Community Mental Health_Final Report

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The Expanded Settings

Community Managed Mental Health Services

Student Placement Project

Final Report

June 2011

This project has been supported by the Department of Health

Anne Holland

Project Worker

Student Placement Project

VICSERV


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Expanded Settings Student Placement Project: Final Report - June 2011 2

Acknowledgements

VICSERV would like to acknowledge the contribution made to this project by the individuals

and organisations from the community managed mental health sector who shared their

expertise regarding student placements and participated in the sector survey and

consultations. VICSERV also acknowledges the agencies from the health and education

sectors who shared models of practice and gave insight into potential strategies to enhance

capacity for student placements in the community managed mental health sector.

VICSERV would like to thank:

Members of the Project Reference Group who provided input and guidance

- Department of Health - Mental Health, Drugs & Regions Division (Sector Quality &Workforce Development) Education & Training, Workforce Leadership & Development

- Mental Illness Fellowship- Inner South Community Health Service- Gateway Community Health- Mind Australia- Centacare, Catholic Diocese of Ballarat Inc.- Pathways

Members of the VICSERV Training Advisory Group for their input

- VICSERV Training Team- Doutta Galla Community Health Service- SNAP Gippsland Inc.- Aspire- Mind Australia- Lantern- Norwood- Mental Illness FellowshipVICSERV also recognises the contribution of DDG Consulting in the management of the

sector survey.


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Abbreviations / definitions

VICSERV Psychiatric Disability Services of Victoria (VICSERV) is thepeak body

representing community managed mental health services in Victoria

DH The Victorian Government Department of Health

PDRSS Psychiatric Disability Rehabilitation and Support Services funding

stream for community managed mental health services

CPN Clinical Placement Networks statewide regional networks tofacilitate and coordinate student placements in the health sector

BPCLE Best Practice Clinical Learning Environment a framework designed

to assist in developing a more coordinated, cohesive and cross-

disciplinary approach to education within and across all health

services

MOU Memorandum of Understanding

PARC Prevention and Recovery Care Services- short term residential step-up

step-down services co-managed by Community Managed Mental

Health Services and AMHS

AMHS Area Mental Health Services

PHAMHS Personal Helpers and Mentors Scheme A federally funded voluntary

outreach program for people aged 16 and over who are seeking

support with their recovery from mental illness.

QICSA Quality Improvement & Community Services Accreditation an

organisation used by the community managed mental health sector

to assess accreditation and service standards measured against the

national Quality Improvement Council (QIC) standards


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Contents

EXECUTIVE SUMMARY ..................................................................................................................................... 6

RECOMMENDATIONS ............................................................................................................................................... 6

1. INTRODUCTION ....................................................................................................................................... 7

1.1 REVIEW OF PROJECT BRIEF........................................................................................................................... 7

1.2 METHODOLOGY ......................................................................................................................................... 7

1.3 REVIEW OF OUTCOMES FROM PART 1:SURVEY REPORT..................................................................................... 8

1.4 ACTIONS ARISING OUT OF SURVEY REPORT....................................................................................................... 9

1.4.1 Follow-up survey ............................................................................................................................... 9

1.4.2 Support agencies to consider evaluation and recruitment strategies ............................................ 10

1.4.3 Follow-up documentation .......................................................................................... ..................... 10

1.4.4 Build on existing student placement strategies and structures to increase capacity within

individual organisations and within the sector ........................................................................................ .... 10

2 WORKFORCE PROFILE ............................................................................................................................ 12

2.1. ABOUT COMMUNITY MANAGED MENTAL HEALTH SERVICES............................................................................... 12

2.1.1. Role of community managed mental health services ..................................................... ............ 12

2.2. WORKFORCE PROFILE OF COMMUNITY MANAGED MENTAL HEALTH SECTOR ..................................................... .... 12

2.3. FACTORS IMPACTING ON AVAILABILITY AND SUITABILITY OF CLINICAL PLACEMENTS ................................................ 15

2.4. CURRENT CAPACITY .................................................................................................................................. 15

3 KEY FINDINGS ........................................................................................................................................ 16

3.1 ROLE OF SECTOR ...................................................................................................................................... 16

3.2 AGENCY GOVERNANCE.............................................................................................................................. 16

3.3 WORKFORCE DEVELOPMENT ...................................................................................................................... 16

3.4 RESOURCES............................................................................................................................................. 16

3.5 EVIDENCE ............................................................................................................................................... 16

3.6 PARTNERSHIPS......................................................................................................................................... 17

3.7 SECTOR GUIDANCE AND SUPPORT ................................................................................................................ 17

4. KEY AREAS TO SUPPORT INCREASED CAPACITY .................................................................................... 18

4.1 DOCUMENTATION.................................................................................................................................... 18

4.1.1 Policy and procedures ..................................................................................................................... 18

4.1.2 Record keeping ............................................................................................................................... 184.2 CURRENT ARRANGEMENTS/PARTNERSHIPS .................................................................................................... 18

4.3 RESOURCES............................................................................................................................................. 19

4.4 SUPERVISION STRUCTURES ......................................................................................................................... 19

4.5 EVALUATION AND RESEARCH ...................................................................................................................... 20

5 STRUCTURES TO SUPPORT INCREASED CAPACITY.................................................................................. 21

5.1 CLINICAL PLACEMENT NETWORKS (CPNS) .................................................................................................... 21

5.2 BEST PRACTICE CLINICAL LEARNING ENVIRONMENT (BPCLE) ........................................................................... 22

5.3 SECTOR SUPPORT AND GUIDANCE ................................................................................................................ 22

5.4 AGENCY GOVERNANCE .............................................................................................................................. 22

5.5 REGIONAL MENTAL HEALTH NETWORKS ........................................................................................................ 22


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6 BENEFITS TO SERVICE SECTOR OF INCREASED STUDENT PLACEMENTS .................................................. 24

6.1 RECRUITMENT AND RETENTION POTENTIAL.................................................................................................... 24

6.2 BUILDING AN EVIDENCE BASE ...................................................................................................................... 24

6.3 SERVICE QUALITY ACTIVITIES ....................................................................................................................... 24

6.4 COST BENEFITS ........................................................................................................................................ 24

6.5 STRONGER NETWORKS .............................................................................................................................. 24

7 RECOMMENDATIONS ............................................................................................................................ 25

8 CONCLUSION ......................................................................................................................................... 28

9 REFERENCES .......................................................................................................................................... 29

10 APPENDICES .......................................................................................................................................... 30

10.1 Appendix 1: Project Plan - Department of Health Workforce Leadership and Development

Community managed PDRSS student placement development program .................................................. 30

10.2 Appendix 2: Community Managed Mental Health Expanded Settings Student Placement Project

Survey Report January 2011 ....................................................................................................................... 3010.3 Appendix 3: Brochure Student Placement Opportunities in the Community Managed Mental

Health Sector ...................................................................... ................................................................ ......... 30


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Executive Summary

Overview: A vision for building capacity in the community managed mental health sector to

increase student placements

The community managed mental health service sector engages, supports and promotes a

coordinated, consistent approach to the provision of student placements into the sector,

thus providing a crucial contribution to the development of a skilled, competent workforce.

The Department of Health Community Managed Mental Health Student Placement Project

was established to support agencies to develop the vision to build capacity to provide

student placements.

This project has introduced (to some agencies) and reinforced (to other agencies) theprinciple that a student placement framework for agencies is crucial to ensuring a skilled

sustainable workforce, which underpins the future development of the community

managed mental health sector.

However, building sector wide, sustainable culture change to incorporate student

placements into core business in this sector has just begun. The following broad

recommendations have been developed to support the next stage of this process.

Recommendations

1. Facilitate whole sector engagement and support culture change in the provision ofstudent placements

2. Establish sector standards of practice for student placements3. Build evidence base for impact of student placements on sector4. Improve coordination and planning of student placements from community based

mental health services and education provider perspectives

5. Increase capacity of community based mental health services to take additionalnumbers of students on placement

6. Enhance quality of learning opportunities for students who undertake placements incommunity based mental health services (refer to the Best Practice Clinical Learning

Environment Framework)

7. Support to community based mental health services in developing systems andprocesses for collecting and managing student placement data

8. Improve understanding among education providers and other stakeholders of therole of the community managed mental health sector and its needs


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1.IntroductionAs part of the new system of clinical placement network arrangements in Victoria, the

Department of Healths (DH) Expanded Settings Project - Community Managed MentalHealth - was established to map student placement activity and identify strategies to

increase student placement capacity. In building capacity, it is important to consider the

quality as well as the quantity of student placement experiences offered. The value for

students is to have placements that enable an opportunity to gain practical experience in

learning about the needs and issues facing mental health consumers in a non-acute, non-

clinical setting. For the community managed mental health service sector, balancing the

needs of consumers and service delivery with the needs of students on placement is a

primary concern.

Psychiatric Disability Services of Victoria (VICSERV) undertook the Department of Health

Community Managed Mental Health Expanded Settings Project. VICSERV is the peak body

representing community managed mental health services in Victoria. It is a membership-

based organisation and provides leadership to the sector.

1.1 Review of Project Brief

The Expanded Settings Community Managed Mental Health Services Student Placement

Project1

was established to support effective student placements within community

managed mental health services by contributing to the capacity of organisations to:

investigate student placement activity undertake student placements participate in the new model of clinical/student placement governance in

Victoria

support an organisational culture that values learning.

1.2

MethodologyThe focus of the project was to:

engage with agencies in the community managed mental health sector scope current student placement activity develop strategies to improve the delivery of and capacity to provide student

placements

facilitate engagement with CPNs investigate relationships with education providers.

1 Appendix 1: Project Plan - Department of Health Workforce Leadership and Development Community

managed PDRSS student placement development program


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The project was overseen by a reference group comprising members from within the

community managed mental health sector and representatives from the Victorian

Department of Health.

1.3 Review of outcomes from Part 1: Survey ReportThe Department of Health Community Managed Mental Health Expanded Settings Project

Survey Report2

highlighted some of the challenges faced by services within this sector in the

provision of student placements to support the development of a skilled workforce and

identified key issues that have an impact on the capacity of the sector to provide increased

student placements.

It was identified that, in order to effectively build student placement capacity, it was

necessary to develop a flexible framework to support the diversity within the sector in both

agency size and function. This framework would incorporate not only strategies to address

the issues but also a range of support structures to enable an optimum balance between the

needs of consumers and service delivery and the needs of students on placement.

Agencies who expressed strong support for student placements and of the benefits to the

sector often lacked documentation or research which could provide a lead to agencies not

yet engaged. Formal procedures could create an avenue to facilitate sector-wide culture

change in the incorporation of student placements into core business.

Concerns about recruitment and retention were a consideration with agencies when

determining whether to take students and in the choice between particular disciplines and

education providers.

One service, which takes very few students, does not consider taking students as they

have no difficulty in recruiting staff.

Some rural services only take students from TAFE and VET courses as there is so much

difficulty recruiting university trained graduates to the country. This is, of course, a

major concern for many rural health services but is more marked in the community

managed mental health sector when paired with the much lower rate of pay.

Other services identify student placements as a very valuable pre-recruiting tool,giving an opportunity to both workplace and student to have a trial.

Many services had clear expectations of the role education providers should play in any

partnership arrangement but expressed concerns about lack of flexibility and support.

Agencies often felt unable to specify their own requirements and considered agreements to

be one-sided. On occasions, agencies felt some pressure from one or more education

providers to provide placements that had not been planned. The amount of time taken in

2Appendix 2: Community Managed Mental Health Expanded Settings Project Survey Report


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the planning and negotiation of student placements could be used more effectively with a

standardised approach to working with education providers.

Improved record keeping, placement along with workplace evaluation processes would

provide support to agencies in the determination of the benefits of student placements.

Having some evidence about the impact of student placements on consumers, workers andservice delivery could substantiate subjective positive attitudes and also be useful in

determining the resources required in the provision of student placements.

Limited resources, particularly a lack of time, were identified as the largest barrier to taking

students across the sector. The allocation of specific resources to the management and

supervision of student placements would support student placements to become

acknowledged across the community managed mental health sector.

A sector Student Placement Resource would provide a guide in the planning and

management of student placements and in the provision of training and support for workers

who supervise students. It would include examples of effective models of practice currently

in use both within and outside the sector.

The development of sector practice standards using the six elements of the BPCLE would

enable the development of a sector-wide student placement structure that was consistent

with generic statewide standards.

The CPNs are seen as a potential source of generic local support, partnership building,

coordination, research and innovation in the provision of student placements. In some of

the CPNs, active engagement and participation from the community managed mental health

sector is already well established. Smaller and less engaged agencies require more support

to participate either directly or via consortia type mental health networks.

The post-survey forums and consultations clarified and reinforced previous findings by

providing more detail and/or different perspectives about the provision of student

placements.

1.4 Actions arising out of survey report1.4.1 Follow-up surveyAgencies who had not responded or who had indicated a willingness to participate at a later

date were approached to contribute to the findings.

A number of issues contributed to limited success in achieving engagement from other

agencies. These included lack of time, identifying the appropriate person to contact, illness,

services moving, change of staff.

No further agencies completed the survey but several contributed information or gave more

detailed information.


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1.4.2 Support agencies to consider evaluation and recruitment strategiesAgencies were consulted through two regional forums and individual meetings.

Although some agencies collect some information and feedback from students, this

information has not been collated. There was some interest in the use of students on

project placements to collate this information.

Agencies felt they had no time to develop evaluation procedures and expressed interest in

models being available through a sector tool kit.

Agencies had varied approaches to the recruitment of staff who had been students on

placement. It appeared that agencies have each developed their own process but there is no

formal recording of outcomes. Agencies were happy with their own process but agreed that

monitoring the staffing profile may be useful. Retention was cited as an issue of greater

concern and this is supported by the VICSERV Training Needs Analysis 2010,3

which found

that:

Forty-seven percent of support workers and managers surveyed indicated that theyare considering and/or planning to leave the sector in the next three years.

Agencies say they are reluctant to employ new university graduates as they leave after a

year. Agencies are happy to explore models of employment that incorporate planned

rotation as part of entry level positions in AMHS.

1.4.3 Follow-up documentationAgencies who had indicated they did not keep records relied on local managers to know

details of students who had been on placement with their service. Others very clearly feltthis was the responsibility of the education provider and did not see any relevance in

keeping records of placements or evaluations.

Several agencies agreed to share their documentation to use as a model both through the

BPCLE and with other agencies within the community managed mental health sector.

1.4.4 Build on existing student placement strategies and structures to increasecapacity within individual organisations and within the sector

Further consultation with agencies who indicated they took students on placement despitebarriers had no formal, transferable strategies to overcome these identified barriers. It

appears that agency culture and management attitudes are the key factors in the promotion

of student placements regardless of any challenges.

Consultations have provided a range of sector specific guidelines, models and links, which

would support the sector to increase capacity to provide student placements within the

3VICSERV (2010) Training Needs Analysis Report , VICSERV Melbourne, page 27 available at

http://www.vicserv.org.au/uploads/documents/VICSERV%20Training%20Needs%20Analysis%20Report.pdf


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context of a recovery orientated model of service delivery. These are incorporated into

Appendix 3 Community Managed Mental Health Student Placement Resource Guide.

Through post-survey forums and consultations, agencies have been encouraged to develop

or strengthen partnerships within their local region and participate in their CPN.

Through consultation with community managed mental health services and education

providers, it has become apparent that there is an extensive range of existing agreements

and arrangements between the two sectors. In part this caters to the variety of student

placement opportunities available, the course requirements and, in part, to the needs of the

sector. Any template for agreements will necessarily be very broad to enable any option or

combination.

Agencies in the sector have identified a number of potential research opportunities such as

the impact student placements have on service delivery.


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2 Workforce Profile

2.1. About community managed mental health servicesIn order to effectively build student placement capacity in a sustainable manner, there

needs to be a clear understanding of the role of community managed mental health services

and the current workforce profile.

2.1.1. Role of community managed mental health servicesState and federal governments have acknowledged the effectiveness of community

managed mental health services in the areas of prevention, rehabilitation, and recovery.

These services support consumers and carers to actively participate and contribute to thebroader community. They also assist at-risk groups to prevent the onset or deterioration of

mental illness and offer pathways to psychosocial rehabilitation, education and training,

employment and appropriate housing. These services promote community understanding

and acceptance of mental illness and support people to lead dignified and independent

lives.

These services include housing support, home-based outreach, psychosocial and pre-

vocational day programs, residential rehabilitation, mutual support and self-help, respite

care and Prevention and Recovery Care (PARC) services. Many VICSERV members also

provide Commonwealth funded mental health programs such as Personal Helpers and

Mentors (PHAMS)4.

This sector can and does play a unique role in the education of health students by providing

opportunities to build skills in a non-acute health setting using a model of recovery oriented

practice.

2.2. Workforce Profile of community managed mental health sectorThe VICSERV Training Needs Analysis Report 2010 provides a picture of the current

workforce profile in the community managed mental health sector.

A survey of 231 respondents (165 support workers and 66 managers) was conducted toinvestigate training needs within the sector. The survey identified current qualifications held

by workers within the workforce.

It should be noted that workers are generally not employed in their professional capacity

but generically as managers or support workers.

4

VICSERV (2009) Strategic Plan Summary 2009-2012, VICSERV, Melbourne, p 6, available at:http://www.vicserv.org.au/uploads/documents/VICSERV_Strategic_Plan_04.pdf


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Qualifications of managers in community managed mental health services 20095

5

VICSERV (2010) Training Needs Analysis Report , VICSERV Melbourne, page 48 available athttp://www.vicserv.org.au/uploads/documents/VICSERV%20Training%20Needs%20Analysis%20Report.pdf


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Qualifications of support workers in community managed mental health services 20096

The findings from the Training Needs Analysis have some relevance to the current Expanded

Settings Student Placement Project with its focus on entry to practice student placements.

Undergraduate training for mental health workers was found not to have adequate

coverage of PDRS philosophy and approaches to providing services.7

The results of this survey identify a range of professional skills and expertise across the

sector, which indicates the potential to offer appropriately supported placements to

students undertaking a range of courses.

6VICSERV (2010) Training Needs Analysis Report , VICSERV Melbourne, page 40 available at

http://www.vicserv.org.au/uploads/documents/VICSERV%20Training%20Needs%20Analysis%20Report.pdf

7

VICSERV (2010) Training Needs Analysis Report, Gaps in existing training coverage, VICSERV, Melbourne, p25, available at: http://www.vicserv.org.au/uploads/documents/VICSERV_Strategic_Plan_04.pdf


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2.3. Factors impacting on availability and suitability of clinical placements Teams are often quite small 3-4 staff including manager Many workers work part time Most often teams are not co-located with other services either communitymanaged mental or community based agencies Intra or inter agency sharing of placements can be a challenge due to geographical

distance

A significant proportion of the workforce has no formal qualifications.

2.4. Current capacityThe majority of services in the community managed mental health service sector are willing

to take students on placement (Project Report - 92%). Of the services who completed thesurvey (less than half of the services in the sector), 79% took students in 2010 and 74%

indicated capacity to take students in 2011.

This discrepancy indicates an ideal starting point to explore strategies to build capacity in

the sector.

Follow-up consultations with agencies not involved in the survey or pre consultations and

forums identified community managed mental health services who currently take students

on an ad hoc basis with no formal structures in place.


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3 Key Findings

3.1 Role of sectorThis project has emphasised the diversity of the sector and also the unique contribution it

makes to student education and training. The focus on recovery orientated, consumer

focused care has resulted in the development of responsive services without a template for

the provision and management of student placements.

3.2 Agency Governance

Perception and practice in the provision of student placements is also diverse and follows

no recognisable pattern. Attitudes, documentation and relationships are not related to the

size or scope of a particular organisation. Nor is a positive attitude necessarily an indicator

of integrated structures to support student placements or engagement in student

placement related activities.

3.3 Workforce development

Few agencies provide clear support and training to workers who supervise students. The

majority are expected to manage placements within existing roles. This creates increased

demand on workers in a sector with a poor rate of retention.

Allocation of specific resources and appropriate student supervision training and support forstaff supervising students are identified as issues not only in mental health but across the

health sector. Projects within the CPNs are addressing the generic supervision training

issues. Sector specific issues as described in this report also need to be addressed.

3.4 Resources

In a sector where there are limited resources to meet a growing need for services, agencies

face the dilemma of justifying allocation of resources to support student placements for no

immediate return.

Effective student placement management structures within an organisation would help to

address the resource barriers raised and support the development of a coordinated

approach to the provision of quality student placements. This could be supported using the

six key elements of the BPCLE as a framework and using opportunities to share resources

between agencies.

3.5 Evidence

The long-term goal of this project is to support the sector to contribute to the development

of a skilled mental health workforce. Although student placements are seen as a positivestrategy in the recruitment of new staff, there is no evidence that student placements in this


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sector result in employment in the agency or in the mental health sector. There is no

evidence that agencies review or collect any information about the impact of student

placements on the organisation.

The need to build an evidence base to support the activities related to and the benefits of

student placements in this sector should be seen as a priority.

3.6 Partnerships

Lack of promotion of the sector to education providers, students and other health service

agencies and limited formal partnership arrangements causes many services to be isolated

from participation in student placement activities. This severely inhibits the development of

effective student placement management structures.

The participation of the community managed mental health sector agencies in their CPNs

may provide an opportunity for them to benefit from partnership building, local

coordination, research and innovation in the area of professional-entry clinical training

which the CPNs will facilitate. Sector agencies in some regions are actively involved in the

activities of the CPNs however more encouragement and support is required to facilitate

active participation across the sector.

3.7 Sector guidance and support

Sector leadership by the peak body allows the use of existing guidance and communication

channels as a foundation to address sector specific requirements for student placements

and to build the skills of the workforce.

Through this project draft guidelines have been developed to support the planning and

provision of student placements in the sector in response to a need identified by agencies,

which do not have structures in place or do not take students on placement. These

guidelines will contribute to, and inform the Department of Healths BPCLE Resource

Development Project. A brochure to promote student placements in the community

managed mental health sector has also been developed8.

Building stronger interagency partnerships and developing sector practice frameworks could

also facilitate increased capacity in the provision of student placements. Effective models of

student placement practice currently in use provide examples, which may be readily

applicable and adaptable across the sector.

Identifying the extent of the potential capacity of the sector has not been achieved within

the timeframe allocated to this project. Project activities and new state-wide structures

such as CPNs and the implementation of the BPCLE, support increased capacity at an

individual agency level. It could be argued that raising the issue through the project has, in

itself, been an effective means of building capacity where agencies which have previously

not taken students or have taken very few are now prepared to do so. For other agencies

with a strong history of providing student placements, the project has highlighted gaps in

procedures which are now being addressed.

8Appendix 3: Brochure Student Placement Opportunities in the Community Managed Mental Health Sector


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4. Key Areas to support increased capacity

The diversity in the sector in agency size, structure and function results in there being no

one correct pathway to the provision of effective student placements. There are a numberof common features but each agency requires an individual structure within a common

framework.

Mapping of the service sector via survey, consultations and regional forums has highlighted

a range of issues which can be grouped into five key areas which impact on the availability

and sustainability of providing student placements.

4.1 Documentation4.1.1 Policy and proceduresFrom the policy and procedures made available, there are consistent factors that could be

applied across the service sector. All policies and procedures should be agency wide with all

workers having an awareness of current policies.

4.1.2 Record keepingMany services currently keep no formal records of student placements. This makes it

difficult to gauge exact student placement data within the sector or within a particular

agency. It is also unclear how these agencies are able to plan and coordinate student

placements in this situation.

4.2 Current arrangements/partnershipsAlthough agencies have some partnership arrangements with education providers, there

was a high degree of dissatisfaction with the relationship between the community managed

mental health service sector and education providers. Where the relationships seemed to

be most effective, there was a two-way formal agreement supported by inter agency

communication with designated workers. Less than half of the agencies participating in the

survey, consultations and forums had a formal agreement in place with education providers.

Often agencies accepted placements from a number of education providers requiring a

different process and agreement for each.

Many agencies identified lack of support from education providers as a factor in not

accepting students on placement, even if an agreement was in place identifying support and

supervision procedures.


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Agencies from the community managed mental health sector found that, despite being a

major employer of graduates from TAFE and VET courses, negotiating balanced agreements

with these education providers as the most challenging.

There has been some concern that the education sector has a lack of understanding and

knowledge about the community managed mental health sector. This has been addressed

by some agencies by presentations to education providers and student groups prior to

placement periods. Others have considered using this strategy to facilitate stronger

relationships.

4.3 ResourcesLack of time, financial and other resources are most often cited as reasons for not taking

students on placements. Agencies that successfully take students on placement on an

ongoing basis, have made provisions and developed structures and strategies to overcome

these difficulties.

Many stakeholders identified that there is value in taking students, as an investment in

future workforce recruitment despite the demand on existing resources. It is estimated that

a medical student placement costs .2EFT to manage which would seem to be about the

same in the allied health disciplines9. However, there has been no cost benefit analysis

undertaken by agencies in this sector to determine costs. Generally workers who supervise

students do so within existing workloads.

Some services have been able to balance this cost by students taking on a caseload as part

of their placement. Others offer students part time employment on conclusion of the

placement. This is not practical in all agencies.

4.4 Supervision structuresMost agencies who take students on placement, have a designated person to provide

supervision. In most cases, this is not part of a formal student placement coordinator role,

but rather a role to be undertaken in addition to other duties. This is an issue across the

health sector where student supervision and student placement management is not clearly

identified as a task with specific time allocated.

Only a third of agencies who completed the survey indicated that the workers providing

supervision for students had some formal training for this role. There are a number of

supervision and clinical supervision courses run by education providers, health service

providers and agencies such as VICSERV. An issue for community managed mental health

services appears to be a lack of time, resources or commitment to attend these courses.

9

Massaro Consulting (2009) Allied Health Clinical Placement Implementation Project, Department of HealthMelbourne, p 12


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Some services have clear processes for supervision of students and support for staff who are

providing supervision.

Models in place for student placements include arrangements for discipline specific

supervision to be provided by the education provider in placements where there is no

supervisor of that discipline available.

4.5 Evaluation and researchAs identified in the Survey Report There is no available documented research into the

impact of student placements in the community managed mental health service sector

(p 9).

Follow up consultations and forums have elicited an acknowledgement that it is necessary

and would be useful to carry out formal evaluations of student placements but have notidentified any current evaluations taking place.


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5 Structures to support increased capacity5.1 Clinical Placement Networks (CPNs)Eleven CPNs have been implemented across the state, each with a network manager,

supported by an executive committee consisting of representatives from both the health

and education sectors. Community managed mental health services are represented on four

of the regional committees with further representation in working groups for specific

projects.

The Chairs of the CPNs, along with representatives from the Council of Victorian Health

Deans, Health Workforce Australia and the Department of Health form the Victorian Clinical

Placements Council (VCPC).10

The VCPC has responsibility for strategic policy setting and

planning, and efficient provision of stakeholder-informed advice to the Department ofHealth and Health Workforce Australia.

Further engagement of agencies in their CPN will enable better links to the broader healthservice sector and education providers.

10

Victorian Clinical Placements Council website (2011) Department of Health, Melbournehttp://www.health.vic.gov.au/vcpc/membership.htm


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5.2 Best Practice Clinical Learning Environment (BPCLE)The BPCLE identifies components of a best-practice clinical learning environment and

proposes a framework against which to build successful learning environments. This project

is using existing examples of best practice to develop a guide across the health sector.

A project aimed at synthesising a single set of guiding principles for establishing and

maintaining high quality clinical learning environments that can be applied across all

health professions and in all health service delivery settings.11

There has been input into the BPCLE project from this project and services in the community

managed mental health sector. This has provided a mechanism to ensure Best Practice

indicators and resources have relevance and usefulness to the community managed mental

health sector.

5.3 Sector support and guidanceVICSERV, as the peak body for the community managed mental health sector, provides

guidance and leadership. This role could be expanded to undertake a range of activities to

build capacity in the sector.

5.4 Agency governanceGovernance in the context of the community managed mental health services relates to the

structures, policies, practices and procedures in place to ensure quality service provision

and client care. Implicit in this is accountability and transparency.

Currently, some services have student supervision in their position descriptions but there is

no evidence that student placements are included in the budget or the strategic plan.

Until this happens across the sector, student placements will continue to be a hidden cost

which has a demonstrated (but not calculated) impact on service delivery.

5.5 Regional mental health networksIn some regions, the mental health alliance has been a useful pathway to enhanced

communication between publicly funded mental health services and the community

managed mental health. There is already cross sector collaboration through the PARCS.

11Department of Health (2009) Best Practice Clinical Learning Environments Within Health Services for

Undergraduate and Early-Graduate Learners Final Report Department of Health Melbourneavailable at: http://www.health.vic.gov.au/__data/assets/pdf_file/0007/338407/BPCLE-Final-Report.pdf


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These partnerships provide a vehicle towards shared placements and support for agencies

for supervision and education of student placements.

In the Hume region, the clinical mental health and community managed mental health

services are in the process of forming a mental health network for student placements to

connect to the CPN. This may be a model that can be applied in other regions.


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6 Benefits to service sector of increased student placements6.1 Recruitment and retention potentialIncreasing the number of quality student placements to the sector and promotion activities

across the health and education sectors will assist in building a broader understanding of

the community managed mental health sector.

Partnerships with public mental health services will enhance opportunities for graduates to

gain experience, participate in ongoing professional development and to create a career

pathway.

6.2 Building an evidence baseClear documentation procedures will enable more readily accessible opportunities to

evaluate student placements and service impacts within the context of the community

managed mental health and the broader health and education sectors.

6.3 Service quality activitiesUtilising evidence from evaluations will guide the development of quality activities and

standards to promote the effectiveness of the community managed mental health sector,

build the skills of the current workforce and benefit consumers, carers and families.

6.4 Cost benefitsStreamlining processes with policies and procedures and formal access pathways will reduce

duplication of activities and save time and resources. Analysis will enable accurate costing

and funding requirements.

6.5 Stronger networksThrough the development of closer working relationships and partnerships across the sector

to support student placements, agencies will be able to share resources and work together

to achieve common goals.


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7 RecommendationsImplementation of the following recommendations will support the engagement of agencies in the sector in

structures as equal partners.

Recommendation Related activities arising from this report

1. Facilitate whole sector engagement and supportculture change in the provision of student

placements

1.1 Encourage agencies to keep sector mailing lists up to dmanagement contacts

1.2 Further consultation with sector to identify strategies tstudent placements and engagement in related activit

networks

1.3 Support agencies to engage and register on CPN mailin1.4 Increased resources to provide opportunities to emplohealth service providers

2. Establish sector standards of practice for studentplacements

2.1 Guidelines, templates, models and links in sector specinto the BPCLE resource development project and rele

2.2 VICSERV Supervision Standards to be reviewed to inclustudent placement supervision

2.3 Investigate potential to develop student placement staccreditation process through QICSA (Quality Improve

Accreditation)

2.4 Promote guidelines for governance structuresi. Policy and proceduresii. Record keepingiii. Human resourcesiv. Strategic direction


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4.4.1 Demonstrate unique opportunities offered byof recovery model

4.4.2 Encourage flexibility of education providers insector to maximise benefit

4.4.3 Support community managed mental health their agencies with agency specific resources

5. Increase capacity of community basedmental health services to take additionalnumbers of students on placement

5.1 Develop tool for agencies to identify existing and need

capacity to take students on placement

5.2 Incorporate Student Placement supervision competen

5.3 Develop and deliver Sector Student Supervision trainin

6. Enhance quality of learning opportunities forstudents who undertake placements in

community based mental health services

(refer to the Best Practice Clinical Learning

Environment Framework)

6.1 Preparation for placement6.1.1 Develop sector specific orientation package6.1.2 Develop pre-placement simulation package

6.2 Support alignment of community managed mental placements and discipline based curriculum requirem

7. Support to community based mental health

services in developing systems and processes

for collecting and managing student

placement data

7.1 Support input into the development state-wide info

8. Improve understanding among educationproviders and other stakeholders of the

role of the community managed mentalhealth sector and its needs

8.1 Input on community managed mental health sector pundergraduate training providers via development of

(brochure and DVD)

8.2 Stimulate promotion of sector to broader health and cproviders through support for:

8.2.1 Publication of sector specific research in sec


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8 ConclusionThis project has emphasised the diversity of the sector and also the unique contribution it

makes to student education and training. The focus on recovery orientated, consumer

focused care has resulted in the development of responsive services without an applicable

template for the provision and management of student placements.

Perception and practice in the provision of student placements is also diverse and follows

no recognisable pattern. Attitudes, documentation and relationships are not related to the

size or scope of a particular organization. A positive attitude is not necessarily an indicator

of integrated structures to support student placements nor engagement in student

placement related activities.

The long-term goal of this project is to support the sector to contribute to the development

of a skilled mental health workforce. Although student placements are seen as a positive

strategy in the recruitment of new staff, there is no evidence that student placements in this

sector result in employment in the agency or in the mental health sector. There is no

evidence that agencies review or collect any information about the impact of student

placements on the organisation.

The need to build an evidence base to support the activities related to and the benefits of

student placements in this sector should be seen as a priority.

Lack of promotion of the sector to education providers, students and other health service

agencies and limited formal partnership arrangements causes many services to be isolated

from participation in student placement activities. This severely inhibits the development of

effective student placement management structures.


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9 ReferencesDepartment of Health (2009) Shaping the future: The Victorian mental health workforce

strategyFinal report, Mental Health and Drugs Division, Department of Health,

Melbourne, available at:

http://www.health.vic.gov.au/mentalhealth/publications/mhworkforce.pdf

National Health Workforce Taskforce (December 2008): Data, capacity and clinical

placements across Australia: a discussion paper, National Health Workforce Taskforce

(NHWT) Melbourne, available at http://www.ahwo.gov.au/publications.asp

NHMRC - National Health and Medical Research Council, endorsed July 2001

How to compare the costs and benefits: evaluation of the economic evidence

Handbook series on preparing clinical practice guidelineshttp://www.nhmrc.gov.au/publications/synopses/cp73syn.htm

Australian Health Ministers Conference (2004), National Health Workforce Strategic

Framework, Sydney

http://www.ahwo.gov.au/

Victorian Department of Health (2007) Clinical Placements in Victoria: Establishing a

Statewide Approach , Department of Health Melbourne

www.health.vic.gov.au/workforce/placements

VICSERV (2010) Training Needs Analysis Report, VICSERV, Melbourne

http://www.vicserv.org.au/uploads/documents/VICSERV%20Training%20Needs%20Anal

ysis%20Report.pdf

VICSERV Strategic Plan 2009-2012, VICSERV, Melbourne

http://www.vicserv.org.au/about-us/strategic-plan.html


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10 Appendices

10.1 Appendix 1: Project Plan - Department of Health Workforce Leadership andDevelopment Community managed PDRSS student placementdevelopment program

10.2 Appendix 2: Community Managed Mental Health Expanded SettingsStudent Placement Project Survey Report January 2011

10.3 Appendix 3: Brochure Student Placement Opportunities in the CommunityManaged Mental Health Sector

Documents

Community Mental Health_Final Report