Academic journal article Australian Health Review

Is the Partners in Recovery Program Connecting with the Intended Population of People Living with Severe and Persistent Mental Illness? What Are Their Prioritised Needs?

Academic journal article Australian Health Review

Is the Partners in Recovery Program Connecting with the Intended Population of People Living with Severe and Persistent Mental Illness? What Are Their Prioritised Needs?

Article excerpt

Introduction

Severe and persistent mental illness (SPMI) is experienced by an estimated 2-3% of the Australian population sometime during their lifetime, equating to around 600000 Australians.1 Defining, understanding and connecting with this population has been challenging. Less than half the people living with mental illness are known by or connected to mental health services.2 The Partners in Recovery (PIR) program is a federally funded initiative designed to connect with this poorly engaged group. Recruitment and identification of specific needs of people living with SPMI has been a key yardstick of the success ofPIR.

Severe and persistent mental illness

One initial difficulty faced by the PIR program has been the lack of clarity regarding the identity of the target population and scarcity of epidemiological data of SPMI.

Mental illness varies in severity. The SPMI characterisation is based on diagnosis, the intensity and duration of symptoms and degree of functional disability.3 This group predominantly comprises people living with schizophrenia and other psychotic illnesses, but also includes people living with severe and disabling forms of depression and anxiety. The Second National Mental Health Survey2 and the Study on Low Prevalence Disorders3 both suggest that people living with an SPMI are likely to be educationally disadvantaged (approximately 50% not completing secondary schooling), unemployed (70-80%), living in unstable housing (< 15% are in a home they own and < 15% are in a familyowned property), socially isolated and lonely (>80% are single, separated, divorced or widowed), often living alone (>30%) and are unlikely to have a person at home that they could describe as a 'carer' (<10%).

Further, comorbidity is common. Physical health comorbidity data demonstrate that people living with SPMI have life expectancies approximately 25 years less than the general population.4 The incidence of diabetes and cardiovascular disease in people with SPMI is four- and threefold higher than that of the general population respectively and 40% of people with SPMI experience weight gain on commonly prescribed psychiatric medication.2,4 Another comorbidity of particular significance is drug and alcohol misuse. People living with psychotic illnesses report smoking rates two - to three fold higher than the general Australian population, alcohol dependence or abuse are four- to fivefold higher than in the general Australian population and drug misuse, abuse or dependence rates are more than 10-fold higher than in the general Australian population.3

Under half, and quite possibly only one-third, of people living with mental illness seek help from mental health services.2,5,6 People living with SPMI are at particular risk of falling through service delivery gaps due, in part, to their complexity of needs, as well as the fragmentation of the Australian mental health service delivery system.7 Almost 50% of participants in the Study on Low Prevalence Disorders3 reported the need for a particular kind of service but being unable to access it due to lack of information, continuity of support or affordability. The PIR program was designed to address this system fragmentation and to better connect with and support people living with SPMI.

What is PIR?

PIR is a federally funded mental health initiative that commenced in mid-2013.8 The A$549.8million program was announced by the Gillard federal Labour government in its 2011-12 Federal Budget. A subsequent change of government led to delayed implementation and a reduced budget of A$430 million over 2012-16. PIR was designed to better support people living with severe and persistent mental illness by developing a more coordinated and multisystem response to meeting the complexity of needs experienced by this population.9 Nationally, 48 PIR programs (of an originally planned 61) were ultimately funded to support 40% of the estimated population of people living with SPMI within their respective program boundaries orregions (www. …

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