What can Primary Health Networks do to strengthen mental health literacy?
Beacon Strategies recently undertook a project with South Western Sydney Primary Health Network (PHN) in partnership with The Peregrine Centre and Troubled Dog to co-design initiatives and resources to strengthen the responsiveness of health services to the mental health literacy needs of the community. Through the experiences and insights shared with us during this project, we thought there was value in unpacking what mental health literacy is, exploring how it can be built in communities, and discussing the role of health services.
Introducing the concept of mental health literacy
Mental health literacy is increasingly being recognised as a priority for improving how people access and experience various types of support to maintain good mental health.
A definition of ‘mental health literacy’ used by the Mental Health Commission of New South Wales is:
“people’s accumulated knowledge and their ability, confidence and comfort to access, understand, appraise, remember and use knowledge about health and healthcare for the mental and physical well-being of people with lived experience of mental illness and those around them.”
While this definition is quite broad, this is intentional — it aims to consider the diverse range of needs, strengths and preferences of people and communities that influence their wellbeing. In particular, it aims to see this from the perspective of lived experience of mental health issues, and from a cultural and health equity lens.
The issue of mental health literacy shows up as a priority in many of the regional health needs assessments compiled by Primary Health Networks (PHNs) across Australia.
As one example of how this impacts the mental health of communities, the South Western Sydney PHN identified several relevant issues in their most recent needs assessment:
community members lacked the knowledge to identify mental health concerns within themselves and others in the community, and lack skills to respond appropriately.
community and provider concerns highlight a need for improvement of general mental health literacy within the wider community, with targeted and culturally appropriate approaches within the community for particular demographics.
demographic profiles of communities in South West Sydney suggests that local residents are more likely to be at a greater risk of poor health literacy
Building the responsiveness of health services
A related concept is mental health literacy responsiveness — the way in which services make information, resources, supports and environments, available and accessible to people with varying mental health literacy strengths and limitations.
The Mental Health Commission of New South Wales has been leading a system-wide approach to improve mental health literacy across NSW. They highlight the importance of this work as:
“the mental health literacy responsiveness of organisations shapes both their accessibility and effectiveness in supporting understanding of preventative and restorative strategies for managing mental and physical health problems.”
This work has led to the development of a Mental Health Literacy Responsiveness Framework, created from ideas generated during workshops held with people with lived experience of mental health issues (their families and carers) and service providers. It includes a range of tools and resources that have been developed across 11 action areas:
Phone and web-based services
Better connected systems
Peer support options
Friendly intake processes
Early action programs
‘Whole health’ strategy
Youth engagement
Professional development
Community engagement
Community supports and services guide
Data and indicators
So what can PHNs do to identify and respond to the mental health literacy needs of their communities?
While the action areas above provide some directions for a system-wide approach to improving the responsiveness of services and supports, they require a considerable and coordinated effort to drive change in local health systems and communities. The Mental Health Commission of NSW has identified Primary Health Networks across NSW (and beyond) as a key audience for translating these resources into practice.
The first step for any PHN is to define the mental health literacy needs of their region. This should acknowledge the diversity of communities within their region, whether that be cultural, age, gender, geographical or other factors that shape people’s needs and experiences.
A set of framing questions like the ones below can be used to guide a meaningful engagement process with relevant community and sector representatives:
Using experience to define mental health literacy needs
If someone in your community was in distress and really struggling, where would they go for help?
What makes a person (or service) trustworthy or welcoming?
What words or phrases would they use to describe mental health?
What support might be typically available to this person?
What supports might the person be connected or referred on to?
What are some of the barriers that exist for the person seeking help?
Creating solutions that respond to identified needs
How might we help people take the first step in connecting to the (right) help?
How might we encourage more conversations in the community, and help these be meaningful and helpful?
How might we better respond to the full range of drivers of despair?
How might we engage health professionals, particularly general practitioners (GPs) and improve their ability to recognise and respond to mental health?
How might we engage other gatekeepers in the community and build their ability to recognise and respond?
As an example of some of the rich insights we captured through our co-design process with a group of people from the South Western Sydney community, we heard about the type of response people wanted or expected, the barriers that people experience in having their needs met, and some of the changes they would like to see happen:
You can see above that this doesn’t represent anything new for PHNs — it’s what they’re already tasked with to strengthen their local health system and improve the coordination of mental health supports to ensure people receive the right care, in the right place, at the right time.
And across all regions of Australia, improving the accessibility and responsiveness of mental health services and supports is needed.
Applying a mental health literacy framework to this work is a helpful way for PHNs to ensure that all of their work genuinely addresses the needs, experiences and preferences of the diverse communities within their region.
Find out more about the work we do with PHNs here.
