Choices, a good choice for many

The latest evaluation of the Choices service, released today, has highlighted the positive impact the service is having on people in crisis, supporting them to address their underlying mental health and social issues and keep them out of hospital or police custody.  

Delivered by Ruah Community Services (Ruah), and funded by WA Primary Health Alliance, Choices is the first service of its kind in Australia, connecting people at risk of poor health outcomes with social and mental health support as they are discharged from emergency departments and justice services.

Since launching in late 2017, the Choices pilot has used peer and case workers to connect with over 3,000 people. A key focus of the service is to provide care coordination and support people to access and remain connected to primary health services in the community.

The independent evaluation, conducted by the University of Western Australia, looked at the support provided to a subset of close to 400 clients and their changes in hospital use and justice contacts after receiving support.

WA Primary Health Alliance General Manager, Mark Cockayne, said Choices is making a real difference to people in crisis, providing them with support that can start them on a path to change, and the autonomy to stay on that path.

“Over the course of the pilot, it was evident that many Choices clients did not have a regular general practitioner (GP) or were presenting to hospital emergency departments with health conditions that could be potentially managed through primary care. This has provided a great opportunity to connect them to a GP who can offer ongoing health care, as well as relevant services and programs in the community,” Mr Cockayne said.

“The evaluation has shown a 35 per cent reduction in the number of clients presenting to emergency departments in the twelve months following support, a great outcome.”

WA Primary Health Alliance Principal Advisor and Research Director, Dr Daniel Rock, said the development of trusting relationships with non-clinical staff can be key to ongoing and sustained contact with services, and Choices offers just that.

“Choices allows clients to navigate the system whilst receiving personalised support from peer support workers who have been in their shoes. We know that care centered around individual needs and preferences helps those at risk of poor health outcomes establish a safe and stable link back into the community, and as the evaluation shows, ultimately reduces recurrent emergency department presentations,” Dr Rock said.

“Mental health, alcohol and other drug use and accommodation were substantial issues faced by Choices clients. More than half of Choices clients presented with issues relating to accommodation and homelessness. For many, this had led to deteriorations in health. Addressing the housing situation is crucial in order to address other issues such as alcohol and other drug use and mental health issues.”

Ruah Chief Executive Officer, Debra Zanella, said the service is a great example of how peer engagement, individualised support and flexibility can help those at risk of poor health outcomes in our community.

“Social isolation, harmful substance use, family breakdown, homelessness, trauma and domestic violence are among factors that contribute to frequent emergency department presentations and interactions with the police,” Ms Zanella said.

“People who present frequently to emergency departments often have underlying needs and challenging life circumstances which often means that treating the immediate issue will not break the re-presentation cycle.  Choices is premised on identifying and addressing these underlying and inter-related needs through peer and community support.”

“The evaluation highlights the positive impact the service is having on the lives of those clients supported and I am thrilled with the results we are seeing,” said Ms Zanella.

This service has been made possible through funding provided by the Australian Government under the PHN Program.

View the Choices Evaluation Report.

Or, watch the webinar WA Primary Health Alliance hosted in partnership with Ruah and the University of Western Australia on June 10.