On Thursday 12 November, Remedy Healthcare officially launched a new mental health program ‘MindStep’ that will assist individuals currently presenting at acute hospitals with anxiety and depression to access additional mental health services and support to help them once they are discharged.
Olympic gold medallist Matthew Mitcham, who has battled with depression and anxiety throughout his career, participated in the official launch and provided a candid account of his experience.
“So many people don’t feel strong enough to reach out just because of the stigma around mental health. The more we talk about it, the more we will break down the stigma. A lot of great things have been done in the mental health space to tackle depression and anxiety but I still think we need to talk about it more,” Matthew said.
The MindStep program is the first of its kind to be launched in Australia to target people discharged from hospital. It is an adaptation of the Improving Access to Psychological Therapies (IAPT) model. This model has been successfully applied in the United Kingdom health system since 2008 and more recently in Flinders Medical Centre in South Australia.
- The Remedy health coaching model is based on individualised, evidence-based interactions via phone, supported by written materials (online or printed) along with integration with primary care, specialists and carers.
- The MindStep program is designed for people with a primary diagnosis of clinical depression and anxiety.
- The program will provide guided self-help for anxiety and depression.
- The model partly fills the gap between acute care and primary care and uses a stepped care model to manage changes in symptom severity—the model complements the usual care patients receive from their GP, psychologist or psychiatrist, but does not replace this.
- MindStep will be delivered by Remedy Healthcare mental health coaches who have undergone comprehensive training in guided cognitive behavioural therapy (CBT) and are supported by software employing sophisticated decision support and ongoing clinical risk evaluation.
- Remedy has two strategic partners for implementation of this program: Flinders University in South Australia and The University of York in the UK. Each will bring their areas of expertise in mental health service delivery to MindStep.
Remedy Healthcare General Manager David Brajkovic said MindStep will be the first application of the IAPT model for post hospitalisation related clinical depression and anxiety.
“MindStep is the culmination of considerable time and resource investment in researching evidence–based mental health models that can be applied to all aspects of the Australian healthcare context,” Mr Brajkovic said.
“Despite its incredible prevalence, mental health continues to be an area that suffers from severe government underfunding. Sadly, this reality is compounded by the fact that people with clinical depression and anxiety who are admitted to a mental health facility are, on average, staying for 20 days or more.
“Once this begins, patients often bounce in and out of these facilities because there are very few services available to assist them— and GPs are often under resourced, or have few options for referral to community-based services to support them.”
Remedy Healthcare identified that while the knowledge and awareness of mental health issues has undoubtedly increased in the past decade, there existed a shortage of measurable programs that would help people recover and reduce the need for them to go to, or back to, hospital. There has until now been a major gap in services.
“Finally, in 2011 we started to see evidence of the success of a program in the United Kingdom called Improving Access to Psychological Therapies or IAPT. Importantly for Remedy, the IAPT program followed a very similar model to the already well-established chronic disease management model in Remedy,” Mr Brajkovic said.
Mental health program research outcomes:
In a study run out of the Flinders Medical Centre emergency department (ED) in Adelaide, 58 percent of people who completed a program met the clinical definition for recovery.
- Patients had a mean of 3.9 presentations to ED in the 12 months prior to commencing the IAPT program.
- In the 8.3 months post-IAPT, this same group had a mean of 1.7 ED presentations, a significant reduction in mean ED presentation of 2.2 (a reduction of greater than 50 percent).
MindStep is a stepped model of care delivered telephonically by Remedy coaches supported by materials available online over a period of 6-8 weeks. The program can be delivered to anyone anywhere in Australia and helps fill the current gap between the GP, the mental health specialist and acute care.
Remedy has partnered with York University in the UK who developed the materials and the system, and Flinders University in South Australia who provide the clinical training for Remedy’s coaches as well as clinical oversight of each and every case.
Remedy Healthcare would particularly like to acknowledge the assistance of Professor Malcolm Battersby at Flinders University who played an integral role in bringing MindStep to life.
Eight Australian private health insurers have already formalised their involvement in the program: Defence Health, Australian Unity, Grand United Health, nib, GMHBA, Teachers Health Fund, Peoplecare, and Health Partners.
“We plan to take this program into both the private and public health sectors. Further, we will be encouraging the general public to refer people they know to be suffering from anxiety or depression to the program. This will help spread the word that there is now an alternative approach for people suffering from anxiety or depression,” Mr Brajkovic said.