ArticleBMC psychiatry2020
Step-up, step-down mental health care service: evidence from Western Australia's first - a mixed-method cohort study.
Article in BMC psychiatry, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 10 citations in OpenAlex.
- Experiences and wellbeing of family members and carers, regarding PARCS across Victoria.Frontiers in psychiatry · 2026Article
- Consumers lived experiences and satisfaction with sub-acute mental health residential services.Social psychiatry and psychiatric epidemiology · 2024Article
- A longitudinal study of the impacts of a stay in a Prevention and Recovery Care service in Victoria, Australia.The Australian and New Zealand journal of psychiatry · 2024Article
- Developing fit-for-purpose funding models for rural settings: Lessons from the evaluation of a step-up/step-down service in regional Australia.Frontiers in psychiatry · 2023Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMental health Step-up, Step-down services (SUSD), also known as subacute services or Prevention and Recovery Services, have emerged to fill an identified gap between hospital-based inpatient care and clinical community-based mental health support. Evidence for the effectiveness of the SUSD service model is limited but growing. Accordingly, this study looked to add to the extant body of knowledge, by (i) assessing change outcomes in mental health and wellbeing, and predictors of these changes, for patients who accessed Western Australia's first SUSD service; and (ii) evaluating patients' satisfaction with service, and what patients value from their stay.
methodsThis was a mixed-method retrospective cohort study. Participants comprised 382 patients who accessed a 22-bed Mental Health SUSD facility and incurred 551 episodes of care during the 01/07/2014-30/06/2016 period. Patients' change outcomes in psychological distress, general self-efficacy, and work and social adjustment from service entry to service exit were analyzed using generalized linear modeling. Simple Pearson's correlation coefficients were calculated for preliminary assessment of the associations between patients' service satisfaction and their change outcomes. Qualitative outcomes that patients valued from their stay were analyzed thematically according to a semi-grounded theoretical approach.
resultsSignificant improvements were observed in patients' self-reported psychological distress, self-efficacy, and work and social adjustment (all p < 0.0001). A strong and persistent baseline effect existed across the three measures. Older age, female gender, and having a dependent child in the same household were protective/enhancing factors for the patients' recovery. Satisfaction with service was high. Patients valued having the time and space to recuperate, gain insight, focus, and create changes in their lives.
conclusionThe encouraging findings, regarding both patients' change outcomes and satisfaction with service, support the value of the SUSD service model for patients with mental illnesses. Strengths and limitations were discussed; ensued recommendations were offered to both service providers and researchers to enhance the robustness of future research findings, to help inform more effective policy and funding decisions related to mental health care.
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