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

5. Service Delivery Model
Develop a long-term, sustainable funding approach with multiple funding streams
The economic evaluation highlighted that headspace operates with multiple funding streams,
however, is overwhelmingly reliant on government funding. Delivery of services at headspace centres
are partly funded by the Australian Government Department of Health through the Youth Mental
Health Initiative. This grant payment covers site costs such as rent, infrastructure and some staff
salaries. In addition, multiple funding streams are leveraged through headspace to pay for direct
services. These funding streams comprise the Medicare Benefits Scheme (MBS), Access to Allied
Psychological Services (ATAPS), the Mental Health Nurse Incentive Program (MHNIP), and the
Rural Primary Health Services (RPHS). In addition, services are funded by centre lead agencies and
consortium members who are required to co-contribute to the running costs of headspace centres.
This is typically managed through the provision of in-kind support and staffing to increase service
capacity.
The economic evaluation highlights great diversity in unit costs across centres and this suggests that
more efficient use of government funds may be achievable. One way to achieve greater efficiency
and less variation in unit costs could be the organisational development and implementation of
performance targets or service goals. A small number of centre manager survey respondents (n=5)
suggested other ways that they believed would make the funding model more equitable across
centres. Suggestions included allocating funds based on client numbers and/or occasions of service
provided, as well as taking into account characteristics of the region to be serviced by the centre
(such as remoteness, local cost of living, and workforce availability).
Evaluation data suggests then that headspace is yet to develop a long-term, sustainable funding
approach. A few stakeholders suggested that this will require greater equity in funding across
centres. The rating of importance given by centre managers to alternative sources of income
suggests that they understand that a diversification of funding sources, particularly an increase in the
contribution of private funding to headspace (through for example philanthropy, social investment and
business partnerships) is required for long-term sustainability.
5.2 To what extent is model fidelity important?
Model fidelity may be defined as the extent to which the delivery of an intervention or program
adheres to the protocol or program model as originally developed (Mowbray et al, 2003). Fidelity
measurement, which is increasingly used in program evaluations, is difficult to apply in this context
as the centre-based headspace program model is not clearly prescribed or manualised. Rather,
each centre operates differently to meet the needs of the local community, and the composition and
expertise of the centre consortiums.
Evaluation data highlights diversity in the implementation of the service model across headspace
centres. During interviews with staff, variation in model implementation was attributed to multiple
factors, in particular local community needs, available resources and differing Lead Agencies. A
small number of staff valued the flexibility in the service model:
Having some from such a long history in the public mental health sector, the adjustability of
the headspace model is really quite good. It’s not rigid with layers of bureaucracy
(Psychologist)
However, not all viewed this as a potential strength that enabled services to fit local community
needs. Rather, a small number of stakeholder respondents viewed this diversity as problematic:
Headspace has been developed as a one size fits all and this limits its capacity to be flexible
around different needs both from a locality perspective and a client’s perspective (Survey
Response No. 8)
[Need to be] more clear about model of care (Survey Response No. 169)
Little clarity of headspace program and service delivery focus (Survey Response No. 17)
headspace National Office is taking steps towards ensuring greater consistency and quality in
service delivery. headspace National Office is undertaking a large project to identify and document
a best practice headspace model. An outcome of this project has been the development of the
Social Policy Research Centre 2015
headspace Evaluation Final Report
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