Taking a strategic approach to expanding service delivery: A case study
One of our key projects during the second half of 2017 was to support a client in planning their expansion into Queensland. In this article, we describe the steps we undertook, what we found, and how a similar approach can help ensure organisations considering expansion to do so successfully.
Our client, a charity with an impressive track record in NSW of supporting children who live in a family affected by mental illness, were seeking guidance in how to align their strategic goals with those of prospective funders and partners in Queensland, and how to best target their service offering to areas of high need.
Our approach involved four key steps:
evidence review—to show the model works
population needs assessment—to identify areas of need
service mapping—to identify competing programs or potential partners
funding environment scan—to source potential funding
Firstly, we found a fairly compelling case for the delivery of the program in Queensland.
Estimates on the incidence of mental illness in Australia indicate that up to 45 per cent of people experience a mental illness at some point in their lifetime.[1]
Of those adults that experience mental illness, between 25 and 50 per cent will be parents of a dependent child at the time of their illness.
Research has shown that children of parents with a mental illness are vulnerable to a range of issues compared to their peers, including:
lower rates of perceived competence[2]
more likely to enter care[3]
higher rates of substance abuse[4]
lower rates of high school completion[5]
more likely to acquire a mental illness or behavioural disorder of their own[4]
Longitudinal studies have shown that the risk of these children developing a mental illness later in life can range from 41 to 77 per cent.[6]
Service models that help children develop knowledge and understanding about their parent’s mental illness, and develop social skills and strategies that eliminate a sense of self-blame, are supported by evidence to protect children against mental illness and break the cycle of adversity within families. We developed a comprehensive program logic that helps to articulate how the service model translates to measurable outcomes and positive social impact.
By supporting children who live with a family member with a diagnosed mental illness, the program aims to:
provide respite for children from the challenges faced within their home environment and from their role as a carer
build their resilience and coping skills
identify children who show signs of distress and refer to the support they require, at the earliest point possible
meet other children who share similar experiences
prevent these children from developing a mental illness of their own.
In Queensland, the prevalence of people living with a mental disorder is generally higher than the rest of Australia. Our modelling showed that while there is significant need in regions all across Queensland based on the estimated number of children affected by a family member’s mental illness, the Primary Health Network (PHN) regions with the highest relative need were Darling Downs and West Moreton and Brisbane North. This assessment was based on data relating to:
prevalence of people living with diagnosed mental illness
rates of high or very high psychological distress
rates of mental health overnight hospitalisations
use of psychological and other mental health support services
socioeconomic disadvantage
The vast majority of mental health services in Australia target those experiencing a mental illness—services that support those indirectly affected, such as the children of parents with a mental illness, are rarer.
Our service mapping process found no significant competing program or service currently being delivered in Queensland, which is important in establishing trusted relationships with organisations already working in the sector. This includes those working in primary care (e.g. GPs, psychologists), local hospitals with mental health units, and other NGOs.
Finally, to find the most appropriate type of funding to establish and sustain the service model in Queensland, we considered various models such as grants, tenders, philanthropic or corporate support, and impact investing. Securing a suitable, stable yet flexible funding stream can be one of the most challenging issues for an organisation seeking to establish a service presence. Arguably the most effective approaches to doing this successfully is an iterative process of scaling up — starting with seed funding to implement a controlled and externally evaluated pilot, then transitioning to a more informed and mature funding model that provides sustainable investment.
Undertaking a structured approach to service expansion means this organisation are better informed about how best to target their efforts, have a greater visibility of strategic risks, and are more likely to be successful. The next step is using this information to present a compelling case to prospective funders and other key partners. We look forward to following this journey.
If you would like to know more about the process, or if you provide funding (government, philanthropic or corporate) to vital services like this and would like us to put you in contact with the organisation, please drop us a line at info@beaconstrategies.net.
References:
[1] Australian Bureau of Statistics, 2007 National Survey of Mental Health and Wellbeing
[2] Maughan, A. et al (2007). Early-occurring maternal depression and maternal negativity in predicting young children’s emotion regulation and socioemotional difficulties. Journal of Abnormal Child Psychology, 35(5), 685- 703.
[3] Leschied, A. et al (2005). The relationship be- tween maternal depression and child out- comes in a child welfare sample: Implications for treatment and policy. Child & Family Social Work, 10(4), 281–291.
[4] Mowbray, C. T. et al (2003). Substance abuse in children of parents with mental illness: Risks, resiliency, and best prevention practices. Journal of Primary Prevention, 23(4), 451–482.
[5] Farahati, F., et al (2003). The effects of parents’ psychiatric disorders on children’s high school dropout. Economics of Education Review, 22(2), 167–178.
[6] Hosman, C. et al (2009). Prevention of emotional problems and psychiatric risks in children of parents with a mental illness in the Netherlands: I. The scientific basis to a comprehensive approach, Advances in Mental Health, 8(3), 250-263