Evaluation of NSW Community-based Mental Health Programs: Community Living Supports and Housing and Accommodation Support Initiative. CLS-HASI Evaluation Report

The Community Living Supports (CLS) and Housing and Accommodation Support Initiative (HASI) are community-based programs that support people with severe mental illness to live and participate in the community, the way that they want to. The programs offer psychosocial support, tenancy support and, where appropriate, clinical mental health services. Many consumers are also supported to access secure housing. CLS-HASI are statewide programs funded by the NSW Ministry of Health (Ministry) and delivered locally through partnerships between local health district (LHD) mental health services and specialist mental health Community Managed Organisations (CMOs). The programs also have a strong partnership with the NSW Department of Communities and Justice (DCJ) and community housing providers for social housing. The Ministry commissioned the Social Policy Research Centre (SPRC) to evaluate the CLS-HASI programs. The evaluation involved two rounds of qualitative interviews and focus groups, as well as the analysis of quantitative program data and statewide outcomes data about consumers. It ran from November 2017 to January 2020. CLS-HASI supported 5,533 consumers in the study period from 2015 to 2019. Most consumers were in the programs for only part of this period. The average time in CLS-HASI was 10.7 months. Overall, the evaluation shows that CLS-HASI is generally working well, achieving its goals and is cost effective. At a broad summary level: • Consumers liked the programs, and most experienced positive outcomes – overall the programs improved wellbeing, helped people better manage their mental health, enhanced aspects of consumers’ physical health and increased opportunities for social inclusion. • Consumer contact with community mental health services decreased by 10% in the first year in CLS-HASI and was 63.7% less if they remained in the programs for more than one year. • Hospital admissions due to mental health decreased by 74% following program entry, and the average length of stay decreased by 74.8% over two years. This improvement was sustained after consumers exited the programs. • Consumers with a new charge in the criminal justice system and with community corrections orders dropped to almost zero in the year after program entry

Social Participation of People with Chronic Mental Health Needs: Building Horizontal and Vertical Forms of Social Capital

Social participation is positively related to mental health recovery and wellbeing, yet people with mental health problems are often socially isolated. This article investigates how social participation was incorporated into an Australian-integrated program that aimed to improve the wellbeing of people with chronic mental health needs. The data are from a longitudinal evaluation of the integrated program, including data linkage (5533 participants) and interviews (111). The paper uses concepts from the network perspective of social capital (bonding, bridging, linking, horizontal, and vertical) as lenses to re-examine the evaluation's findings about the consumers' social participation in life areas (social, leisure, and productive) facilitated by the program. This social capital perspective offers a lens to examine the breadth and intensity of participation experienced by the consumers taking part in the support program. The article adds to the literature about how service providers can improve social participation and therefore consumers' opportunities for recovery and wellbeing. The analyses found that the support increased people's social interaction and their capacity in the community. Their social interaction was mostly with other people in the service. Often their interactions in the community were only transactional. Few consumers participated in activities in productive life areas, and few of the activities promoted vertical social capital in social networks outside the service. The implications are that service providers need greater attention on facilitating a variety of social participation activities that can extend mental health consumers' horizontal and vertical social capital and so further contribute to their current and future recovery and wellbeing

Excel implementation of finite difference methods for option pricing

This paper presents and explains finite difference methods for pricing options and shows how these methods may be implemented in Excel. We cover both the explicit and the implicit finite difference methods. Each uses a numerical approximation to the partial differential equation and boundary condition to convert the differential equation to a difference equation. The difference equation can be solved using Excel and this solution is a numerical approximation to the option price. This paper explains how we obtain the difference equation from the differential equation and shows the reader how to implement and solve the difference equation using Excel

Barriers and facilitators to implementing community outreach work, and inter-professional collaboration with regional partners

Abstract : Objective. Community outreach workers support individuals in accessing the health and community services they require through various forms of proximity approaches. Even though community outreach has been available in the province of Quebec (Canada) for the past 40 years, it is still difficult to implement and sustain, especially with families of young children. The aim of this study was to document barriers and facilitators to implementing community outreach practices, and to describe how such workers collaborate with sectoral (e.g. health care) and inter-sectoral (e.g. municipalities, community organizations, schools) partners. Methodology. We performed a content analysis on 55 scientific and grey literature documents, and transcriptions of 24 individual interviews and 3 focus groups with stakeholders including parents, community outreach workers, health care employees, and inter-sectoral partners. Results. This study reveals four categories of barriers and facilitators to the implementation of community outreach work (i.e. organizational factors, nature of the work and worker-related factors, family-related factors, external factors). With regards to collaboration, community outreach workers deal with various partners. Good inter-professional collaboration is achieved through positive interactions and communication, shared or co-developed activities for the families, co-intervention with families, and strategies to enhance role awareness and inter-sectoral meetings. Conclusion. Results highlighted that many factors interact and can either influence, positively or negatively, the opportunity to implement community outreach work. The collaborative practices identified may help to maximize facilitators and overcome barriers. Advocacy and a better understanding of how to integrate community outreach work within health services while maintaining the workers’ flexibility are needed to sustain this practice

Comparing children's care work across majority and minority worlds

Comparative qualitative methodologies that investigate children's lives in sharply contrasting socio-economic, political and welfare contexts are relatively unusual. Yet within an increasingly interdependent globalised world, comparative research and dialogue across binaries seems ever more important. In this chapter, we critically reflect on global conceptualisations of young caregiving and discuss the methodological and ethical challenges that arose in our comparative study of children caring for a parent/relative living with HIV in Tanzania and the UK. We discuss the potential problems and benefits of using the term "young carer" and suggest that levels of support and recognition of children's caring roles in particular countries do not follow a simple Majority/Minority world binary, but rather reveal a more complex picture. We argue that developing global perspectives that work across geographical, linguistic and disciplinary boundaries can facilitate greater understanding of the commonalities and diversities of children's caring lives globally

Policies to change attitudes to people with disabilities

Negative attitudes are a major barrier to the equality of people with disabilities. Governments and other organisations have implemented numerous programs to change attitudes towards people with disabilities. We analyse published evidence about the effectiveness of such programs using a framework of the interrelationship between three levels of policy intervention to change attitudes: personal level – directed at changing the attitudes of individuals; organisational level – concerning attitudinal barriers in domains such as employment, education and health; and government level – legally mandating behaviour change. The analysis finds that the following policy types can be effective if used together: policies that involve direct contact with people with disability; information and awareness campaigns; education and training about disability; and antidiscrimination enforcement. Policy characteristics that contribute to effectiveness include: a positive program experience for participants; multi-faceted and prolonged interventions; and adequate program resources. Policy effectiveness to change attitudes relies on corresponding reinforcement at all three policy levels

Analysing choice in Australian individual funding disability policies

The Australian National Disability Insurance Scheme (NDIS) will allocate funding packages to people with disability who are assessed as needing paid support. The NDIS is an example of individual funding, which is currently not the dominant way of organising disability support in Australia. Individual funding aims to increase opportunities for personal choice. We present a framework for understanding current individual funding policies in each Australian jurisdiction according to two policy dimensions that potentially enable greater personal choice for people with disability: who holds their allocated funds and where support can be purchased. The findings show wide disparities in choice across the country, particularly due to constrained funds and the shortage of support to purchase in regional areas. The analysis demonstrates that NDIS implementation will need to consider that, while individual funding can be empowering for some people with disability, enabling choice can be challenging for administrators and service provider

NDIS Peer Support Practice Review: Stage 4 Report

This project, led by researchers from the Australia and New Zealand School of Government, aims to build the organisational capacity of disability support organisations (DSOs) to provide peer support. It reviews current good practice approaches to implementing peer support networks in the Australian disability sector, and undertakes an international research and literature review on best practice delivery of peer support programs. The project develops and evaluates a suite of resources and training materials designed for organisations providing peer support programs, and develops good practice guidelines on implementing peer support programs to inform investment in peer support programs and networks in the future