young people and a school support program working with secondary schools in order to prevent suicide and support schools in the event of a suicide. In other words headspace and its staff have had a very busy few years. What started off as a great idea has progressed to be a comprehensive national system of care for young people 12 to 25. headspace has challenged the way Australians think about mental health care, stigma and community treatment. It is a system that at its very heart and at all levels is driven and critiqued by young people. Importantly (and somewhat counter intuitively) it involves key community organisations not previously involved in the provision of mental health care within its core service platform. The headspace model is both as innovative as it is simple. The discussion will focus on the key success factors of the initiative and detail some of the significant achievements that are easily replicable.

Conference Name: 
Presentation Date: 
November, 2013
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