Integrated mental health atlas of the Western Sydney Local Health District: gaps and recommendationsAna Fernandez A B F , James A. Gillespie C , Jennifer Smith-Merry B , Xiaoqi Feng C D E , Thomas Astell-Burt D , Cailin Maas A B and Luis Salvador-Carulla A B
A The Mental Health Policy Unit, Brain and Mind Centre, The University of Sydney, 100 Mallett Street, Camperdown, NSW 2050, Australia.
B Centre for Disability Research and Policy, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia. Email: email@example.com; firstname.lastname@example.org
C Menzies Centre for Health Policy and Sydney School of Public Health, The University of Sydney, City Road, Edward Ford Building A27, NSW 2006, Australia. Email: email@example.com
E Early Start Research Institute, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia. Email: firstname.lastname@example.org
F Corresponding author. Email: email@example.com
Australian Health Review 41(1) 38-44 http://dx.doi.org/10.1071/AH15154
Submitted: 17 August 2015 Accepted: 1 February 2016 Published: 24 March 2016
Objective Australian mental health care remains hospital centric and fragmented; it is riddled with gaps and does little to promote recovery. Reform must be built on better knowledge of the shape of existing services. Mental health atlases are an essential part of this knowledge base, enabling comparison with other regions and jurisdictions, but must be based on a rigorous classification of services. The main aim of this study is to create an integrated mental health atlas of the Western Sydney LHD in order to help decision makers to better plan informed by local evidence.
Methods The standard classification system, namely the Description and Evaluation of Services and Directories in Europe for Long-term Care model, was used to describe and classify adult mental health services in the Western Sydney Local Health District (LHD). This information provided the foundation for accessibility maps and the analysis of the provision of care for people with a lived experience of mental illness in Western Sydney LHD. All this data was used to create the Integrated Mental Health Atlas of Western Sydney LHD.
Results The atlas identified four major gaps in mental health care in Western Sydney LHD: (1) a lack of acute and sub-acute community residential care; (2) an absence of services providing acute day care and non-acute day care; (3) low availability of specific employment services for people with a lived experience of mental ill-health; and (4) a lack of comprehensive data on the availability of supported housing.
Conclusions The integrated mental health atlas of the Western Sydney LHD provides a tool for evidence-informed planning and critical analysis of the pattern of adult mental health care.
What is known about the topic? Several reports have highlighted that the Australian mental health system is hospital based and fragmented. However, this knowledge has had little effect on actually changing the system.
What does this paper add? This paper provides a critical analysis of the pattern of adult mental health care provided within the boundaries of the Western Sydney LHD using a standard, internationally validated tool to describe and classify the services. This provides a good picture of the availability of adult mental health care at the local level that was hitherto lacking.
What are the implications for practitioners? The data presented herein provide a better understanding of the context in which mental health practitioners work. Managers and planners of services providing care for people with a lived experience of mental illness can use the information herein for better planning informed by local evidence.
References National Mental Health Commission. Report of the national review of mental health programmes and services. Canberra: Australian Government; 2014.
 Mental Health Commission of NSW. Living well report: Putting people at the centre of mental health reform in NSW. Sydney: NSW Mental Health Commission; 2014.
 Mendoza J, Bresnan A, Rosenberg S, Elson A, Gilbert Y, Long P, Wilson K, Hopkins J. Obsessive hope disorder: reflections on 30 years of mental health reform in Australia and visions for the future. Technical report. Caloundra: ConNetica; 2013.
 Medibank Private. The case for mental health reform in Australia: a review of expenditure and system design. 2013 [cited 2014 27 November]. Available at: https://www.medibankhealth.com.au/files/editor_upload/File/Mental%20Health%20Full%20Report.pdf [verified 14 January 2015].
 Department of Health. Fourth National Mental Health Plan: an agenda for collaborative government action in mental health 2009–2014. Canberra: Commonwealth of Australia; 2009.
 Australian Health Ministers. National Mental Health Plan. Canberra: Department of Health and Ageing; 1992.
 Rosen A, Gurr R, Fanning P. The future of community-centred health services in Australia: lessons from the mental health sector. Aust Health Rev 2010; 34 106–15.
| The future of community-centred health services in Australia: lessons from the mental health sector.CrossRef | 20334766PubMed |
 Rosen A, Gurr R, Fanning P, Owen A. The future of community-centred health services in Australia: ‘When too many beds are not enough’. Aust Health Rev 2012; 36 239–43.
| The future of community-centred health services in Australia: ‘When too many beds are not enough’.CrossRef | 22935108PubMed |
 Saxena S, Sharan P, Cumbrera MG, Saraceno B. World Health Organization’s mental health atlas 2005: implications for policy development. World Psychiatry 2006; 5 179–84.
| 17139355PubMed |
 Saxena S, Thornicroft G, Knapp M, Whiteford H. Global mental health 2 – resources for mental health: scarcity, inequity, and inefficiency. Lancet 2007; 370 878–89.
| Global mental health 2 – resources for mental health: scarcity, inequity, and inefficiency.CrossRef | 17804062PubMed |
 Parrott R, Hopfer S, Ghetian C, Lengerich E. Mapping as a visual health communication tool: promises and dilemmas. Health Commun 2007; 22 13–24.
| Mapping as a visual health communication tool: promises and dilemmas.CrossRef | 17617010PubMed |
 Fernandez A, Salinas-Perez JA, Gutierrez-Colosia MR, Prat-Pubill B, Serrano-Blanco A, Molina C, Jorda E, Garcia-Alonso CR, Salvador-Carulla L. Use of an integrated atlas of mental health care for evidence informed policy in Catalonia (Spain). Epidemiol Psychiatr Sci 2014; 16 1–13.
| 1:CAS:528:DC%2BC2cXhs1yisbY%3D&md5=8be37b4b1eae0257b81bfdf3bf15072eCAS |
 Montoya D. Western Sydney: An economic Profile. Briefing Paper No 6/2012. NSW Parlimentary Research Service. Available at: https://www.parliament.nsw.gov.au/prod/parlment/publications.nsf/0/1003F4B4BE8C5699CA257A5B00205266/$File/Western%20Sydney%20An%20Economic%20Profile%20Briefing%20Paper%2006%202012.pdf [verified 18 Feb 2016].
 Astell-Burt T, Feng X. Investigating ‘place effects’ on mental health: implications for population-based studies in psychiatry. Epidemiol Psychiatr Sci 2015; 24 27–37.
| Investigating ‘place effects’ on mental health: implications for population-based studies in psychiatry.CrossRef | 1:STN:280:DC%2BC2MzgslCltg%3D%3D&md5=793c893b4aafb150cb0fb3a07a559f27CAS | 25424460PubMed |
 Salvador-Carulla L, Alvarez-Galvez J, Romero C, Gutierrez-Colosia MR, Weber G, McDaid D, Dimitrov H, Sprah L, Kalseth B, Tibaldi G, Salinas-Perez JA, Lagares-Franco C, Roma-Ferri MT, Johnson S. Evaluation of an integrated system for classification, assessment and comparison of services for long-term care in Europe: the eDESDE-LTC study. BMC Health Serv Res 2013; 13 218
| Evaluation of an integrated system for classification, assessment and comparison of services for long-term care in Europe: the eDESDE-LTC study.CrossRef | 23768163PubMed |
 The Refinement Research Consortium. The refinement project. 2011. Available at: http://www.refinementproject.eu/results.php [verified 14 January 2015].
 Salvador-Carulla L, Saldivia S, Martinez-Leal R, Vicente B, Garcia-Alonso C, Grandon P, Haro JM. Meso-level comparison of mental health service availability and use in Chile and Spain. Psychiatr Serv 2008; 59 421–8.
| Meso-level comparison of mental health service availability and use in Chile and Spain.CrossRef | 18378842PubMed |
 Lesage A, Rhéaume J, Laberge F. L’application Québécoise du modèle Européen de cartographie des services de santé mentale pour les personnes souffrant de troubles mentaux graves. JASP 2002. 2002. Available at: http://jasp.inspq.qc.ca/Data/Sites/1/SharedFiles/presentations/2002/20021120-Rheaume-ModeleEuropeenCartographie.pdf [verified 14 January 2015].
 Salvador-Carulla L, Amaddeo F, Gutierrez-Colosia MR, Salazzari D, Gonzalez-Caballero JL, Montagni I, Tedeschi F, Cetrano G, Chevreul K, Kalseth J, Hagmair G, Strabmyr C, Park A, Sfetcu R, Wahlbeck K, Garcia , Alonso C. Developing a tool for mapping adult mental health care provision in Europe: the REMAST research protocol and its contribution to better integrated care Int J Integr Care 2015; 15
| Developing a tool for mapping adult mental health care provision in Europe: the REMAST research protocol and its contribution to better integrated careCrossRef |
 Department of Health. Partners in recovery. 2014. Available at: http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-pir [verified 14 January 2015].
 Department of Health. National service framework for mental health. London: Department of Health; 1999.
 Thornicroft G, Tansella M. The balanced care model for global mental health. Psychol Med 2013; 43 849–63.
| The balanced care model for global mental health.CrossRef | 1:STN:280:DC%2BC38jpt1ajug%3D%3D&md5=b2f0a79e150a694f5cb8bb9e403a8967CAS | 22785067PubMed |
 Thornicroft G, Tansella M. Components of a modern mental health service: a pragmatic balance of community and hospital care: overview of systematic evidence. Br J Psychiatry 2004; 185 283–90.
| Components of a modern mental health service: a pragmatic balance of community and hospital care: overview of systematic evidence.CrossRef | 15458987PubMed |
 Marshall M, Lockwood A. Assertive community treatment for people with severe mental disorders. Cochrane Database Syst Rev 2000; 2 CD001089
| 10796415PubMed |
 Siskind D, Harris M, Kisely S, Brogan J, Pirkis J, Crompton D, Whiteford H. A retrospective quasi-experimental study of a community crisis house for patients with severe and persistent mental illness. Aust N Z J Psychiatry 2013; 47 667–75.
| A retrospective quasi-experimental study of a community crisis house for patients with severe and persistent mental illness.CrossRef | 23567635PubMed |
 Marshall M, Crowther R, Sledge WH, Rathbone J, Soares-Weiser K. Day hospital versus admission for acute psychiatric disorders. Cochrane Database Syst Rev 2011; 12 CD004026
| 22161384PubMed |
 Priebe S, McCabe R, Schutzwohl M, Kiejna A, Nawka P, Raboch J, Reininghaus U, Wang D, Kallert TW. Patient characteristics predicting better treatment outcomes in day hospitals compared with inpatient wards. Psychiatr Serv 2011; 62 278–84.
| Patient characteristics predicting better treatment outcomes in day hospitals compared with inpatient wards.CrossRef | 21363899PubMed |
 Walsh FP, Tickle AC. Working towards recovery: the role of employment in recovery from serious mental health problems: a qualitative meta-synthesis. Int J Psychosoc Rehabil 2013; 17 35–49.
 Grove B. Mental health and employment: shaping a new agenda. J Ment Health 1999; 8 131–40.
| Mental health and employment: shaping a new agenda.CrossRef |
 Smith-Merry J, Gillespie J, Hancock N, Yen I. Integrating care for chronic mental ill-health: the Partners in Recovery Western Sydney study. Int J Integr Care 2014; 14
| Integrating care for chronic mental ill-health: the Partners in Recovery Western Sydney study.CrossRef |
 Meadows GN, Enticott JC, Inder B, Russell GM, Gurr R. Better access to mental health care and the failure of the Medicare principle of universality. Med J Aust 2015; 202 190–4.
| Better access to mental health care and the failure of the Medicare principle of universality.CrossRef | 25716601PubMed |
 Department of Health. Australian Government response to Contributing Lives, Thriving Communities: review of mental health programmes and services. Commonwealth of Australia; 2015. Available at: http://www.health.gov.au/internet/main/publishing.nsf/Content/0DBEF2D78F7CB9E7CA257F07001ACC6D/$File/response.pdf [verified 10 December 2015].