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This hospital to community bridging aims to reduce frequency of re-admission, particularly for people whose social supports are diminished, who are at risk of leaving hospital with a week's medication and not attending GP appointments, and those consumers who may be waiting for referrals to community mental health services to be actioned.

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There are many dimensions to such challenges, and this paper focuses on issues relating to long-term care in old age. The debate around such matters has been similar in the UK and in Australia. In both countries, a history of incrementalism and poorly presented policy reform has contributed to widespread public mistrust, and a sense of injustice at the extension of means-testing or user pays principles.\n\nThis paper examines the analysis and conclusions of a Royal Commission in the UK, set up to explore options for the finance and structure of long-term care. A fundamental principle advanced by the Commission is that the risk of needing long-term care should be shared by all citizens, rather than borne by those who have the misfortune to need such care. 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"2009-07-14T09:12:26Z", "dateModified": "2010-04-08T17:30:17Z" } }, { "key": "J8FH5M4T", "version": 1, "library": { "type": "group", "id": 2832, "name": "Mental Health Funding", "links": { "alternate": { "href": "https://www.zotero.org/groups/mental_health_funding", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/2832/items/J8FH5M4T", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/mental_health_funding/items/J8FH5M4T", "type": "text/html" } }, "meta": { "createdByUser": { "id": 10941, "username": "bibliografree", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/bibliografree", "type": "text/html" } } }, "lastModifiedByUser": { "id": 209359, "username": "XieXiePDX", "name": "Julie Flaming", "links": { "alternate": { "href": "https://www.zotero.org/xiexiepdx", "type": "text/html" } } }, "creatorSummary": "Cook et al.", "parsedDate": "2008", "numChildren": 1 }, "data": { "key": "J8FH5M4T", "version": 1, "itemType": "journalArticle", "title": "A self-directed care model for mental health recovery", "creators": [ { "creatorType": "author", "firstName": "J.A.", "lastName": "Cook" }, { "creatorType": "author", "firstName": "C.", "lastName": "Russell" }, { "creatorType": "author", "firstName": "D.D.", "lastName": "Grey" }, { "creatorType": "author", "firstName": "J.A.", "lastName": "Jonikas" } ], "abstractNote": "Self-directed care programs give participants control over public funds to purchase services and supports for their own recovery. Data were examined for 106 individuals and showed that compared with the year before enrollment, in the year after enrollment, participants spent significantly less time in psychiatric inpatient and criminal justice settings and showed significantly better functioning. Of approximately $58,000 in direct expenditures by participants over 19 months of operation, 47% was spent on traditional psychiatric services, 13% on service substitutions for traditional care, 29% on tangible goods, 8% on uncovered medical care, and 3% on transportation. Early positive results of this pilot program support replication and evaluation else-where.", "publicationTitle": "Psychiatric Services", "publisher": "", "place": "", "date": "2008", "volume": "59", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "600-602", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "", "citationKey": "", "url": "http://www.scopus.com.proxy.library.adelaide.edu.au/inward/record.url?eid=2-s2.0-49749122165&partnerID=40", "accessDate": "2009-08-21T04:08:00Z", "PMID": "", "PMCID": "", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "Scopus", "callNumber": "0000", "rights": "", "extra": "", "tags": [], "collections": [ "TQ9TW6KM" ], "relations": {}, "dateAdded": "2009-08-21T04:08:00Z", "dateModified": "2010-04-08T17:30:16Z" } }, { "key": "J6M2DXFW", "version": 1, "library": { "type": "group", "id": 2832, "name": "Mental Health Funding", "links": { "alternate": { "href": "https://www.zotero.org/groups/mental_health_funding", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/2832/items/J6M2DXFW", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/mental_health_funding/items/J6M2DXFW", "type": "text/html" } }, "meta": { "createdByUser": { "id": 10941, "username": "bibliografree", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/bibliografree", "type": "text/html" } } }, "lastModifiedByUser": { "id": 209359, "username": "XieXiePDX", "name": "Julie Flaming", "links": { "alternate": { "href": "https://www.zotero.org/xiexiepdx", "type": "text/html" } } }, "creatorSummary": "Spandler and Vick", "parsedDate": "2005", "numChildren": 1 }, "data": { "key": "J6M2DXFW", "version": 1, "itemType": "journalArticle", "title": "Enabling access to direct payments: An exploration of care co-ordinators decision-making practices", "creators": [ { "creatorType": "author", "firstName": "H.", "lastName": "Spandler" }, { "creatorType": "author", "firstName": "N.", "lastName": "Vick" } ], "abstractNote": "Background: Increasing demands for the greater take-up of direct payments necessitates the willingness and ability of care co-ordinators to be able to meet this challenge. Aim: To consider how workers have responded to direct payments in practice and how they can enable or limit greater access. Method: The analysis presented here is primarily based on 20 in-depth interviews with care co-ordinators who took part in an evaluation of a national pilot to implement direct payments in mental health. Results: Three key responses were identified which mediated care co-ordinators' pursuit of direct payments as an option for clients: using selective criteria; incorporating it into a dominant framework (of 'providing services') and re-conceptualizing their role as enabling greater capacity for choice and control. In order to make sense of these responses it was necessary to examine their conflicting work context. Conclusions: Initiatives such as direct payments suggest the need to re-appraise the role of care co-ordinators and may require a significant shift in the focus of their practice. Whilst tensions inherent in their role may make this shift difficult, the analysis also suggests that it could lead to opportunities for putting into practice ideas about user empowerment which should be central to their practice. Declaration of Interest: None. © Shadowfax Publishing and Taylor & Francis Group Ltd.", "publicationTitle": "Journal of Mental Health", "publisher": "", "place": "", "date": "2005", "volume": "14", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "145-155", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "", "citationKey": "", "url": "http://www.scopus.com.proxy.library.adelaide.edu.au/inward/record.url?eid=2-s2.0-20444501848&partnerID=40", "accessDate": "2009-07-16T07:20:28Z", "PMID": "", "PMCID": "", "ISSN": "", "archive": "", "archiveLocation": "", "shortTitle": "Enabling access to direct payments", "language": "", "libraryCatalog": "Scopus", "callNumber": "0008", "rights": "", "extra": "", "tags": [ { "tag": "Community mental health", "type": 1 }, { "tag": "Decision making", "type": 1 }, { "tag": "Direct payments", "type": 1 }, { "tag": "Independent living", "type": 1 }, { "tag": "Self determination", "type": 1 } ], 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