A model for clinical and educational psychiatric service delivery in remote communities

Objective: A model of intermittent psychiatric service provision to rural and remote New South Wales communities by metropolitan psychiatrists and mental health professionals has been evaluated. The services provided included peer support to lone mental health and generic health workers, direct psychiatric care to clients in their own environment and skills development education sessions to general health staff and other professionals affiliated with health care (e.g. police and ambulance officers). Method: There were 10 visits of teams made up of a psychiatrist and another mental health professional to six rural and remote locations. Outcomes of the services delivered were examined including clinical services and teaching skills training sessions. Indirect outcome measures included changes to Pharmaceutical Benefits Scheme prescription patterns in areas serviced and data regarding transfer of clients for psychiatric care in regional centres. Difficulties in evaluation are discussed. Results: The feasibility of intermittent service provision was demonstrated. Education packages were well received and a positive change in workers' attitudes toward mental health practice was found. Conclusion: Intermittent psychiatric services in remote settings add value to health care delivery particularly when dovetailed with skills-based education sessions.