Using technology to improve access to emergency mental health care in rural and remote Australia: an evaluation of the Mental Health Emergency Care-Rural Access Program (MHEC-RAP)

Abstract

The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) aims to improve access, safety, and service coordination of specialist emergency mental health care via telehealth technologies. The program was planned and developed in response to the population needs and unique geographic conditions to provide specialist care while maintaining and supporting the role of existing local services. It is the first to provide 24-hour access to a regionally-based team of specialists offering relevant and responsive information, support, and clinical services for all providers, patients, and residents needing emergency care from the rural and remote communities across western New South Wales (NSW), Australia. This evaluation of MHEC-RAP applied a case study methodology and the theory of access to determine whether the program provides accessible specialist emergency mental health care. The five individual studies reported here contribute to the evaluation aims of describing program activity, assessing the provision and experience of emergency mental health care through MHEC-RAP, examining program impact on access, and informing further program development, adaptation, and transferability. This evaluation is the first to examine emergency telepsychiatry use in EDs, to apply the time and motion study method to assess program efficiency, and to present a telepsychiatry model structure that may be adapted or implemented elsewhere. This evaluation offers evidence of a practical telepsychiatry program that is providing accessible emergency mental health care for consumers in communities across western NSW and is changing local practice and perspective. It also enhances the theory of access proposing a modification to the theory with the inclusion of a sixth concept - awareness. The individual study results can be used to guide the continuing development of MHEC-RAP as well as provide insights for program transferability or the development, delivery, and evaluation of other new and existing telepsychiatry services across Australia and abroad.