In a health care environment that has historically struggled to find effective or sustainable alternatives to overly relying on acute and crisis mental health care, the Step-Up Step-Down model has emerged as a potentially valuable option in a system of care (Thomas & Rickwood, 2013).
Step-Up Step-Down services provide residential accommodation supported by 24 hour staffing that frequently includes both clinical staff and recovery-focused non-clinical supports. Maximum lengths of stay vary in this model of care but are typically around one month.
Western Australia’s first step-up, step-down mental health service opened in Joondalup in 2013 with 22 beds. In 2017 Neami researchers partnered with University of Western Australia Research Fellow Dr Hanh Ngo to undertake an evaluation of the Joondalup Mental Health Step-Up Step-Down (JMHSS) service. Dr Ngo has undertaken an independent analysis of data obtained from consumers during the course of their stay at the Joondalup Mental Health Step-up step-down Service (JMHSS) and data obtained from the Western Australian Data Linkage Branch.
Findings demonstrate the value of the service as being a space that consumers can access to prevent escalation of illness and/or admission to hospital, or alternatively as a space to consolidate recovery gains and self-management skills after spending time in hospital. Pre and post measurement data revealed that consumers achieve significant recovery and wellbeing gains over the course of their stay at the JMHSS. Findings so far can be accessed from the links below.
The inclusion of a matched control cohort has also added to the internal validity of the evaluation. On a broader scale, the findings derived from this project have contributed to the existing scant body of evidence for the clinical and economic effectiveness of the Step-Up Step-Down service model.
As an opportunity for continuous improvement we are also undertaking additional activities to gain an understanding of how the service is experienced by: 1) those who use it to support their own recovery and wellbeing, and 2) the variety of stakeholders linked to the services operations and management.
Led by principles of co-design, members across two working groups have been undertaking a collaborative inquiry process to review findings from the study and provide insights from experience and observation about areas of practice and process within the JMHSS service. Collaborative inquiry in this context refers to ‘understanding and constructing meaning around experience for the purpose of enhancing practice’. The goal is to identify areas that are important to maintain and strengthen and those that could be enhanced or modified. We anticipate that the findings from these working groups will be released in March 2018.
If you would like to know more about this project please contact Keren Wolstencroft email@example.com