Routine measurement of outcomes in Australia's public sector mental health services

OBJECTIVE: This paper describes the Australian experience to date with a national 'roll out' of routine outcome measurement in public sector mental health services. METHODS: Consultations were held with 123 stakeholders representing a range of roles. RESULTS: Australia has made an impressive start to nationally implementing routine outcome measurement in mental health services, although it still has a long way to go. All States/Territories have established data collection systems, although some are more streamlined than others. Significant numbers of clinicians and managers have been trained in the use of routine outcome measures, and thought is now being given to ongoing training strategies. Outcome measurement is now occurring 'on the ground'; all States/Territories will be reporting data for 2003-04, and a number have been doing so for several years. Having said this, there is considerable variability regarding data coverage, completeness and compliance. Some States/Territories have gone to considerable lengths to 'embed' outcome measurement in day-to-day practice. To date, reporting of outcome data has largely been limited to reports profiling individual consumers and/or aggregate reports that focus on compliance and data quality issues, although a few States/Territories have begun to turn their attention to producing aggregate reports of consumers by clinician, team or service. CONCLUSION: Routine outcome measurement is possible if it is supported by a co-ordinated, strategic approach and strong leadership, and there is commitment from clinicians and managers. The Australian experience can provide lessons for other countries.

Do Australian public sector employees have the type of culture they want in the era of new public management?

New public management theory proposes that public sector organisations should be managed more like private sector organisations. It is therefore expected that public sector managers will have preferences for an organisational culture that will reflect the culture of private sector organisations, with an external rather than internal orientation. The current research investigated the idea that managers' perceptions of ideal organisational culture would be different to the bureaucratic model of culture (internally oriented), which has traditionally been associated with public sector organisations. Responses to a competing values culture inventory were received from 925 public sector employees. Results indicated that the bureaucratic model is still pervasive; however, managers prefer a culture that is more external, and less control focussed, as expected. Lower level employees expressed a desire for a culture that emphasised human relations values.

Do adults in contact with Australia's public sector mental health services get better

This paper describes the outcomes of episodes of care for adults in public sector mental health services across Australia, with a view to informing the debate on service quality. Health of the Nation Outcome Scales (HoNOS) change scores and effect sizes were calculated for 14,659 acute inpatient episodes and 23,692 community episodes. The results showed that people in contact with public sector mental health services generally do get better, although the magnitude of improvement depends on the setting and episode type. This confirmatory finding is particularly positive, given current community concerns about the quality and effectiveness of mental health services.

Going up? Women in the public sector

Abstract: Purpose – This paper aims to document women's reflections on their careers over a ten-year period to provide quantitative baseline data on which to frame follow-up in-depth interviews. The participants work in the public service in Queensland (Australia) and had been recommended for, and participated in, women in management (WIM) courses conducted in the early 1990s. Design/methodology/approach – Data were collected by means of a survey (containing closed and open items) which gathered demographic data and data related to employment history, perceptions of success and satisfaction, and the women's future career expectations. Findings – Findings revealed that the percentage of women in middle and senior management had increased over the ten-year period, although not to the extent one might have anticipated, given that the women had been targeted as high flyers by their supervisors. While not content with their classification levels (i.e. seniority), the majority of the cohort viewed their careers as being successful. Practical implications – Questions arise from this study as to why women are still “not getting to the top”. There are also policy implications for the public service concerning women's possible “reinventive contribution” and training implications associated with women only courses. Originality/value – The study is part of an Australian longitudinal study on the careers of women who attended a prestigious women-only management course in the early 1990s in Queensland. This is now becoming a study of older women.