Exploring Health Care in Secure Settings - Custodial Health
Author: Dr Allison Salmon, Director, The Centre for Impact & Change
Allison recently presented a paper at the 2023 Health Care in Secure Settings Conference hosted by Justice Health NSW. This niche conference draws together health professionals working with adults and young people in Australia's forensic mental health and criminal justice systems.
Allison presented the findings of an independent evaluation she led for One Door Mental Health, along with her collaborators Marg Scott (https://www.linkedin.com/in/margaret-scott-gaicd-56ba1121/overlay/contact-info) and Professor Deb Black (https://www.sydney.edu.au/medicine-health/about/our-people/academic-staff/deborah-black.html).
More about the evaluation:
Forensic Mental Health consumers face multiple challenges in reintegrating into the community, including stigma, discrimination, social exclusion, enduring mental health problems and lack of adequate accommodation and support.
One Door Mental Health delivers the Forensic Reintegration Program (FRP) and provides a non-clinical, psychosocial service to eligible forensic patients of the Morisset Hospital Forensic Unit. The One Door FRP is funded by NSW Health and delivered in partnership with HNELHD. The Program is focused on establishing a satisfying and safe life in the community for eligible consumers via planned, stepped resocialisation and vocational activities.
In 2022, One Door Mental Health commissioned an independent evaluation to assess FRP effectiveness and inform future planning.
The evaluation included:
A pragmatic literature review that informed this evaluation
An overview of the One Door FRP, including Frameworks, Models of Care, Consumer Journey, and Program Logic Model
Qualitative and quantitative findings.
Methods A pragmatic literature review focused on the following:
Reintegration challenges for Forensic Mental Health Consumers
What reintegration support programs need to offer, and how?
What reintegration support programs achieve, and what ethical challenges?
Evaluation questions included i) key elements or requirements for success; ii) key impacts and indicators of success; iii) barriers to Program success and how the Program can be strengthened; and iv) requirements to scale the Program.
One Door FRP operational data for 2022 was collated.
Qualitative data was collected via Key Informant Interviews and Focus Groups with clients, staff and stakeholders (ethical approved via HNELHD - ETH02070.)
Main findings
Operational data for 2022 between nine and twelve consumers were regularly enrolled; 374 supervised days of leave offered; an average of 3 hours of one-to-one support; 3 to 5 hours of group activities per week. Documented improvements for 90% of consumers.
Qualitative data identified the critical program elements of success as a) committed onsite staff; b) effective partnerships with the Clinical Treatment Team (CTT), the Mental Health Review Tribunal (MHRT) and local community services; c) support from senior leadership; d) integrated Program reporting; and e) a flexible model of Program delivery.
Positive outcomes were broad and well described by the participants and ranged from increased self-esteem, pride, and sense of achievement to significant changes in leave provisions and discharge for this group of people who are typically marginalised and survivors of trauma.
"The One Door FRP supports an underserved cohort of people with significant mental illness, and this is a Program for those at the very top of a pyramid of need and illness facing multiple stigmas". Kathi Boorman, One Door Mental Health CEO, 2022
To learn more about the 2023 Health Care in Secure Settings Conference – HCSS website.
To learn more about One Door Mental Health –www.onedoor.org.au
To read Dr Allison Salmon's publications – Allison Salmon - Google Scholar
Please get in touch if you'd like to hear more
