Need for mental health services epidemiology
[Music] the first step in needs-based mental health planning is to quantify expected need for mental health services in the population to do this we need to understand not just how many people are already using mental health services but also who else in the population may need services if we can reduce barriers and improve access to care this video explains how the framework epidemiology component models the number of people needing mental health services we will cover the scope of services in the framework model how need groups are defined data used to quantify need intensity of service need by level of severity demand for individually tailored care and additional factors that influence the types of care required the goal of the epidemiology is to quantify the number of people with mental health service needs in australia for a given year the framework uses this information to help estimate the types and amounts of services that should be available importantly the framework is designed to be used by mental health planners and so it focuses on need for services generally governed and funded within the health system this includes population mental health interventions primary mental health care specialised community and bed-based mental health services and psychosocial supports other services such as drug and alcohol treatment general disability services and aged care are not included in the framework model the model starts with an average australian population within each of six age groups rates of need within each age group are modeled for a nominal population of 100 000 people mental health promotion and mental illness prevention apply to the whole population but otherwise a proportion of each age group is identified as having mental health service needs this is further broken down by severity of illness functioning and other factors to create knee groups of populations with similar levels of mental health service need in a year estimates of the number of people with a mental illness are drawn mainly from burden of disease studies and nationally representative population surveys these model 12-month prevalence across a range of mental disorders including both common and lower prevalence conditions diagnoses that are the primary responsibility of non-mental health services are not directly included regardless of diagnosis the model does include people who have mental or behavioral symptoms or psychological distress and need to access mental health services it is also adjusted to include populations with mental health service needs who may be missed from general population surveys such as people who are homeless or living in residential aged care while diagnosis is used as a data source to estimate need in the framework need for mental health services is rolled up across different disorders the levels of severity and psychosocial functioning are more important than diagnosis for determining the intensity and range of services that people will need the framework does not model at the level of specific medications or therapy types for particular disorders for each age group populations with a mental illness are split into three levels of severity and functioning there are three additional levels for populations who need services but do not have a current mental illness diagnosis including relapse prevention for people with a past diagnosis indicated prevention for people experiencing symptoms or distress and selective prevention for at-risk populations such as children living with a parent who has a severe mental illness estimated numbers of people in the latter three groups have been derived from population surveys and research studies not everyone with a diagnosis or symptoms will want or need to access formal health services some people particularly those with less severe symptoms may prefer to use self-help materials or informal support from their family and community the framework includes an adjustment for expected demand for mental health services which generally decreases with severity level the level of demand has been estimated from population survey data and rounded up to allow for improvements in help seeking additional factors beyond severity are used to create knee groups that represent people with similar service needs particularly for populations with severe mental illness the knee groups are based on additional complexity such as comorbidities or specialized service needs such as young people experiencing their first episode of psychosis this modeling results in multiple different knee groups for each age group the framework then outlines care profiles and resourcing required for each need group the rates of need can be adapted to a particular region of australia and year based on population size and demographic mix such as the number of people in different age groups and who identify as aboriginal or torres strait islander you should now have a basic understanding of how population need and demand for mental health services has been modeled in the framework further information on the epidemiology can be found in the framework documentation package
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