Abstract

IntroductionMental health services are fragmented in Australia leading to a priority being placed on whole-of-community approaches and integration. We describe the LifeSpan suicide prevention intervention developed by the Black Dog Institute that draws upon nine evidence-based community-wide strategies. We examined the suicide prevention Collaborative group at each site. We evaluated how the social capital of the community and service providers changed, and how the brokerage roles of the Collaborative affected integration of effort.MethodsThis was a two phase, explanatory mixed methods study. Participants were LifeSpan Coordinators, The Collaborative and working group members at four LifeSpan sites in New South Wales (three metropolitan/regional, one regional/rural). Quantitative social network data was collected through an online survey and analysed using Gephi software. Qualitative data through focus groups and interviews with Lifespan Coordinators and community stakeholders.ResultsThe social network survey was administered in three sites and was completed by 83 people. Data gave quantitative evidence of increased engagement across key stakeholders in each region who had not previously been working together. Nominations of other collaborators showed this network extended beyond the formal structures of The Collaborative. LifeSpan Coordinators were empirically identified as key players in the networks. Qualitative data was collected from 53 individuals (18 interviews and five focus groups) from across all sites. Participants identified benefits of this collaborative approach including greater capacity to run activities, better communication between groups, identification of “who’s who” locally, improvement in the integration of priorities, services and activities, and personal support for previously isolated members. LifeSpan Coordinators were key to the smooth running of The Collaborative. This may represent a risk to sustainability if they left. The collaboration model that suited metropolitan sites was difficult to sustain in rural sites, but gains were seen in better coordinated postvention efforts.ConclusionLifeSpan Coordinators were noted to be exceptional people who magnified the benefits of collaboration. Geographic proximity was a potent driver of social capital. Initial engagement with local stakeholders was seen as essential but time-consuming work in the implementation phase. Coordinators reported this important work was not always acknowledged as part of their formal role.

Highlights

  • Mental health services are fragmented in Australia leading to a priority being placed on whole-ofcommunity approaches and integration

  • Vision 2030 for Mental Health and Suicide Prevention, developed by the National Mental Health Commission of Australia speaks of delivering mental services through “a unified system that takes a whole-of-community, whole-of-life and person-centred approach to mental health” and recommends that the design of mental health and wellbeing services start with local communities [5]

  • The model for implementation was similar but unique at each site with the Coordinators coming under the governance of either the Local Health District (LHD) that provide acute hospital and outreach community services, the Primary Health Network (PHN) that provide general practitioner and community based allied health services, or both

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Summary

Introduction

Mental health services are fragmented in Australia leading to a priority being placed on whole-ofcommunity approaches and integration. It is widely acknowledged that mental health services in Australia suffer from fragmentation and gaps between general and mental health, and social services, and suffers from a whole-of-community approach. Partners in Recovery Programs, for example, show the value of having a care coordinator, knowledgeable about available general and mental health, and social services to facilitate support of people with severe and persistent mental illness [6]. Brophy describes these coordinators as “boundary spanners” [7]. We argue that the key to successful implementation of mental health initiatives, and progress towards a wholistic response to need, is to prioritise a strategy of building social capital across key stakeholders in the community

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