Patterns of mental health care provision in urban areas: A comparative analysis for local policy in the ACT

PLoS One. 2023 Apr 12;18(4):e0284241. doi: 10.1371/journal.pone.0284241. eCollection 2023.

Abstract

Urbanisation presents specific mental health challenges, requiring a better understanding of service availability in urban areas for mental health care planning. Our objective is to analyse patterns of urban mental healthcare provision in Australia, and compare these with relevant national and international regions to inform urban mental healthcare policy and planning. Following a health ecosystems approach, we use a standardised service classification instrument, the Description and Evaluation of Services and DirectoriEs (DESDE), and Mental Health Care Atlases, to compare the availability, bed capacity and diversity of services providing specialised mental health or psychosocial care that are universally accessible (ie provided at no or low cost only in all relevant care sectors in four Australian and three international urban regions. We used a heuristics approach and an homogeneity test. Applicability to local policy was assessed using the Adoption Impact Ladder. Community care was less developed in Australia than internationally, except in the case of residential care in Australian Capital Territory, our reference area. Alternatives to hospitalisation were scarce across all regions. The Atlas was applicable to regional and local mental health planning. Differences in pattern of care between regions has implications for planning, equality of access to care and prioritisation of resources. An ecosystems approach is relevant to service planning in mental healthcare at local level.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Australia
  • Ecosystem
  • Humans
  • Mental Health Services*
  • Mental Health*
  • Policy

Grants and funding

LSC Western Sydney Partners in Recovery, 2014 http://www.newhorizons.net.au/temp/pir/ No LSC the University of Sydney, 2015 https://www.sydney.edu.au/ No LSC PIR East and South East Sydney, 2015 https://www.neaminational.org.au/ No LSC PHN Canberra ACT, 2016 https://www.chnact.org.au/ No LSC Western Australia Primary Health Alliance, 2018 https://www.wapha.org.au/ No No author CONICYT (National Commission for Scientific and Technological Research), 2008 https://www.conicyt.cl/ No LSC #A/ 013204/07 and #A/019376/08 Inter-University Cooperation Program projects, AECID, 2007-2008 https://www.aecid.es/ES/sectores-de-cooperaci%C3%B3n No LSC Mental Health Network of Gipuzkoa, Departamento de Salud, 2015 https://www.euskadi.eus/gobierno-vasco/departamento-salud/inicio/ No Not author Project number: 261459 Refinement project, Seventh Framework Programme (7FP), 2011-13 https://ec.europa.eu/info/index_es No The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.