Is headspace making a difference to young people’s lives?

5. Service Delivery Model
Table 5.2 Proportion of future care decisions for clients after specific occasions of service (OoS) 31
Future care decisions All OoS First OoS Last OoS*
Commence treatment at headspace 15.6 52.3 5.3
Continue current treatment 65.8 23.2 61.9
Treatment goals have been met, not further treatment required at this time 2.7 2.3 11.4
Allocate to other headspace service in conjunction with current treatment 3.6 5.4 2.8
Allocate to other headspace service and cease current treatment 1.3 2.7 1.4
Formal referral to other service in conjunction with current treatment 2.1 2.8 2.5
Formal referral to other services and case current treatment 0.8 2.1 1.7
Young person has decided not to continue 1.0 2.7 2.7
No referrals made 3.6 1.6 6.0
Other 3.4 5.0 4.4
* Last occasion of service refers to the last recorded occasion of service within the hCSA data.
Source: Authors calculations from hCSA data.
Thus the overwhelming majority of young people access headspace services without a formal
referral, and are treated by staff within the centre. This latter finding is likely because the consortium
model ensures that young people are able to access a diverse range of services within a centre. The
interview data does not, however, align easily with the findings that only a very small proportion of
headspace clients receive referrals to other services. All interviewed staff (n=25) spoke of referring
clients to other services in their community when the support the young person required could not
be provided in-house. Indeed, 93% (n=26/28) of centre managers rated headspace as ‘somewhat
effective’ or ‘very effective’ in providing referrals to other services within the broader service system.
Respondents in the Survey of Centre Managers most commonly identified referring young people
to Child and Adolescent Mental Health Services (CAMHS). Qualitative data indicates that referral
to CAMHS and Adult Mental Health Services (AMHS) is likely to be made when young people are
assessed as having severe and complex mental health problems that require intensive intervention.
Some data indicates that CAMHS and headspace staff see each other as a referral option and
resource. CAMHS, for example, includes links to headspace factsheets on their website. Some
data also indicates that the connection between headspace and CAMHS is variable, working well in
some sites and not so well in others. Evaluation data indicates that headspace and CAMHS do not
share clients and that in instances where young people had sought treatment from both services,
one service would discontinue treatment following a discussion on what would be best for the young
person.
The next most commonly reported referral locations (in order and according to respondents in the
Survey of Centre Managers) were tertiary mental health services for children and young people,
youth services, non-government community service organisations providing non-clinical services (for
example Salvos and Mission Australia) and housing and accommodation services.
Interview data provides some additional insight into referral processes with three of the 25 staff
interviewed expressing concerns about referrals to and from CAMHS. As evidenced in the final quote
below, some of the difficulty is related to the fact that both services treat young people with mental
health problems and that assessment of the most suitable service is often done during treatment.
We have specifically had a meeting at CAMHS because there was misunderstandings
between our services and what we actually do and can provide and how they refer to us
and vice versa. Following that meeting… they had concerns that we were talking about
clients, yet no identifying information was used… So instead of taking from that meeting that
we need to refer properly with the referral form, they decided that we had problems with
confidentiality… So stuff like that is really difficult. I think we get some resentment from their
service (Intake Officer)
A GP might say that they have a 12 year-old with a behavioural disturbance for instance
31
There are 5% of occasions of service with missing service type information. Clients who visited headspace only
once during 2013/14 are not counted as the last visit. Authors calculations from hCSA data.
Social Policy Research Centre 2015
headspace Evaluation Final Report
91