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Non-clinical, community and peer-led mental health support models may hold the key to shifting our care systems rapidly. There is real opportunity to strengthen these supports for Australia’s most vulnerable and marginalised groups, including for Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse (CALD) communities and older people.

Leveraging recent momentum

2020 has seen drought, bushfires, floods and a global pandemic and the psychological, social and economic impacts on Australian communities are still unfolding. Even without these events, one in five Australians aged 16-85 years already experiences an anxiety, affective or substance use disorder in any given year. Social isolation is often one of the most significant challenges faced by individuals with mental health issues, and during a time when we have been physically isolated from each other, peer support programs and community engagement have never been more important.

The government has announced an additional $48.1 million of funding to support the Mental Health and Wellbeing Pandemic Response Plan, focussed on reaching vulnerable groups in the community.1 These past months have also seen a rise in community mental and social support programs, with communities banding together to build resilience during the rapidly evolving and challenging situation.

What are non-clinical, community and peer-led mental health services?

Non-clinical, community and peer-led mental health services are innovative approaches that support mental health closer to where people interact, work and reside outside of traditional clinical settings.

At its core, peer-led mental and social support assume that people who have had similar and lived experiences can better relate and therefore offer more authentic empathy and validation. This promotes a wellness model that focuses on strengths and recovery.

There are two types of non-clinical, community and peer-led mental health services. The first is based in the general community, for example group-based short-term counselling, psycho-educational skill building, social prescribing schemes and other support provided by peer workers. The second is based in more structural environments such as academic settings, schools and workplaces. These non-clinical mental health services not only benefit individuals and community, but also benefit organisations and the broader health system.

Benefits for the community

Strengthening of community-based and peer-led supports is needed to achieve positive long-term health benefits for the community.

Non-clinical, community and peer-led mental health services can help with early prevention of more long-term mental health disorders and have been associated with reduced rates of suicide deaths.2 3 This is achieved by enhancing the mental health literacy and awareness of the community, which can reduce the potential escalation and severity of mental health conditions.

An exemplar is the peer-led Health and Recovery Program (HARP), aimed at supporting participants to be more effective managers of their chronic mental health diseases. A review of HARP found that peer-led programs demonstrated promising results, improving a range of health outcomes.4 A social prescribing scheme in the United Kingdom has also led to positive outcomes of improved self-esteem, confidence, and mental well-being, as well as reduced levels of anxiety, depression and negative mood.5 Social prescribing programs thus help to prevent escalation of complex health risks and are already being trialled across Australia by a number of Primary Health Networks, including the North Western Primary Health Network and the Gold Coast Primary Health Network.6 7 8

Benefits for the organisation

As we move towards the recovery phase and the ‘new normal’ begins to take hold, now is the time to embed employee support while the workforce transitions to a new state of work.

Mental health challenges are common in the working population, and growing awareness of these challenges has been paralleled by a rapid expansion of workplace mental health interventions. Mental health literacy in the workplace is gaining acceptability as a means to screen, prevent and effectively manage depression, anxiety and other common mental health problems among employees. Engaging in social support through social activities and peer support are vital in helping individuals manage workplace stressors.9 Notably, 68 percent of organisations introduced at least one new wellness benefit by late March 2020 to aid employees during the COVID-19 pandemic.10

There is a need to build upon the work of peak bodies and industry groups that help to drive a positive mental health culture in the workplace. For example, Beyond Blue’s National Workplace Program aims to raise awareness of depression and anxiety as a treatable illness, improve help-seeking behaviours, reduce stigma, and equip workers with the confidence and skills to help their colleagues. Similarly, the Black Dog Institute is leading Australia to build a mentally healthier society, and has partnered with significant organisations including Google, Philips, and Virgin Australia.

Benefits for the health system

Community-based mental health services help to shift demand away from clinical settings, alleviating pressure on hospitals and emergency departments.

Reduced hospital admissions and demand for inpatient beds could potentially result in cost savings and improved efficiencies for Australia’s overall mental health system. Leveraging mental health supports in the community is key to reshaping the traditional health system that has mainly been reliant on infrastructure and resources in hospital settings.

Opportunities to strengthen non-clinical, community and peer-led mental health supports

Current disruptions create a unique opportunity to strengthen key areas of non-clinical, community and peer-led mental health supports. This will help ensure that the benefits to the community, organisations and the health system can be achieved.

There is a real opportunity for community-based mental health supports to improve their cultural competence. This is important in providing support for the hard to reach and most vulnerable cohorts of the community. These include Aboriginal and Torres Strait Islander people and CALD communities, who often find it difficult to access culturally safe and appropriate mental health support. Non-English speaking CALD groups also face a literacy and communication barrier to access. Improving cultural competency will help non-clinical, community and peer-led mental health supports engage these often-isolated communities.

There is also a need to strengthen peer-led and group-based mental health support for our elderly populations, who are more prone to the adverse impacts of social isolation. This is particularly relevant now as we are required to physically distance ourselves from our elderly loved ones, leaving them with heightened risk of experiencing social isolation and loneliness.

Our connection with each other, our loved ones and the community are crucial to our mental health and wellbeing. Now more than ever we need to band together and prioritise mental health.

KPMG Australia’s Response

Mental health is KPMG’s number one wellbeing priority with a key focus on investing in mental health through our program of work with the Heart On My Sleeve movement (HOMS). This includes building leadership capability at the Partner, Director and front-line leader level and within peer support networks. Building the confidence and capability of leaders and peers to effectively engage in mental health conversations helps to reduce the stigma associated with mental ill health. Our mental health initiatives include:

  • Enhancing our existing Mental Health Peer Support network by delivering training and extending the reach with peer support circles.
  • Delivery of face to face and virtual HOMS workshops that provide practical insight to enable early interventions.
  • Co-creation and launch of online e-learn modules equipping our people with the theoretical knowledge and skills necessary to have and host real conversations about mental wellbeing as an “experiencer” and as a supporter.

Footnotes:

  1. Department of Health, 2020, COVID-19: $48.1 Million for National Mental Health and Wellbeing Pandemic Response Plan
  2. Kelly, Jorm and Wright, 2007, Improving mental health literacy as a strategy to facilitate early intervention for mental disorders
  3. Pirkola, 2009, Community mental-health services and suicide rate in Finland: a nationwide small-area analysis
  4. Druss et al, 2010, The Health and Recovery Peer (HARP) Program: A Peer-Led Intervention to Improve Medical Self-Management for Persons with Serious Mental Illness
  5. Chatterjeea et al, 2018, Non-clinical community interventions: a systematised review of social prescribing schemes
  6. North Western Melbourne PHN, 2019, Social prescribing
  7. IPC Health, 2019, Social Prescribing
  8. Primary and Community Care Services, Plus social: A new social participation and care coordination service
  9. Ozbay F, Johnson DC, Dimoulas E, Morgan CA, Charney D, Southwick S, 2007, Social support and resilience to stress: from neurobiology to clinical practice, Psychiatry (Edgmont), 4(5):35-40
  10. Gartner, 2019, HR Leaders Should Consider Three Strategies to Support Employees’ Holistic Health During the COVID-19 Outbreak

 

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