Right care, first time, where you live

Right care, first time, where you live’ is a national program where we co-develop with communities, decision-support tools using systems modelling and simulation to guide investments in sustained, coordinated and digitally enhanced youth mental health care. These enhanced care systems will be delivered regionally and in ways that are co-designed and governed by local communities and their relevant health agencies. This decision-support ecosystem will navigate a challenging decision-making environment and strengthen and coordinate the delivery of mental health in a responsive and dynamic way.

This research program aims to bring an evidence-based discipline to investments in Australia’s youth mental health systems that will provide young people with timely access to the right level of care, delivered early in the course of illness, and for a sufficiently long-period, to ensure that they thrive economically and socially. Specifically, this means that more young people get back on a positive developmental trajectory towards enhanced social, educational and vocational functioning – back to school, back to work and thriving in their communities.

ARTICLES

Mental health: build predictive models to steer policy

Predictive models in mental health can steer policy by combining economic, social and medical data to forecast need and design services to address the growing mental health crisis. Drawing together qualitative and quantitative evidence and data, models should capture changes triggered by the pandemic — such as education loss, job loss, domestic violence, social isolation, fear and uncertainty. Models should forecast demand for community mental-health services and acute care, including emergency-department presentations and psychiatric hospitalizations, as well as outcomes such as suicidal behaviour. Before allocating significant investments, alternative scenarios should be simulated to reveal the combination, scale, targeting, timing and duration of health, social and economic policies and initiatives that will deliver the greatest impacts.

Which Social, Economic, and Health Sector Strategies Will Deliver the Greatest Impacts for Youth Mental Health and Suicide Prevention? Protocol for an Advanced, Systems Modelling Approach

Simulation allows researchers and decision makers to move beyond what can be manipulated within the scale, time, and ethical limits of the experimental approach. Such learning when achieved collectively, has the potential to enhance regional self-determination, help move beyond incremental adjustments to the status quo, and catalyze transformational change. This research seeks to advance efforts to establish regional decision support infrastructure and empower communities to effectively respond. In addition, this research seeks to move towards an understanding of the extent to which systems modelling insights may be relevant to the global mental health response by encouraging researchers to use, challenge, and advance the existing work for scientific and societal progress.

A Dynamic Approach to Economic Priority Setting to Invest in Youth Mental Health and Guide Local Implementation: Economic Protocol for Eight System Dynamics Policy Models

Mental health can be defined as a complex dynamic system where decision makers are challenged to prospectively manage the system over time. This protocol paper describes the approach to equip eight system dynamics (SD) models across Australia to support priority setting and guide portfolio investment decisions, tailored to local implementation context. Equipping SD models to undertake economic analysis is intended to support local priority setting and help optimise implementation regarding the best value mix of investments, timing and scale. The objectives are to improve allocative efficiency, increase mental health and economic productivity.

Right care, first time: a highly personalised and measurement-based care model to manage youth mental health

The model of our highly-personalised measurement based care explicitly aims to prevent progression to more complex and severe forms of illness and is better aligned to contemporary models of the patterns of emergence of psychopathology. Inherent within this highly personalised approach is the incorporation of other evidence-based processes, including real-time measurement-based care as well as utilisation of multidisciplinary teams of health professionals. Data-driven local system modelling and personalised health information technologies provide crucial infrastructure support to these processes for better access to, and higher quality, mental health care for young people.

VIDEOS

Program Overview

Phase I – Systems modelling and simulation through participatory approach

Phase II – Embedding the systems model in an ongoing monitoring, evaluation and system improvement decision-support ecosystem

Phase III – Economic analysis and return on investment(s)

Phase IV – Synthesise knowledge from all eight regional systems models to refine a national model

ACT Case study