One year on: Step Up Step Down mental healthcare keeping people out of hospital

An innovative approach to mental health care has succeeded in keeping patients out of the Territory’s emergency departments and hospitals, its first performance report has shown.

The Garran Step Up Step Down facility opened in April last year, promising to provide a middle-of-the-road model of care for people who required support beyond what can be provided by community services but not acute hospital care.

Clients of the facility can either “step up” from community care or “step down” from hospital care.

At the time, ACT Mental Health Minister Emma Davidson said it should help keep people out of hospital and acute inpatient services.

Unlike a traditional inpatient setting, participants are free to come and go as they please.

More than 140 clients have received support from the six-bed centre since April last year.

Ms Davidson said the centre formed an important part of the ACT’s mental health care landscape and it had proved successful in its first year.

“While early intervention is the priority to support people before their mental health issues become more heightened, we recognise that there are some who require higher levels of care beyond community services,” she said.

“Initiatives like this have shown they can prevent people reaching a crisis point and needing to go to hospital.”

An analysis of the facility showed 78 per cent of ‘step up’ participants reported they would have presented at an ED if not for the centre.

Ninety per cent of people who attended the program, which is operated by Stride, stayed out of hospital within the first 14 days of leaving the facility.

Only 10.6 per cent sought hospital readmission during that period.

The average daily bed occupancy rate was 91 per cent for the six-bed facility.

Most ‘step down’ participants had spent the entirety of the two weeks prior to their admission in hospital, with 61 per cent reporting to have recently attempted suicide.

Participants stayed for an average of 11.95 days and spent 59.5 hours in group-based supports.

Depression was the primary reason for admission, followed by borderline personality disorder and schizophrenia.

At the end of the program, participants recorded improvements in symptoms of anxiety and depression as well as self-rated recovery improvements.

It’s not the only innovative space intending to keep people out of acute and hospital settings as that area experiences high levels of pressure.

Last year, the ACT’s first Safe Haven cafe commenced a year-long trial in Belconnen.

Those spaces are intended to be open to those experiencing mental health concerns or emotional distress.

They’re intended as an easier entry point to the system than a clinical emergency room and are suitable for people who require support beyond what can be provided by community organisations.

The PACER (Police, Ambulance, Clinician, Emergency Response) program is also helping people stay out of hospital by providing on-the-ground assistance to those needing a mental health response.

Anyone experiencing distress can seek immediate advice and support through Lifeline (13 11 14), Kids Helpline (1800 55 1800), or the digital mental health gateway, Head to Health.
If you are concerned about suicide, living with someone considering suicide, or bereaved by suicide, the Suicide Call Back Service is available at 1300 659 467.

In an emergency, call triple zero (000).