Exploring patient-centred pathways for mental health care
Like many people, Associate Professor Jennifer Smith-Merry's life has been impacted by the mental ill-health and suicide of family members and friends, many of whom had been failed by the services and policy frameworks that should have been helping them.
Her experiences have helped shape her work as the research leader at the Faculty of Health Sciences Centre for Disability Research and Policy, where she's one of the greatest advocates of patient-centred healthcare.
She measures her success on the extent to which she can help individuals with disability and mental ill-health to live well. She achieves this by undertaking research that focuses on listening to people and developing high-quality research evidence that reflects their experiences.
Her research aims to involve disability and mental health consumers with policy-making and practices - to make changes and develop better service responses to address individual needs.
Custody to community for people with mental illness
The 'Custody to Community' (C2C) intervention (pdf, 1.2MB) is just one example where she has demonstrated the need for consumer participation in designing health systems and processes for mental health care.
We know that mental health conditions are more common among prisoners than in the general community. We also know that people with untreated mental illness are more likely to experience poor health outcomes after they are released from jail - including death, increased rates of drug and alcohol misuse, homelessness and reincarceration.
The C2C intervention identified best-practice in transition support and attempted to implement this practice for 14 people with mental ill-health transitioning from the criminal justice system into the Sydney Local Health District.
"For the group of 14 mental health consumers who participated, only half were still engaged with the program at the end of the 28-day data collection period… A significant failing resulting from a lack of understanding about existing barriers and facilitators of effective transition", says Associate Professor Smith-Merry.
Identifying systemic issues in the current model of care, Associate Professor Smith-Merry's research team from the Centre for Disability Research and Policy at the University of Sydney found that drug problems, unstable accommodation and poor communication and information systems were key barriers preventing mental health consumers to accessing support services and completing programs.
From this, she has developed recommendations to improve mental health service responses to address individual needs. They proposed a system-wide approach for reform, with an integrated information system that would facilitate personalised consumer-care.
Her research is the first step for reform. The recommendations will require strong policy prioritisation and action by high level actors including the New South Wales Mental Health Commission, the NSW Government, Justice Health and Corrections NSW.
Associate Professor Smith-Merry is currently leading a large project analysing coronial data to understand the context of mental health-related deaths. The NSW Mental Health Commission funds this research.
