Abstract
In response to the evolving mental health and alcohol and other drugs (AOD) landscape, Western Victoria Primary Health Network (WVPHN) co-designed an integrated, evidence informed, partnership-led service model that blended mental health and AOD services under a single model of care called “Step Thru Care” (STC).
STC provides blended, wrap around mental health and AOD services for people living in western Victoria experiencing co-occurring mental health and AOD support needs. STC is designed to provide equity of service and access to the local community.
The STC model was developed via an extensive co-design process throughout 2021-2022, which involved a wide range of local stakeholders including health service providers, Aboriginal Community Controlled Health Organisations (ACCHOs), people with lived experience, and natural supporters (such as carers and family members). The model was also informed by key documents such as the Royal Commission into Victoria’s Mental Health System, the National Mental Health and Suicide Prevention Plan, and other evidence-based literature. The model was validated through a market sounding process involving service providers from across the western Victorian region. A competitive tender process ensued, with successful applicants commencing services on 1 July 2023.
STC is a place-based, outcome focused, partnership-led model that delivers blended care that is tailored to better address both the AOD and mental health needs of the local community. The model also aims to provide sustainable solutions to regional workforce shortages through strategies such as embedding the lived experience peer workforce into STC’s workforce under the appropriate clinical governance. STC also uses a blended funding strategy, enabling service providers to allocate funds in a way that best meets the needs of the local community.
As service delivery has only recently commenced, it is too early to provide evaluation outcomes of the STC model. Evaluation has been built into the program design, with outcome measures such as the K10, AUDIT, DUDIT, and consumer and provider experience being collected, monitored, and evaluated over the next three years by an agency external to WVPHN.
STC exemplifies a step towards wider system reform and builds on our understanding of commissioning good practice by demonstrating how commissioning processes can drive system reform at a local level, deliver improved services, and facilitate integration to meet population health needs.
The next steps include evaluating the impact of STC and exploring opportunities to build upon the model, such as modular service offerings and co-commissioning with other organisations.
This abstract presents the STC model as a promising approach to blended AOD and mental health service delivery, offering insights, innovations, and challenges that can inform agencies seeking to implement similar models of care. It underscores the importance of service integration and place-based commissioning to meet the complex needs of populations facing co-occurring mental health and AOD support needs.