Title of slide. Characteristics of clients with a. Click to edit Master text styles Second level. Third level

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Lenard Mills
5 years ago
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community nursing service in Melbourne, Victoria Dr Joanne Enticott

1 Title of slide Characteristics of clients with a mental Fourth health level diagnosis: Understanding the clients of the RDNS community nursing service in Melbourne, Victoria Dr Joanne Enticott Dr Marissa Dickens Dr Amee Morgans Ms Barbara Williams Prof Colette Browning

2 Title Project of slide Goal: The aim is to profile the mental health issues in Second users of level a large community health services provider. We will do this in order to better understand» Fifth the level demands on the RDNS services and develop better approaches for these clients.

3 Title Method of slide Creation of a health and wellbeing profile: Unique registry of longitudinal community care clients Diagnoses (primary dx & other) Care received Financial, accommodation & social activity too 24,663 clients commenced an episode of care in 2014 predominantly in Greater Melbourne

4 Mental health diagnoses Title of slide Client profile: Average age: 71 years Over two-thirds Fourth were level aged 65+ years Two-thirds lived in the least disadvantaged areas of Melb, Victoria 17% had a mental health diagnosis One-in-six Proportion of Individuals with Any Mental Health Diagnosis 19,832, 83% 3,975, 17% Mental Health Diagnosis All Others

5 Mental health diagnoses Title of slide - National prevalence is onein-five - prevalence Fourth increases level in clinical samples - prevalence decreases in older people Proportion of Individuals with Any Mental Health Diagnosis 3,975, 17% One-in-six 19,832, 83% Mental Health Diagnosis All Others

6 Mental health diagnoses Title of slide In clients with a mental health diagnosis: One quarter had Fourth primary level diagnosis (pink slice),...meaning that mental health was designated as the reason(s) for which the nurse was visiting the client Proportion of of Individuals with with Primary Any Mental and Secondary Health Diagnosis Diagnoses 937, 4% 3,975, 17% 3,038, 13% 19,832, 83% Mental Primary Health Diagnosis Secondary All None Others

Percentage of Individuals with a Mental Health Diagnosis Mental Health Diagnoses Title of slide 45.0% 40.0% 35.0% 30.0% 25.0% 20.0% 15.0% Mental Health Diagnoses by ICD-10 F10 F99 Code Category 10.

7 Percentage of Individuals with a Mental Health Diagnosis Mental Health Diagnoses Title of slide 45.0% 40.0% 35.0% 30.0% 25.0% 20.0% 15.0% Mental Health Diagnoses by ICD-10 F10 F99 Code Category 10.0% 5.0% 0.0% F30-F39 Mood [affective] disorders F40-F48 Neurotic, stressrelated and somatoform disorders F20-F29 Schizophrenia, schizotypal and delusional disorders F10-F19 Mental and behavioural disorders due to psychoactive substance abuse F70-F79 Mental retardation F90-F99 Unspecified mental disorder ICD-10 Code Category F80-F89 Disorders of psychological development F60-F69 Disorders of adult personality and behaviour F90-F98 Behavioural and emotional disorders with onset usually occurring in childhood and adolescence F50-F59 Behavioural syndromes associated with physiological disturbances and physical factors % N 2,227 1,

8 Mental health diagnoses Title of slide

Torres Strait Islander descent (ATSI), 1.4%* Accessing the Homeless Person s Project (HPP), 13%* (*0.

9 Title Socio-demographic of slide profile People with a mental health dx were more likely to be Female, 57%* (*52%, no mental health) Under the age of 65 years, 42%** (**24%, no mental health) Born Third in Australia, level 60%* (*50%, no mental health) Of Aboriginal Fourth or level Torres Strait Islander descent (ATSI), 1.4%* Accessing the Homeless Person s Project (HPP), 13%* (*0.5%, no mental health) (*2%, no mental health) Alive at January 2016, 92%* (*86%, no mental health) Not accessing Department of Veterans Affairs (DVA) Services, 5%* (*8%, no mental health)

10 Title Visit of & slide Activity Profile Average episodes of service did not differ between groups Both groups averaged 1.2 episodes in 2014 (with a range of 1-24 episodes)

11 Percentage of Individuals Title Visit of profile slide Most Common Visit Types for Those with and Without a Mental Health Diagnosis 55.2 Second 54.0 level 30 Mental Health Diagnosis All Others Visit At Home Consultation (telephone or other) Telephone CSC client related Visit Type Client documentation Fax CSC Client related Direct care - face to face

12 Title Visit of & slide Activity Profile Average episodes of service did not differ between groups Both groups averaged 1.2 episodes in 2014 (with a range of 1-24 episodes) Profile of visits did not differ between groups Visit type profile was similar too (previous slide) But.. Number of client-related activities did differ The yearly client-related activities logged by RDNS staff were, on average: 50 per client with no mental health dx 69 per client with mental health dx 87 per client with mental health as Primary dx Individuals with a mental health diagnosis received more activities than those without

13 Title Visit of & slide Activity Profile Client-related activities for clients with a mental health Second diagnosis level Activities conducted during Visit at a Home Monitoring and surveillance 130,460 (30.8) Medication 120,698 (28.5) Counselling and support 49,380 (11.7) Tech Care - Wound 26,949 (6.36) Client care coordination/collaboration 17,364 (4.1) Assessment - Other 10,743 (2.5) General Nursing Care (GNC) 10,185 (2.4) Personal Care 6,074 (1.4) Tech Care - Other 5,553 (1.3) Documentation (HPP only) 4,678 (1.1) Various other general nursing activities (all these individually are <1%) 41,422 (9.8) Total 423,506 (100.0)

14 Title Conclusion of slide Click One-in-six to edit had mental Master health text diagnosis styles lower than the Australian national prevalence of one-in-five higher than the aged-adjusted one-in-ten prevalence estimate. These RDNS figures may represent significant under-reporting Particularly given the link between chronic disease and poorer mental health Consistent with population findings, mood and anxiety disorders were most common in our sample Clients with mental health disorders require 40% more clientrelated activities by RDNS, and 80% more if primary dx is mental health disorder

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