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Article << Previous     |     Next >>   Contents Vol 38(1)

Successful provision of emergency mental health care to rural and remote New South Wales: an evaluation of the Mental Health Emergency Care–Rural Access Program

Emily Saurman A D, David Lyle A, David Perkins B and Russell Roberts C

A Broken Hill University Department of Rural Health, University of Sydney, PO BOX 457, Broken Hill, NSW 2880, Australia. Email: david.lyle@health.nsw.gov.au
B Centre for Rural and Remote Mental Health, Forest Road, Orange, NSW 2800, Australia. Email: david.perkins@newcastle.edu.au
C Mental Health and Drug and Alcohol Services, Western NSW Local Health District, Bloomfield Hospital, Forest Road, Orange, NSW 2800, Australia. Email: russell.roberts@health.nsw.gov.au
D Corresponding author. Email: emily.saurman@sydney.edu.au

Australian Health Review 38(1) 58-64 http://dx.doi.org/10.1071/AH13050
Submitted: 25 February 2013  Accepted: 16 October 2013   Published: 13 December 2013

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Objective To evaluate a rural emergency telepsychiatry program, the Mental Health Emergency Care–Rural Access Program (MHEC-RAP), which aims to improve access to emergency mental health care for communities throughout western New South Wales (NSW).

Methods A descriptive analysis of service activity data from the introduction of the MHEC-RAP in 2008 to 2011 using Chi-squared tests and linear regression modelling to assess change and trends over time.

Result There were 55 959 calls to the MHEC-RAP, 9678 (17%) of these calls initiated an MHEC-RAP service (~2500 each year). The use of video assessment increased over 18 months, then levelled off to an average of 65 each month. Health care provider use increased from 54% to 75% of all contacts, and 49% of MHEC-RAP patients were triaged ‘urgent’. Most (71%) were referred from the MHEC-RAP for outpatient care with a local provider. The proportion of MHEC-RAP patients admitted to hospital initially increased by 12%, then declined over the next 2 years by 7% (by 28% for admissions to a mental health inpatient unit (MHIPU)).

Conclusion The MHEC-RAP is well established. It has achieved acceptable levels of service activity and continues to be as used as intended. Further research is required to confirm how the MHEC-RAP works in terms of process and capacity, how it has changed access to mental health care and to document its costs and benefits.

What is known about the topic? Rural and remote communities have poorer access to and use of mental health services. Telehealth care is a reliable and accepted means for providing non-urgent mental health care.

What does this paper add? The MHEC-RAP is a practical and transferable solution to providing specialist emergency mental health care, and support for local providers, in rural and remote areas via telehealth. There is a possible impact upon the problem of recruiting and retaining a mental health workforce in rural and remote areas.

What are the implications for practitioners? Providing reliable remote access to specialist mental health assessment and advice while supporting providers in rural communities can result in better outcomes for patients and services alike.


[1]  Parslow RA, Lewis V, Marsh G. The general practitioner’s role in providing mental health services to Australians, 1997 and 2007: findings from the national survey of mental health and wellbeing. Med J Aust 2011; 195: 205–9.
| PubMed |

[2]  Eckert KA, Taylor AW, Wilkinson DD, Tucker GR. How does mental health status relate to accessibility and remoteness? Med J Aust 2004; 181: 540–3.
| PubMed |

[3]  Jackson H, Judd F, Komiti A, Fraser C, Murray G, Robins G, et al Mental health problems in rural contexts: what are the barriers to seeking help from professional providers? Aust Psychol 2007; 42: 147–60.
CrossRef |

[4]  Australian Institute of Health and Welfare (AIHW). Rural, regional and remote health: a study on mortality. AIHW catalogue no. PHE95. Canberra: AIHW; 2007.

[5]  Morley B, Pirkis J, Naccarella L, Kohn F, Blashki G, Burgess P. Improving access to and outcomes from mental health care in rural Australia. Aust J Rural Health 2007; 15: 304–12.
CrossRef | PubMed |

[6]  Dunbar J, Hickie I, Wakerman J, Reddy P. New money for mental health: will it make things better for rural and remote Australia? Med J Aust 2007; 186: 587–9.
| PubMed |

[7]  Burgess PM, Pirkis JE, Slade TN, Johnston AK, Meadows GN, Gunn JM. Service use for mental health problems: findings from the 2007 National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 2009; 43: 615–23.
CrossRef | PubMed |

[8]  Westwood B, Westwood G. Multi-presenter mental health patients in emergency departments: a review of models of care. Aust Health Rev 2001; 24: 202–13.
CrossRef | CAS | PubMed |

[9]  Taylor J, Edwards J, Kelly F, Fielke K. Improving transfer of mental health care for rural and remote consumers in South Australia. Health Soc Care Community 2009; 17: 216–24.
CrossRef | PubMed |

[10]  Sivakumar S, Weiland TJ, Gerdtz MF, Knott J, Jelinek GA. Mental health-related learning needs of clinicians working in Australian emergency departments: a national survey of self-reported confidence and knowledge. Emerg Med Australas 2011; 23: 697–711.
CrossRef | PubMed |

[11]  Stuhlmiller CM, Tolchard B, Thomas LJ, de , Crespigny CF, Kalucy RS, King D. Increasing confidence of emergency department staff in responding to mental health issues: an educational initiative. Australas Emerg Nurs J 2004; 7: 9–17.
CrossRef |

[12]  Buckley D, Weisser S. Videoconferencing could reduce the number of mental health patients transferred from outlying facilities to a regional mental health unit. Aust N Z J Public Health 2012; 36: 478–82.
CrossRef | PubMed |

[13]  Greater Western Area Health Service. Mental Health Emergency Care–Rural Access Project, draft version 2. Orange: Greater Western Area Health Service; 2007.

[14]  Health NSW. NSW TeleHealth: information for health professionals. Sydney: NSW Government; 2002. Available at http://wwwchweduau/prof/telehealth/nsw_health_professional_telehealth_brochurepdf [verified 2010]

[15]  NSW Health Working Group. The Rural Mental Health Emergency and Critical Care Access Plan. Orange: Mental Health and Drug and Alcohol Organisation; 2007.

[16]  Myhill K. Innovations in mental health service delivery for rural communities, 5th National Rural Health Conference. Adelaide: National Rural Health Alliance; 1999.

[17]  Buist A. Telepsychiatry in Australia. In Wootton PYR, Paul McLaren, eds. Telepsychiatry and e-mental health. London: Royal Society of Medicine Press; 2003. pp. 113–23.

[18]  Smith G, Williams T, Papaluca M, Lumbus A. A review of RuralLink and the Mental Health Emergency Response Line. Mt Claremont: Department of Health, Western Australia; 2011.

[19]  Baigent MF, Lloyd C, Kavanagh SJ, Ben-Tovim DI, Yellowlees PM, Kalucy RS, et al Telepsychiatry: ‘tele’ yes, but what about the ‘psychiatry’? J Telemed Telecare 1997; 3: 3–5.
CrossRef | PubMed |

[20]  Clarke P. A referrer and patient evaluation of a telepsychiatry consultation-liaison service in South Australia. J Telemed Telecare 1997; 3: 12–4.
CrossRef | PubMed |

[21]  Richardson LK, Frueh BC, Grubaugh AL, Egede L, Elhai JD. Current directions in videoconferencing tele-mental health research. Clin Psychol Sci Pract 2009; 16: 323–38.
CrossRef |

[22]  Norman S. The use of telemedicine in psychiatry. J Psychiatr Ment Health Nurs 2006; 13: 771–7.
CrossRef | CAS | PubMed |

[23]  Moffatt JJ, Eley DS. The reported benefits of telehealth for rural Australians. Aust Health Rev 2010; 34: 276–81.
CrossRef | PubMed |

[24]  Yellowlees P, Burke MM, Marks SL, Hilty DM, Shore JH. Emergency telepsychiatry. J Telemed Telecare 2008; 14: 277–81.
CrossRef | PubMed |

[25]  Saurman E, Perkins D, Lyle D. Mental Health Emergency Care–Rural Access Project: first year evaluation report. Broken Hill: Centre for Remote Health Research, Broken Hill University Department of Rural Health; 2009.

[26]  Saurman E, Perkins D, Roberts R, Roberts A, Patfield M, Lyle D. Responding to mental health emergencies: implementation of an innovative telehealth service in rural and remote NSW, Australia. J Emerg Nurs 2011; 37: 453–9.
CrossRef | PubMed |

[27]  Australian Bureau of Statistics (ABS). Census data: table builder. Canberra: ABS; 2011. Available at http://abs.gov.au/websitedbs/censushome.nsf/home/tablebuilder?opendocument&navpos=240 [verified 22 November 2013]

[28]  Nutbeam D, Harris E, Wise M. Theory in a nutshell, 3rd edn. Sydney: McGraw-Hill; 2010.

[29]  Australian Institute of Health and Welfare (AIHW). Mental health services in Australia 2007–08. AIHW catalogue no. HSE88. Canberra: AIHW; 2010.

[30]  Commonwealth of Australia. Fourth national mental health plan: an agenda for collaborative government action in mental health 2009–2014. Barton: Commonwealth of Australia; 2009.

[31]  National Rural Health Alliance Inc. Fact sheet 14: suicide in Australia. Deaking West: National Rural Health Alliance; 2009.

[32]  Government NSW. Mental Health Act 2007. 2007; Available from: http://www.austlii.edu.au/au/legis/nsw/consol_act/mha2007128/ [verified 2009]


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