Seventeen health services constitute the Victorian adult clinical mental health system.
Adult specialist mental health services are aimed primarily at people aged 16 to 64 years with a serious mental illness or disorder who experience significant levels of disturbance and psychosocial disability (for example, schizophrenia). People may also present in situational crisis that may lead to self-harm or inappropriate behaviour towards others.
All clinical adult area mental health services provide intensive community treatment, mobile support and continuing care.
Clinical adult area mental health services generally include:
Inpatient treatment services
Acute inpatient services
An acute inpatient service is any service needed for an acute episode of mental illness, which may include a multi-day inpatient stay. These services provide voluntary and compulsory short-term inpatient management and treatment during an acute phase of mental illness.
They provide a range of therapeutic interventions and programs to patients and their families during an acute episode to learn more about the impact of the illness, explore ways to better manage the illness, improve coping strategies and move towards recovery. (All of the age-based mental health provide acute inpatient services for people who cannot be assessed and treated safely and effectively in the community).
A person admitted to an acute inpatient unit usually has a high level of dependency on the service and needs secure and intensive management until they have recovered enough to be treated effectively and safely in the community. These units are located in general hospitals.
Consultation and liaison psychiatry
Consultation and liaison psychiatry delivers mental health services to people who have a primary medical condition admitted to general hospital settings that may be associated with a mental illness. The Victorian Government funds 14 health services to provide consultation and liaison psychiatry.
Psychiatric assessment and planning unit
Psychiatric assessment and planning units (PAPUs) deliver fast access to short-term specialist psychiatric assessment and treatment for people experiencing an acute episode of mental illness. Admission to a PAPU can be voluntary or compulsory.
PAPUs provide treatment for drug-induced psychosis, medication overdose, suicidal ideation, comorbid medical conditions, or when there is the need for a person to be assessed under the Mental Health Act 2014.
PAPUs operate 24 hours a day, seven days a week. The length of stay in a PAPU is limited to 72 hours.
Depending on the outcome of assessment and response to treatment, a person admitted to a PAPU may be discharged to either an acute mental health inpatient bed, a subacute PARC service, or a community-based public or private mental health service, which may involve the person’s general practitioner.
Residential treatment services
Secure extended care inpatient services
Secure extended care units (SECUs) provide medium to long-term inpatient treatment and rehabilitation for people who have unremitting and severe symptoms of mental illness or disorder. SECUs use a recovery-oriented approach. Services are provided on a regional basis and are gazetted to take compulsory customers. SECUs provide treatment and care to people who need a high level of secure and intensive clinical treatment.
These units are located in hospital settings. As SECUs are not in all catchments, cross area access arrangements are established.
Community care units (CCUs)
CCUs provide medium to long-term clinical care and rehabilitation services in a home-like environment. They support the recovery and rehabilitation of people seriously affected by mental illness to develop or relearn skills in self-care, communication and social skills in a community-based residential facility with the aim to returning to the community.
Prevention and recovery centres (PARC)
PARC services are community-based, short-term supported residential services for people experiencing a mental health problem, but who do not need (or no longer require) a hospital admission.
They aim to avoid acute inpatient admissions or allow a person to be discharged sooner from an inpatient unit by providing clinical treatment and short-term residential support.
PARC services are usually a partnership between area mental health services and clinical services. They are not currently available in all catchment areas.
Outpatient treatment services (Community based clinical treatment)
Acute community intervention service
Provides urgent advice, referral and treatment to people with a mental illness who are acutely ill or in crisis. The service is provided through telephone triage, mental healthcare in emergency departments and community mental health.
Continuing care teams
Continuing care teams provide non-urgent assessments, treatment, case management, support and continuing care services in the community. This is the largest component of adult community-based services.
These teams frequently liaise with general practitioners and other community mental health workers.
Families where a parent has a mental illness
The Families where a Parent has a Mental Illness (FaPMI) strategy aims to reduce the impact of parental mental illness on all family members through timely, coordinated, preventive and supportive action.
FaPMI coordinators are employed across 11 adult mental health services statewide. They work closely with mental health services and network partners to provide secondary and tertiary consultation, as well as workforce development, coordination or local collaborative care and support for peer programs for children and young people. FaPMI coordinators do not generally provide direct clinical care.
Homeless outreach psychiatric services
Homeless outreach psychiatric services provide specialist clinical and treatment responses tailored to people who do not engage readily with mental health services. The services use an assertive outreach approach to provide assessment and secondary consultation to homelessness services and other mental health workers. Services are not currently available in all catchment areas.
Mental health and police response
Mental Health and Police (MHaP) Response is a joint police and mental health service for people who need urgent mental health assessment and treatment in the community.
Adult clinical mental health services work in partnership with Victoria Police to provide timely, appropriate, urgent, mental health assessment, treatment and support, including referrals to further community support where required.
MHaP Response currently operates in 12 area mental health catchments across the state.
Mobile support and treatment
Mobile support and treatment services operate extended hours seven days a week and provide intensive long-term support for people with prolonged and severe mental illness and associated high-level disability.
Youth program – early psychosis services
Early psychosis services are for young people aged 16–25 who are experiencing a first episode of psychosis. The services are available statewide as a subspecialty program in specialist adult mental health services. They are closely linked to child and adolescent mental health services.