Partnering to address rural health workforce challenges in Western NSW

Experiences of Young People and Their Carers with a Rural Mobile Mental Health Support Service: A Qualitative Study

Mental health difficulties during teenage years are common. They are also a risk factor for later mental and physical health problems. Rural young people are at a greater risk for mental health difficulties and have less access to services than their urban counterparts. The purpose of this study was to explore the experiences of young people and their carers with mental health support provided by a rural mobile service, and to identify access enablers from the perspective of the service users. A qualitative descriptive approach was used to analyse twelve interviews with current service users and eight interviews with family members of young people who had accessed the service. Three main themes were identified: (a) access and flexibility, (b) the qualities and strategies of the clinicians, and (c) experiences of change. The mobile service was perceived to be effective in producing a positive change in mental health, relationships, and the attainment of life goals. Key enablers to access included the flexibility of the mobile service, the variety of service delivery modes and therapeutic methods offered, the ease of access facilitated by the location in schools, and the autonomy of young people in how they chose to utilise the service. This study provides information about what is important to rural young people and their families in the provision of mental health services. The findings have implications for changing the way services are organized and operated. Healthcare policies and services could support a user-led model design that incorporates access and use-enablers and removes barriers to rural mental health support.

Collaborative care: Primary health workforce and service delivery in Western New South Wales-A case study

OBJECTIVE

To explore how four small towns in rural New South Wales known as the 4Ts are addressing challenges accessing quality care and sustainable health services through a collaborative approach to workforce planning using the collaborative care framework.

DESIGN

Descriptive case study approach.

SETTING

The collaborative care project was developed as a result of ongoing partnerships between 2 rural Local Health Districts, 2 Primary Health Networks and a non-governmental health workforce organisation. The collaboration works with 5 subregions each comprising 2 or more rural communities. This paper focuses on the 4Ts subregion.

PARTICIPANTS

Stakeholders of the collaborative design including organisations and the community.

INTERVENTION

A place-based approach to co-designing health services with community in one sub-region of Western New South Wales.

MAIN OUTCOME MEASURES

A synthesis of field observations and experiences of community and jurisdictional partners in implementation of the 4Ts subregional model. Mapping of implementation processes against the collaborative care framework.

RESULTS

The collaborative care framework is a useful planning and community engagement tool to build health workforce literacy and to impact on system change at the local level. We identify key elements of effectiveness in establishing the 4Ts model, including the need for coordinated health system planning, better integrating existing resources to deliver services, community engagement, building health workforce literacy and town-based planning.

CONCLUSION

This study adds to the body of knowledge about how to successfully develop a collaborative primary health care workforce model in practice. The findings demonstrate that the implementation of a collaborative primary health care workforce model using the collaborative care framework can improve service access and quality, which in turn might facilitate workforce sustainability.

Interprofessional education in the rural environment to enhance multidisciplinary care in future practice: Breaking down silos in tertiary health education

OBJECTIVE

Western Sydney University has implemented a rural interprofessional learning programme to promote collaborative care approaches to enhance cross-discipline communications, improve knowledge and clarity of roles and improve patient care and outcomes.

DESIGN

Rural interprofessinal learning is an interprofessional educational approach, consisting of simulations of complex health events. Simulation methodology frames the study with a focus on human interaction. A mixed-methods evaluation has been conducted, incorporating pre- and post- event participant surveys along with semi-structured focus groups.

SETTING

Simulations are conducted in the rural setting, including community settings, working farms and rural hospitals.

MAIN OUTCOME MEASURES

Reflexive thematic analysis was used to identify themes measuring students' perceptions of interdisciplinary care, knowlede of other health discipline roles and skills and how they believe the exercise will influence their future practice. Facilitator feedback regarding the efficacy of the simulations was also recorded and analysed using reflexive thematic analysis.

PARTICIPANTS

Care of simulated patient(s)/bystander(s) is primarily provided by paramedicine, nursing and medical students; however, increasing interest has expanded the programme to include students from a range of allied health professions. Simulations are facilitated by a multidisciplinary team of experienced practitioners and specialists.

INTERVENTION

Four rural interprofessional learning events have been held.

RESULTS

120 students have participated in the evaluation. Findings include increased understanding of the contributions of other disciplines in enhancing patient care, team approaches, cross-discipline communication and a need to engage in collaborative care in future practice.

CONCLUSION

Creating a collaborative learning environment creates a culture of multidisciplinary care, enhancing patient care and improving outcomes. The rural interprofessional learning model is an effective interprofessional educational approach, which can be repeated, refined and improved for continual professional development.