Abstract

Background: Prevention and Recovery Care (PARC) services are relatively new sub-acute residential services that have supported people with mental ill-health in Victoria since 2003. Operated from a partnership model between non-governmental agencies and clinical mental health services, PARC services integrate intensive recovery-focused psychosocial input with clinical mental health care. Aim: To describe and contrast the 19 PARC services operating in Victoria at the time of the study, in terms of structures and function, resources, and content and quality of care. Method: Nineteen participants, one representing each PARC, completed two surveys: the first, a purpose-designed survey relating to the government guidelines for PARC services, and the second, the Quality Indicator for Rehabilitative Care. Results: Descriptive analyses highlighted that PARC services have operated in inner-city, urban, and regional areas of Victoria, from between 1 and 14 years. Participants reported that a recovery approach was at the core of service delivery, with a vast array of group and individual programs on offer. Across the state, there was variation in the quality of services according to the Quality Indicator for Rehabilitative Care domains. Conclusions: This study has identified that there is variation in the structure and function, resourcing, and content and quality of care offered across Victoria’s PARC services even though, in the main, they are guided by government guidelines. Hence it appears that the services adapt to local needs and changes in service systems occurring over time. The findings indicate emerging evidence that PARCs are providing recovery-oriented services, which offer consumers autonomy and social inclusion, and therefore likely enable a positive consumer experience. The range of individual and group programs is in line with the Victorian guidelines, offering practical assistance, therapeutic activities, and socialization opportunities consistent with consumer preferences. Further research into implementation processes and their impacts on quality of care is warranted concerning this and similar service models.

Highlights

  • Acute inpatient mental health care has been criticized for being expensive, restrictive, coercive, and unpopular with service users [1], and community-based residential alternatives have developed as a result

  • The first Prevention and Recovery Care (PARC) service was established in Victoria in 2003, and the most recent one opened in 2016

  • Gathering comprehensive descriptions of 19 PARC services and their practice demonstrates the degree of variation in the structure, resourcing, and content and quality of care offered across the Victorian PARCs, and provides a contextual foundation for the more rigorous qualitative and quantitative studies that are in process

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Summary

Introduction

Acute inpatient mental health care has been criticized for being expensive, restrictive, coercive, and unpopular with service users [1], and community-based residential alternatives have developed as a result. Acute inpatient care typically provides more intensive support to people experiencing a mental health crisis and/or a significant exacerbation of the symptoms of their mental illness requiring immediate treatment, some community-based crisis services exist for the same purpose. PARC services are being implemented elsewhere in the country, with the aim of improving mental health outcomes and preventing hospital admissions for people who are acutely unwell [5]. They have a strong emphasis on integrating clinical mental health care with intensive recovery-focused psychosocial input. Operated from a partnership model between non-governmental agencies and clinical mental health services, PARC services integrate intensive recovery-focused psychosocial input with clinical mental health care

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