Reifels Lennart, Bassilios Bridget, King Kylie E, Fletcher Justine R, Blashki Grant, Pirkis Jane E
Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia.
Aust Health Rev. 2013 Jun;37(3):312-7. doi: 10.1071/AH12203.
We review the evidence on innovations in Tier 2 of the Access to Allied Psychological Services (ATAPS) program, which is designed to facilitate the provision of primary mental healthcare to hard-to-reach and at-risk population groups (including women with perinatal depression, people at risk of self-harm or suicide, people experiencing or at risk of homelessness, people affected by the 2009 Victorian bushfires, people in remote locations, Aboriginal and Torres Strait Islanders and children with mental disorders) and the trialling of new modalities of service delivery (e.g. telephone-based or web-based CBT). The primary focus is on the uptake, outcomes and issues associated with the provision of ATAPS Tier 2.
Drawing on data from an ongoing national ATAPS evaluation, including a national minimum dataset, key informant interviews and surveys, the impact of ATAPS innovations is analysed and illustrated through program examples.
ATAPS Tier 2 facilitates access to, uptake of and positive clinical outcomes from primary mental healthcare for population groups with particular needs, although it requires periods of time to implement locally.
Relatively simple innovations in mental health program design can have important practical ramifications for service provision, extending program reach and improving mental health outcomes for target populations. What is known about the topic? It is recognised that innovative approaches are required to tailor mental health programs for hard-to-reach and at-risk population groups. Divisions of General Practice have implemented innovations in the Access to Allied Psychological Services (ATAPS) program for several years. What does this paper add? Drawing on data from an ongoing national ATAPS evaluation, this paper presents a systematic analysis of the uptake, outcomes and issues associated with provision of the innovative ATAPS program. What are the implications for practitioners? The findings highlight the benefits of introducing innovations in primary mental healthcare in terms of increased access to care and positive consumer outcomes. They also identify challenges to and facilitators of the implementation process, which can inform innovation efforts in other primary care contexts.
我们回顾了“获得联合心理服务（ATAPS）计划”二级创新的相关证据，该计划旨在促进为难以接触到的高危人群（包括围产期抑郁症妇女、有自残或自杀风险的人、经历或有无家可归风险的人、受2009年维多利亚丛林大火影响的人、偏远地区的人、原住民和托雷斯海峡岛民以及患有精神障碍的儿童）提供初级精神卫生保健，并对新的服务提供模式（如基于电话或网络的认知行为疗法）进行试验。主要重点是与提供ATAPS二级服务相关的接受情况、结果和问题。
利用正在进行的全国ATAPS评估数据，包括国家最低数据集、关键信息提供者访谈和调查，通过项目实例分析并阐述了ATAPS创新的影响。
ATAPS二级促进了有特殊需求人群获得初级精神卫生保健、接受该保健并取得积极的临床结果，尽管在当地实施需要一段时间。
心理健康项目设计中相对简单的创新可能对服务提供产生重要的实际影响，扩大项目覆盖范围并改善目标人群的心理健康结果。关于该主题已知的情况是什么？人们认识到需要采用创新方法为难以接触到的高危人群量身定制心理健康项目。全科医疗部门已在“获得联合心理服务（ATAPS）计划”中实施创新数年。本文补充了什么内容？本文利用正在进行的全国ATAPS评估数据，对创新的ATAPS计划的接受情况、结果和相关问题进行了系统分析。对从业者有何启示？研究结果突出了在初级精神卫生保健中引入创新在增加获得护理机会和取得积极消费者结果方面的益处。它们还确定了实施过程中的挑战和促进因素，可为其他初级保健环境中的创新努力提供参考。
