The development of outcomes frameworks is in line with a broader shift at The Benevolent Society to standardise outcomes, processes, and practices to support consistent service delivery for consumers across the life span. It also reflects a funding shift to not only reporting service outputs (how much did we do?) but also consumer and community outcomes (is any one better off?). Ultimately the development outcome frameworks across The Benevolent Society’s main service streams will ensure that the organisation is responding to the voices of consumers and communities, by delivering services according to the best available evidence on what works.

This presentation will detail the process The Benevolent Society has undertaken to develop a mental health outcomes framework for the PHaMs, Partners in Recovery and headspace program. Key elements in its development included the establishment of clear governance structures- including a Consumer Reference Group, engaging staff and consumers in the development of program logics, an extensive review of evidence based literature and external consultations with government, peak bodies, academics and other organisations delivering mental health programs. This process lead to the identification of 6 high level outcomes and associated indicators which will guide ongoing service delivery and improvement processes. Critical success factors and lessons learnt throughout this process will also be shared, from a research, service delivery and consumer perspective.

The presentation by an expert advisor to the project concerns the lessons to be learned from the Mental Health Integration Index (MHII) (2014) a recent Europe-wide survey on mental health and integration and the policy and provision for supporting people with mental illness. The MHII serves to provide facts on integration in order to inform policy development. At the heart of the project is an 18 indicators benchmarking index ranking 30 countries.

Mental illness exacts substantial human and economic costs on Europe, and a substantial treatment gap exists. It is the case though that the leading countries in the index are not the only sources of best practice in integrating those with mental illness. Findings are presented in terms of environment; access; opportunities and governance. Some key results:

• Employment is the field of greatest concern for those with mental-illness, but also the area with the most inconsistent policies across Europe

• Real investment separates those addressing the issue from those setting only aspirational policies

• Europe as a whole is only in the early stages of change from institution to community-based care.

• Lack of data makes greater understanding of this field difficult,


Finally, future concerted actions are considered.

This paper describes the continuing journey to establish the psychometric properties of ROSSAT. The Mental Health Coordinating Council (MHCC) have continued in their journey of validation of the ROSSAT, a reflective-practice quality-improvement tool developed in partnership with NSW Being (formerly NSW CAG) for mental health services, workers and other stakeholders. MHCC and NSW Being commenced a project in 2009/10 to identify and develop a resource to assist the community sector in delivering recovery oriented services. ROSSAT was designed to help organisations assess their level of recovery oriented practice. While firmly grounded in the voice of lived experience, further activity was undertaken in 2013/14 to psychometrically validate and refine the tools; through a partnership with the University of Sydney.

Details about the project literature review update; consumer, carer and worker focus groups conducted to assess face, construct and content validity; the subject matter expert survey; data analysis; National Mental Health Standards cross-referencing; and, toolkit revision have been previously reported. For 2015, MHCC’s focus has been on developing a range of education/training and consultancy services to support sector uptake of ROSSAT. Our research has identified that a large number of organisations and workers will be required to have experience of ROSSAT to continue its psychometrics journey and establish objective rating scales.

At present, there is no single classification used for mental health services. The Independent Hospital Pricing Authority (IHPA) has been working to develop the Australian Mental Health Care Classification (AMHCC) which will be used to price public mental health services across settings from 2016, but can also have broader application.

The AMHCC will improve the clinical meaningfulness of mental health classification, leading to an improvement in cost predictiveness, and support new models of care.

An effective way of classifying care across settings will be of use to many different levels of the health system. The AMHCC will allow individual services and systems such as state and territory health departments, Local Health Networks, NGOs and private organisations to better understand how their services work and where clinical, financial and other resources are applied, and will enable performance benchmarking across similar services.

IHPA presented an overview of preliminary work on the classification to the 2014 TheMHS Conference. A first draft of the AMHCC has now been prepared and will be piloted in late 2015. This paper explains how the AMHCC is constructed, how it will be applied, areas for development in later iterations, and ongoing opportunities to participate in this work.