10.1.1. Questions about the scope of the MDS¶
- Coverage of community-based suicide prevention activities
- Coverage of digital health services
- Coverage of whole of region services regardless of who funds
- Appropriateness of occasions of service as a counting measure
- Exclusion of ‘non clinical’ time
- Are headspace services covered by the requirements?
- Are EPYS centres covered?
- Coverage of Mental Health Nursing services
PHNs raised a number of questions regarding the scope of the MDS and whether specific areas of commissioned activity were intended to be covered. The Overview paper covers the scope issue (page 4), an extract of which is copied below:
“The new arrangements are designed to capture data on PHN-commissioned mental health services delivered to individual clients, including group-based delivery to individual clients …
The scope of coverage will not extend to services targeted at communities, such as the community capacity building activities previously funded under projects sourced from National Suicide Prevention Program funding. Collection and reporting of activities of this type requires a different approach to ‘counting’ and identification of the ‘client’. PHNs commissioning activities of this type will have flexibility to establish local data reporting arrangements that suit requirements.”
PHNs raised a number of questions to further clarify the scope of the PMHC MDS, summarised below.
10.1.1.1. Coverage of community-based suicide prevention activities¶
10.1.1.1.1. Activities such as mental health and suicide awareness training and whole of community health promotion programs (non-clinical services) (e.g., Farm-Link). targeted at groups or whole communities, are not a good fit for the PHMC MDS. They are currently reported to the National Suicide Prevention Program) MDS which finishes on the 30th June 2016. What is the mechanism for the future?¶
PHN-commissioned services of this type are outside the scope of the PMHC MDS.
Regional whole-of-community suicide prevention activities previously funded directly by the Department and now transferred to PHNs (e.g., Farm-Link) have previously reported to the National Suicide Prevention Program MDS managed by Australian Healthcare Associates under contract to the Department. The Department is currently exploring options to continue this collection and will advise PHNs accordingly, with a view to ensuring continuity of reporting of community-based suicide prevention activities.
Suicide prevention oriented services provided to individuals are in scope for collection and reporting to the PMHC MDS.
10.1.1.2. Coverage of digital health services¶
10.1.1.2.1. Are the PHNs expected to collect and upload all of the data outlined under the six Mental Health Priority Areas? If so it will be difficult to collect this data for referrals made to e-mental health sites such as mood gym, mind spot etc. There are also challenges around self-help groups.¶
As indicated, scope of coverage is all PHN-commissioned mental health services delivered to individual clients, regardless of mode of service delivery.
Digital health services present particular challenges that need to be unbundled to resolve a way forward. Where PHNs refer the consumer to self-help, clinician unmoderated assistance (e.g., Mood Gym), this is not a PHN-commissioned service as such and falls outside of the scope of collection. Similarly, referral to a nationally funded clinician-moderated service such as Mindspot is not a PHN-commissioned services and falls outside of scope, bypassing the need for data collection.
However, there are acknowledged issues where a PHN enters a funding agreement with a digital health provider to provide individually tailored, clinician-moderated services to specific populations within their regions. Such services clearly fall within scope. The Department is considering the options to capture the required data. These include setting up arrangements for digital providers to collect and submit data on behalf of PHNs.
10.1.1.3. Coverage of whole of region services regardless of who funds¶
10.1.1.3.1. Are we only reporting on services and processes that we are commissioning and undertaking or the region as a whole?¶
The PMHC MDS is designed to cover only those services commissioned by PHNs.
10.1.1.4. Appropriateness of occasions of service as a counting measure¶
10.1.1.4.1. This unit of counting is not appropriate for the full range of services that might be commissioned by PHNs, for example, whole of community-oriented prevention activities¶
This is agreed. The scope of the PMHC MDS does not cover every activity that a PHN may commission.
Where activities are outside the scope of the PMHC MDS, PHNS are expected to set up their own arrangements to collect data suitable for reporting purposes. See also the response above regarding Coverage of community-based suicide prevention activities.
10.1.1.5. Exclusion of ‘non clinical’ time¶
10.1.1.5.1. The MDS only captures actual clinical time. Administrative tasks such as arranging for case conferences, updating electronic health information records, undertaking program contractual management tasks, travelling to service provision venue amongst others, are currently not being captured.¶
The focus of the PMHC MDS collection is on clinical service delivery to individual clients. It is acknowledged that clinician have to undertake other activities to maintain their clinical work and time spent on these can be significant. However, any broadening of scope to include as mandatory other activities would create an unacceptable data reporting burden on clinical service providers, all of whom are practitioners independent of the PHN.
It should be noted however that the PMHC MDS differs from the previous ATAPS collection in allowing a range of services delivered ‘on behalf’ of the client to be recorded. Section 4.4 of the Overview paper (‘Determining what activities are in scope for reporting as service contacts”) provides the relevant details.
10.1.1.6. Are headspace services covered by the requirements?¶
10.1.1.6.1. Are services funded through headspace expected to collect the PHMC MDS?¶
First-stage development of the MDS will not include existing youth-specific services (headspace, Early Psychosis Youth Services) that currently collect and report a standardised dataset to headspace National Office. Pending the future of these arrangements, and access to data by PHNs, the PHMC MDS can be expanded at a future stage to allow incorporation of headspace and Early Psychosis Youth Services should this be required.
10.1.1.7. Are EPYS centres covered?¶
10.1.1.7.1. Are services funded as Early Psychosis Centres expected to collect the PHMC MDS?¶
First-stage development of the MDS will not include existing youth-specific services (headspace, Early Psychosis Youth Services) that currently collect and report a standardised dataset to headspace National Office. Pending the future of these arrangements, and access to data by PHNs, the PHMC MDS can be expanded at a future stage to allow incorporation of headspace and Early Psychosis Youth Services should this be required.
10.1.1.8. Coverage of Mental Health Nursing services¶
10.1.1.8.1. Are services previously delivered under MHNIP expected to collect the PHMC MDS?¶
From July 2016, funding has been provided to PHNs through a flexible funding pool to enable commissioning of a wide range of primary mental healthcare and suicide prevention services at regional levels. As such the MHNIP and other programs that have transitioned into the flexible funding pool, and their associated guidelines, are no longer applicable.
All 31 PHNs are required to collect and enter/upload data into the PMHC MDS. The PMHC MDS has been developed to capture the broader range of mental health services now being commissioned by PHNs, including services previously delivered under MHNIP. However, principal responsibility for establishing regional arrangements for data collection and reporting rests with PHNs.