Too many pilots within mental healthcare says NIMC

There is an “excessive level” of pilot projects within mental health services, according to the national implementation and monitoring committee (NIMC) end-of-term analysis report.

The NIMC is responsible for overseeing implementation of the national mental health strategy, Sharing the Vision. The new report covers the first term of the committee from 2021-2023.

According to the report, the number of pilots in mental healthcare has resulted in “limited whole population” service improvement.

“To enable the mental health outcomes of the whole population to improve, service improvement should focus on national roll-out (where possible, while mindful of interdependencies, such as resourcing requirements),” the report states. “Though there is value in piloting services, the perceived over-reliance on pilot project service development in only one or two areas can be a barrier to integrated needs-based service development and innovation.”

The report argues an initiative should be considered for national implementation when there is a strong evidence-base.

In quarter four of 2021, more than half (54 per cent) of the work in relation to implementing Sharing the Vision’s policy recommendations had ‘not started’. This had reduced to 5 per cent by the end of the NIMC’s first term.

Currently, approximately 5 per cent of recommendations are ‘paused’.

On average, 30 per cent of implementation leads reported having issues that were impacting on delivery, with severity ranging from ‘minor’ to ‘major’.

All recommendations with a short-term timeframe for delivery have commenced and are in progress.

However, as reported by the Medical Independent in November, the timeline for implementing these recommendations has been extended due to the difficulty in meeting the original deadlines.

The timeline for delivery of medium- and long-term recommendations will be considered by the Department of Health as part of the development of future implementation plans.

The report also notes “considerable capacity constraints” across all mental health services. “The NIMC acknowledges that every effort is made to prioritise urgent cases and that severity of presenting symptoms as well as an assessment of risk are always taken into account.”

The second term of the NIMC commences this month. It will run until the end of 2027.