Patients Co-Designing Victoria’s Mental Health System

Our report to the Royal Commission into Mental Health provided evidence that clinical services developed using co-design methodologies, can advise how to reform the Victorian Mental Health System so that it delivers clinical value to every Victorian.

Our systems analysis highlighted many issues with the current mental health system; emergency department (ED) presentations have risen and our top 200 presenters costing Monash Health over $69 million in 5 years. To solve these issues, 11 recommendations outline the critical elements necessary to deliver a stronger mental health system. Key stakeholders were included in this co-design process eg., Psychology, ED, and Psychiatry.

We sought to create a mental health system of care that was designed around the needs, experiences and outcomes of mental health clients. Our report showcases the significant insights that guided the development of agile clinical services; agile Psychological Medicine, agile Recovery from Trauma, agile Comprehensive Care.

Every client who receives treatment in an agile clinical service is followed up to see if they returned to mental health services. Our illustration shows that after treatment, patients experienced improved outcomes and present less to ED. If implemented state-wide, agile clinical services has the potential to improve the overall wellbeing of Victorians.

Design is the art and science of resolving paradoxes to potentiate action in dynamic human social systems that foster renewal, growth and evolution in our community.

We transformed transactional care into human centred relational care, where people recover (see Kalen’s Story).

Psychology and Specialist Services (PSS) at Monash Health has continuously measured and analysed what clinical services our clients need to stay well. The design process outlined in our report has become a benchmark for service design and innovation within the PSS. Agile clinical services are presently embedded within the mental health program.

The process of innovation by Monash Health has delivered ongoing value-based mental health care, as defined by improved client outcomes and experience, and measured by client feedback. To understand how the system is behaving, systems behavioural and patient activity analytics were used (see illustrations).

Clinicians and patients who participated in the design process willingly engaged in a growth agenda and were energized by the co-design process; this also commenced their recovery journey. Our report engaged employees across several disciplines and leadership levels within Monash Health, led by the Director of Psychology with assistance from the Psychology Research and Design Team.

Our redesign process is informed by complexity science and implemented using psychologically informed change principles from cognitive, behavioural and emotional domains.

A core design feature detailed in our report is the use of patient activity analytics to better understand the patient experience. We mapped several patient journeys to assess the value of clinical services for patients, identify potential issues and improve quality of care.