NSW Psychosocial Research Project: Supplementary document on project scope

The NSW Ministry of Health commissioned a report by David McGrath Consulting on psychosocial support provision and need for people experiencing mental health challenges in NSW as part of the NSW Psychosocial Research Project.

Last updated: 23 January 2026
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The project defines psychosocial support as β€œnon-clinical and recovery-oriented services, delivered in the community by funded community managed organisations and tailored to individual needs, which support people experiencing moderate to severe mental health conditions to live independently and participate in the community."

To be included in the analysis, programs needed to:

  • Meet the definition of psychosocial support above and
  • Align with the Specialised Mental Health Community Support Services element in the National Mental Health Service Planning Framework (NMHSPF) taxonomy.

Eligible services and programs were reviewed by the consultant and an advisory group to determine whether they met the definition.

A list of all the programs considered as part of the analysis and whether they were determined to be in and out of scope for the analysis is listed below.

Programs determined in scope for the analysis

Please find the programs below that were determined in scope for the analysis. These programs align with the Specialised Mental Health Community Support Services element in the National Mental Health Service Planning Framework (NMHSPF) taxonomy

NSW Health Housing and Accommodation Support Initiative (HASI) Plus

  • Reported by: NSW Health
  • Location: Statewide (4 host LHDs)
  • Program description: HASI Plus is a statewide program for people with severe mental health conditions and significant difficulties managing day to day living. The program is community-based, transitional, rehabilitation and recovery-oriented and integrates clinical and intensive psychosocial support with stable, community-based accommodation.
  • Important note: The clinical component has been removed from this program.

Housing and Accommodation Support Initiative (HASI) and Community Living Supports (CLS)

  • Reported by: NSW Health
  • Location: All LHDs and Albury
  • Program description: Community based psychosocial supports for people with severe mental health conditions throughout NSW, to live and participate in the community. HASI/CLS operate as a statewide partnership between CMOs and LHDs. CMOs are funded to provide psychosocial, daily living and medication support while LHDs provide clinical care.   

Mental Health Community Living Supports for Refugees (MH-CLSR)

  • Reported by: NSW Health
  • Location: WSLHD, ISHLHD, SLHD, HNELHD, MNCLHD, SWSLHD, MLHD
  • Program description: First of its kind in the world program which provides trauma informed, recovery-oriented, culturally safe and responsive psychosocial supports to refugees and people seeking asylum who are experiencing psychological distress, mental ill health and/or impaired functioning. The program is open to all ages and support for the entire family is considered.

Resolve

  • Reported by: NSW Health
  • Location: WNSW and NBM LHDs
  • Program description: Provides recovery-oriented community based mental health support. The program aims to reduce hospital admissions, measured by a reduction in National Weighted Activity Units (NWAU). Funded through a Social Impact Bond, where investors provide some capital and pay running costs to the service provider, with government payments based on outcomes achieved.

Youth Community Living Support Services (YCLSS)

  • Reported by: NSW Health
  • Location: HNELHD, NBMLHD, NNSWLHD, SWSLHD, WSLHD
  • Program description: Non-clinical recovery-oriented psychosocial support services, delivered in the community by funded non government providers tailored to individual needs, which support young people (aged 15-25 with flexibility) experiencing or recovering from severe mental health conditions, and their families/carers, to gain independence and participate in the community.

Family and Carer Mental Health Program (FCMHP)

  • Reported by: NSW Health
  • Location: Statewide
  • Program description: Statewide program delivered across 15 LHDs in partnership with five CMOs and Justice Health and Forensic Mental Health Network. Districts work to enhance the skills of mental health service staff to work with families and carers as partners in care, while CMOs provide training and education, one to one support, group support and advocacy services for families and carers of people with mental health conditions.

Mental Health In-Reach Service (MH- IRS)

  • Reported by: DCJ
  • Location: SESLHD, SLHD, CCLHD
  • Program description: Provides housing support and facilitates access to community mental health services for people currently in mental health inpatient facilities, to support their transition to independent living in the community, break the cycle of homelessness, and prevent discharges from mental health facilities into rough sleeping. MHIRS is a partnership between NGOs delivering care coordination supports, LHDs delivering clinical supports and DCJ. It has operated since July 2022 as a pilot project in two locations.

Together Home

  • Reported by: DCJ
  • Location: Across NSW, dependent on demand
  • Program description: This is a Housing First informed program for 2 years of housing and wrap-around support for people with a history of rough sleeping. The program also aims to provide ongoing linkages with support services including mainstream services to reduce a participant's return to homelessness.
  • Note – tenancy component of support removed. 

Commonwealth Psychosocial support program

  • Reported by: SENSW PHN
  • Location: SNSWLHD and ISLHD
  • Program description: Psychosocial support service delivered by peer support workers with lived experience of mental ill- health to support individual recovery goals in groups and 1:1 support.

Community Psychosocial Support Program

  • Reported by: NSPHN
  • Location: NSLHD and region
  • Program description: Recovery-oriented and trauma-informed psychosocial supports tailored to individual needs. Support to test or re-test eligibility for NDIS for consumers requiring more intensive on-going supports. Service navigation support for people experiencing psychosocial disability to access appropriate psychosocial, clinical and primary health care.            

Commonwealth Psychosocial Support Program( Connector Hub South Western Sydney)           

  • Reported by: SWSPHN
  • Location: South Western Sydney
  • Program description: Community based psychosocial support program for people with severe mental health conditions and related psychosocial needs in south western Sydney. Connector Hub provides time limited recovery support for people to achieve their goals and improve wellbeing.

Connect and Thrive

  • Reported by: CESPHN
  • Location: Across the CESPHN region (SESLHD, SLHD, SVHN, Inner West)
  • Program description: Individual support that involves 1:1 support with a mental health or peer worker. Regular group support programs and social activities are also available with a focus on employment, physical health, social isolation, etc. Assistance with testing eligibility for psychosocial support within the NDIS also provided.

Continuity of Support

  • Reported by: CESPHN
  • Location: Across the CESPHN region (SESLHD, SLHD, SVHN, Inner West)
  • Program description: Individual support that involves 1:1 support with a mental health or peer worker. Regular group support programs and social activities are also available with a focus on employment, physical health, social isolation, etc. Assistance with testing eligibility for psychosocial support within the NDIS also provided.

Commonwealth Psychosocial Support Program

  • Reported by: NBMPHN
  • Location: Penrith, Hawkesbury, Blue Mountains, Lithgow LGAs
  • Program description: Community based psychosocial support to people with severe mental health conditions throughout NSW, to live and participate in the community. Flourish Australia provides this program to enhance the independence of those eligible to integrate into the community and build skills to support independent living and encourages vocational skill building.

Commonwealth Psychosocial Program

  • Reported by: HNECCPHN
  • Location: HNECC Region
  • Program description: Non-clinical community based supports that aim to facilitate recovery in the community for people experiencing mental health conditions – through a range of services to help people manage daily activities, rebuild and maintain connections, build social skills and participate in education and employment

Youth Transitional Care Pilot

  • Reported by: HNECCPHN
  • Location: Newcastle
  • Program description: Targeted at young people (12-18 years) with mental health difficulties including suicidal ideation who do not require tertiary mental health care. The aim of the program is to provide an early intervention psychosocial response which avoids further presentations at an Emergency Department and inpatient admission within 28 days of the most recent hospital discharge

Commonwealth Psychosocial Support Program

  • Reported by: WSPHN
  • Location: Seven Hills - predominantly The Hills LGA and Blacktown LGA; Parramatta - predominantly the Parramatta and Cumberland LGA's
  • Program description: Recovery support for people living with severe mental health challenges through connection with a Recovery Support Worker who providers individual psychosocial support, service navigation and support for applying to NDIS.

Bilingual Hospital to Home

  • Reported by: WSPHN
  • Location: Parramatta
  • Program description: For people from culturally and linguistically diverse (CALD) communities to connect with mental health services, and integrate back into the community, following discharge from an acute or community mental health service.The service providers holistic, person-centred, psychosocial support to people to ensure all their needs - daily living, housing, financial, health-related supports are in place to ensure smooth and supported integration back into the community.

Sunflower House

  • Reported by: MPHN
  • Location: Wagga Wagga
  • Program description: Provides a range of non-clinical place-based psychosocial supports to people with severe mental health conditions who do not meet eligibility criteria for the NDIS and who access Sunflower House.

Psychosocial Support Service Initiative - Well Connected

  • Reported by: MPHN
  • Location: Across Murrumbidgee PHN region
  • Program description: Provides a range of non-clinical community-based support to people with severe mental health conditions. Also providing services available outside of usual business hours when other support services are traditionally unavailable.

Psychosocial support for young people

  • Reported by: HNCPHN
  • Location: North Coast region. Including MNC and NNSW LHD footprints.
  • Program description: Delivery of the Commonwealth Psychosocial Support Program through a multidisciplinary, person centred, hub and spoke model of care as part of an overall stepped care approach to improving mental health and wellbeing. The service offers non-clinical community based supports that aim to facilitate recovery in the community for people experiencing mental health conditions, through the development of individualistic care/support plans that offer a range of services to help people manage daily activities, rebuild and maintain connections, build social skills and participate in education and employment.

Psychosocial support services - Western (PSY2-25)

  • Reported by: WNSWPHN
  • Location: Bourke, Brewarrina, Walgett, Cobar, Bogan, Warren, Coonamble Warrumbungle, Gilgandra, Narromine, Dubbo Regional, Mid-Western Regional, Bathurst, Orange, Blayney, Cabonne, Oberon, Cowra, Weddin, Forbes, Parkes; Far West - Broken Hill, Central darling, Wentworth, Balranald, Unincorporated NSW
  • Program description: Non-clinical community-based supports that aim to facilitate recovery in the community for people experiencing mental health conditions through a range of services to help people manage daily activities, rebuild and maintain connections, build social skills and participate in education and employment. Psychosocial supports and services are commissioned to work in partnership with individuals who are not more appropriately supported through state and territory programs and are significantly affected by severe mental health conditions, which has an impact on their associated psychosocial functional capacity. These services, in partnership with families and carers (as appropriate), provide a range of non- clinical community-based support to these individuals to achieve their recovery goals.

Primary Integrated Care Supports

  • Reported by: CESPHN
  • Location: Across the CESPHN region (SESLHD, SLHD, SVHN, Inner West)
  • Program description: Provides clinical care and coordination from mental health nurses who work collaboratively with peer workers for psychosocial support. Note – clinical component of the program has been removed.

Telehealth Psychiatry Service

  • Reported by: CESPHN
  • Location: Across the CESPHN region (SESLHD, SLHD, SVHN, Inner West)
  • Program Description: Provides free psychiatry services via Telehealth. Clinical Care Coordinators provide psychosocial support to people as they await their appointment and provide follow-up psychosocial care. Note – clinical component of the program has been removed.

Psychosocial Support for Refugees who Identify as LGBTIQ+

  • Reported by: WSPHN
  • Location: Auburn
  • Program Description: Peer-led support groups by people with lived experience to share information, service navigation and counselling. Large focus on educating service providers and psychoeducation for consumers, and to design sensitive, safe and inclusive programs and trainings which are rolled out through NSW Health. Note – only direct support component included.

The Assisted Discharge Program (ADP)

  • Reported by: HNELHD
  • Location: HNELHD
  • Program Description: Comprehensive and practical non-clinical support for people being discharged from inpatient mental health services. Intensive, short-term (up to 6 weeks) and goal directed support. Enhanced support to people who do not have access to other funding (and/or are ineligible to apply) during the transitional period of leaving hospital. Contracted to Flourish Australia.

Kaiyu Konnect program

  • Reported by: HNELHD
  • Location: HNELHD - Newcastle/Lake Macquarie
  • Program Description: Provision of social and skill development activities and support for people at risk or living with severe and persistent mental health conditions and their carers. Contracted to Samaritans Foundation.

ARAFMI Family and Carer program

  • Reported by: HNELHD
  • Location: HNELHD
  • Program Description: Provision of counselling, support groups, educational programs for carers and families of people with a mental health condition. Contracted to Samaritans Foundation.

Billabong program

  • Reported by: HNELHD
  • Location: HNELHD - Tamworth
  • Program Description: Provision of social, recreational vocational, personal wellbeing and referral services tailored to individual needs of active members located in New England region. Contracted to Billabong Clubhous inc. 

ARAFMI – One Door Mental Health Family and Carer services

  • Reported by: ISHLHD
  • Location: Helensburgh to Foxground
  • Program Description: Community based service for families and carers supporting people experiencing mental health challenges. Provides information to families and carers via telephone and/or newsletters/brochures/handbooks. Empowers families and carers via coordinated education and support groups and provides a service that is integrated and connected with other mental health supports in the Illawarra community.

Flourish Australia New Outlook Wollongong Project

  • Reported by: ISHLHD
  • Location: Helensburgh to Foxground
  • Program Description: Community based services that provide psychosocial groups with emphasis on peer led and peer co-facilitated sessions. Flourish provides in-reach into mental health inpatient settings to support early engagement, development of community network (sense of belonging), support transition out of acute hospital settings and reduce hospital re-admission.

Southern Youth and Family Services Youth Health

  • Reported by: ISHLHD
  • Location: ISHLHD
  • Program Description: Provides services to young people (12-25 years) in a casual drop in centre model. It is a safe place for young people to gain access to the support and services they need as well as make referrals required, in a non clinical setting that many of them feel more comfortable accessing.

Supporting Recovery Service

  • Reported by: MLHD
  • Location: MLHD - Deniliquin and Griffith regions (Flourish); MLHD - Tumut, Temora and Young regions (Wellways)
  • Program Description: Community based psychosocial supports to assist people to build personal resilience and sustainably manage the impacts of their health conditions. This service is intended to work closely and in collaboration with MLHD clinical services to provide complimentary care and shared care planning to support consumer participation economically and socially in the community to improve individual quality of life.

Home Based Outreach Service - Flourish

  • Reported by: MLHD
  • Location: MLHD - Tumut region including Tumbarumba, Gundagai, Batlow and Adelong communities
  • Program Description: Community based service designed to support people with severe mental health conditions to live independently in the community. This new approach was designed to be delivered using flexible individualised hours of support that respond to consumer need and changing demands across towns.

Young Peoples Program (YPP)

  • Reported by: NBMLHD
  • Location: NBMLHD catchment (LGAs - Penrith, Blue Mountains, Hawkesbury, Lithgow)
  • Program description:  Provides recovery-oriented psychosocial outreach support to young people aged 16 - 24 years that have a lived experience of mental health issues.

GROW

  • Reported by: NNSWLHD
  • Location: NNSWLHD
  • Program description: Community peer support and education to build social connections, psychosocial education, pathways to access employment.

Pioneer Clubhouse

  • Reported by: NSLHD
  • Location: Balgowlah, NSLHD
  • Program description:  Provides social contact for people with mental health conditions to reduce isolation, enhance participation through volunteer work, education and workplace training activities or activities that promote health and wellbeing.

Young Peoples Outreach Program

  • Reported by: SESLHD
  • Location: SESLHD catchment area
  • Program description:   Recovery focused community based psychosocial support program provided by Flourish Australia which is designed for young people (aged 15 to 25) with serious mental health conditions who are not a participant of the NDIS. The team work closely with clinicians to provide holistic support in the community. Short to medium term (average 6 months) support. Provides support for participant for on a 1:1 basis as well as workshops and social outings. Recovery goal-focused program.

STRIDE Mental Health

  • Reported by: SESLHD
  • Location: Eastern Suburbs Sydney
  • Program description:  Community based rehabilitation and recovery service that provides a range of social, leisure and therapeutic programs for people with mental health conditions, working collaboratively with consumers to achieve person centred care.

Buckingham House - Flourish Australia

  • Reported by: SESLHD
  • Location: Surry Hills, Sydney
  • Program description:   Provides supports to people in the community living with mental health issues to live meaningful and fulfilling lives. The centre provides a range of self-care, recreational, social, and skill development-based groups as well as individualised goal-based supports. Programs are based on consumer involvement through co-production, co-facilitation and/or peer support/peer workers.

Home Based Outreach Service (HBOS)

  • Reported by: SNSWLHD
  • Location: Queanbeyan/Cooma Goulburn/Yass Bega Valley
  • Program description: Originally modelled on the statewide HASI program as a greater need for support was identified by the LHD.

Disability Trust

  • Reported by: ​SWSLHD
  • Location: Wingecarribee and Wollondilly (SWSLHD)
  • Program description: Assists participants to maintain stable mental health and wellbeing to enable them to live as independently as possible and without hospital admissions due to mental health challenges.

Community Links-Kaleidoscope Program

  • Reported by: ​SWSLHD
  • Location: Wingecarribee and Wollondilly (SWSLHD)
  • Program description:  Supports children and young people in families with mental health conditions, using an early intervention framework. Note - partly in scope 12-17 year olds (4-11 year olds out of scope)

Kurinda Adolescent Service - Stride Mental Health

  • Reported by: WSLHD
  • Location: WSLHD
  • Program description:  Medium-term transitional supported living accommodation (24/7) for young people (aged 14-24). Three levels of supported accommodation are available: high support, semi-independent support and independent accommodation. Young people can stay from short to medium term, depending on their individual needs. The primary goal of the program is to assist young people to attain the skills they need to live independently in the community either on their own or with family or friends. Note – non acute bed-based support.

Buduwa

  • Reported by: SLHD
  • Location: SLHD - suburb of Burwood
  • Program description: Based on the Prevention and Recovery Care (PARC) model. A 10 bed collaborative partnership between SLHD and New Horizons offering short term recovery focused residential support and treatment services provided in a least restrictive care and supportive environment. Note – non acute bed-based support.

Camperdown Units

  • Reported by: SLHD
  • Location: Camperdown, Sydney
  • Program description:  24/7 supported accommodation and rehabilitation service with clinician in reach from the Camperdown Assertive Outreach Team. Note – non acute bed-based support

Lilyfield Outreach

  • Reported by: SLHD
  • Location: SLHD
  • Program description: Note – non acute bed based support.

Mawarra

  • Reported by: SLHD
  • Location: Ashfield, Sydney  
  • Program description: Transitional supported living for people with complex mental health problems and difficulties maintaining community tenure. Note – non acute bed-based support

Biala

  • Reported by: SLHD
  • Location: Inner West, Sydney  
  • Program description:  Medium term accommodation support for people living with complex mental health problems, functional deficits and difficulties maintaining community tenure. Note – non acute bed-based support.

Momentum Collective Third Sector Australia Residential support recovery program

  • Reported by: MNCLHD
  • Location: Coffs Harbour
  • Program description: Community based NGO funded MAG service which aims to provide non-acute care to adults in residential settings. Services are residential in nature and provide accommodation and recovery oriented rehabilitation for people whose needs are associated with severe mental health conditions, the associated clinical symptoms, and unresolved psychosocial or functional disability. Note – non acute bed-based support.

Momentum Collective

  • Reported by: NNSWLHD
  • Location: NNSWLHD
  • Program description: Community based psychosocial support to people with severe mental health conditions to live and participate in the community. Funded to provide psychosocial, daily living and medication support while LHDs provide clinical care. Funded to also provide 24/7 supported accommodation and transitional accommodation in the community. Note – non acute bed-based support.

Prevention and Recovery Centre-ICLA

  • Reported by: SESLHD
  • Location: Bondi, Sydney
  • Program description: Aims to facilitate early intervention and provide more intensive community supports in a step up/step down model in a least restrictive environment with recovery based and trauma informed care. PARC has a unique shared care model with PARC providing enhanced psychosocial supports and the Community Mental Health Team providing clinical supports. The model has 24/7 hour staffing ,7 days a week, with a mixed staffing model of clinical and non-clinical where guests stay for up to 28 days. Note – non acute bed-based support.

Tamworth Homeless Men’s Program

  • Reported by: HNELHD
  • Location: HNELHD – Tamworth
  • Program description: Provision of short term accommodation, support and safety for men with mental health conditions who have been identified as being homeless or at risk of homelessness in the New England region. Contracted to Flourish Australia. Note – non acute bed-based support.

Northern Sydney Supported Accommodation Service (NSSA)

  • Reported by: NSLHD
  • Location: NSLHD – Hornsby and Ryde Sectors
  • Program description:  Two sites within the NSLHD, Mental Health Drug and Alcohol Service. Delivered within a psychosocial rehabilitation and recovery framework. Note – non acute bed-based support.

Stepping Stones: Mental Health Consumer Homelessness Intensive Rehabilitation Program

  • Reported by: NSLHD
  • Location: NSLSD - Macquarie Hospital
  • Program description:  Intensive rehabilitation program with the aim to support people with mental health conditions experiencing homelessness or at risk of homelessness. Supports development of living skills, community engagement, establishment of support networks and sustainable housing/discharge planning. Note – non acute bed-based support.

Notes: The NSW Department of Education reported that they do not fund any psychosocial support programs which would meet the definition for this analysis.

Programs determined out of scope

Table 2 lists the programs that were nominated for the analysis but were determined out of scope. The following principles were used to guide decisions about whether a program was out of scope:

  • Programs that do not align with the Specialised Mental Health Community Support Services element in the NMHSPF taxonomy.      
  • Programs that were not operational during 2022–23.
  • Programs that provide linkage/referral services only.
  • Programs that are primarily clinical in focus or are considered a clinical substitution service (noting that these are covered under a different part of the NMHSPF taxonomy).
  • Programs that are designed to have a suicide prevention focus.
  • Programs that have an alcohol and other drug focus.
  • Programs that had insufficient data to be included or where it was not possible to separate the clinical and psychosocial support components.
  • Programs where services do not align with psychosocial supports as defined for this analysis.
  • Programs with broad or non-specific populations not specifically targeting people with moderate to severe mental health conditions (e.g supports available for the general population).
  • Programs that are primarily exercise or physical health programs (compared to psychosocial support programs that include physical health components).

LikeMind

  • Funder: NSW Health
  • Location: WNSWLHD, NBMLHD, WSLHD, MLHD
  • Program Description: Provides coordinated health and social care services in a hub setting. Targeted at adults between 25 and 65 years with moderate to severe mental health conditions. Consumers can receive services in four areas: mental health, primary health, drug and alcohol and vocational and social needs (including linkages to employment and housing).
  • Rationale: Unable to separate clinical and psychosocial support.

Next Steps Suicide Aftercare

  • Funder: SENSW PHN
  • Location: SNSWLHD and ISLHD
  • Program Description:  A psychosocial program staffed by skilled peer workers who work closely with the person to help reduce their risk and take steps towards the life they want.
  • Rationale: Suicide prevention focus

Integrated Recovery Service for people with severe/complex mental health conditions

  • Funder: SENSW PHN
  • Location: SNSWLHD and ISLHD except Shoalhaven LGA
  • Program DescriptionRecovery-oriented services for adults with severe and complex episodic mental health needs. Delivered by mental health clinicians and peer support workers with lived experience of mental health conditions.
  • Rationale: Partly delivered by clinicians. Unable to separate non-clinical component

Shellharbour Head to Health

  • Funder: SENSW PHN
  • Location: Shellharbour (ISLHD) or via telehealth
  • Program Description:  Psychological therapy as part of a multidisciplinary team that includes peer workers.
  • Rationale: Not operating in 2022-23 financial year

Wollongong Mental Health Hub

  •  Funder: SENSW PHN
  • Location: Wollongong LGA
  • Program Description:  Psychological therapy as part of a multidisciplinary team that includes peer workers.
  • Rationale: Not operating in 2022-23 financial year

Shoalhaven Mental Health Hub

  •  Funder: SENSW PHN
  • Location: ShoalhavenLGA
  • Program Description:  Psychological therapy as part of a multidisciplinary team that includes peer workers.
  • Rationale: Not operating in 2022-23 financial year

Bega Mental Health Hub

  •  Funder: SENSW PHN
  • Location: Bega Valley LGA
  • Program Description:  Psychological therapy as part of a multidisciplinary team that includes peer workers.
  • Rationale: Not operating in 2022-23 financial year

Moruya Mental Health Hub

  •  Funder: SENSW PHN
  • Location: Eurobodalla and Snowy Monaro LGAs
  • Program Description:  Psychological therapy as part of a multidisciplinary team that includes peer workers.
  • Rationale: Not operating in 2022-23 financial year

Queanbeyan Mental Health Hub

  •  Funder: SENSW PHN
  • Location: Queanbeyan-Palerang LGA
  • Program Description:  Psychological therapy as part of a multidisciplinary team that includes peer workers.
  • Rationale: Not operating in 2022-23 financial year

Goulburn Mental Health Hub

  •  Funder: SENSW PHN
  • Location: Goulburn- Mulwaree LGA
  • Program Description:  Psychological therapy as part of a multidisciplinary team that includes peer workers.
  • Rationale: Not operating in 2022-23 financial year

AOD services

  •  Funder: SENSW PHN
  • Location: All SENSW
  • Program Description: Services may provide psychosocial supports to consumers
  • Rationale: Alcohol and other drug focused

Indigenous mental health services (Social and Emotional Wellbeing)

  •  Funder: SENSW PHN
  • Location: All SENSW
  • Program Description: Services may provide psychosocial supports to consumers.
  • Rationale: Unable to separate psychosocial support component

Keeping Body in Mind – Primary

  •  Funder: CEPHN
  • Location:  UNSW Lifestyle Clinic in Randwick (referrals from across CESPHN)
  • Program Description: Improve the physical health and wellbeing of people experiencing severe mental health conditions through evidence-based exercise and dietary interventions.
  • Rationale: Physical health program

Psychosocial and AoD Comorbidity Support Program

  •  Funder: HNECCPHN
  • Location:  All HNECCPHN. Residential/offices located: Mid-Coast Cessnock Newcastle Central Coast
  • Program Description: Non-clinical community-based supports that aim to facilitate recovery in the community for people experiencing AoD concerns – through a range of services to help people manage daily activities, rebuild and maintain connections, build social skills and participate in education and employment.
  • Rationale: Alcohol and other drug focused

Psychosocial Services for Children

  •  Funder: HNECCPHN
  • Location:  Tamworth, Armidale
  • Program Description: Provide psychosocial support for children aged 5-12 years who are demonstrating behaviours as a result of mental health issues or whose parents/carers have a mental health condition, and the child is at risk of greater emotional, coping or behavioural issues, or school and community disengagement.
  • Rationale: Age range under 12 years

Service Navigation

  •  Funder: HNECCPHN
  • Location:  HNECCPHN
  • Program Description: Provide a telephone service, assessing need and making appropriate referrals to services within the HNECCPHN.
  • Rationale: Phone referral service

Youth Ambassador and Older Persons Mental Health Support Programs

  •  Funder: WSPHN
  • Location:  Auburn, Sydney
  • Program Description: Youth Ambassador - Mental Health literacy and suicide prevention programs focused on young people, in particular prominent refugee and asylum seeker groups (including South Sudanese, Hazara, Tamil and Arabic communities). The program develops the skillsets of young people to provide peer support, recognise the signs of mental distress, and navigate people to available services or cultural supports.Older Persons - supports migrant, asylum seeker and refugee seniors to overcome isolation and anxiety through social groups, skill development, outdoor activities, age-appropriate fitness activities and cultural gatherings. The program works on identifying older people at increased risk of social isolation and any related health concerns - and supports them to access culturally appropriate services.
  • Rationale: Workforce development program

The Shed

  •  Funder: WSPHN
  • Location:  Emerton
  • Program Description: Targeted towards First Nations people. Supports people at risk of serious stress and suicide, generally on account of cumulative stress often due to disadvantaged situations, providing a platform of connection with many services such as public housing providers, legal services and financial counsellors.
  • Rationale: General target group (not people with moderate to severe mental health conditions)

Live Life Get Active

  •  Funder: WSPHN
  • Location:  Kellyville, Lidcombe, Merrylands, Parramatta, Rouse Hill, Telopea, Toongabbie
  • Program Description: Free outdoor exercise camps provided by professionally qualified personal trainers in 7 locations across Western Sydney. The program is also offered online through on demand sessions.
  • Rationale: Physical health program

Psychosocial Support Service Navigator

  •  Funder: MPHN
  • Location:  Across Murrumbidgee PHN region
  • Program Description: Improve access to the health system for people with severe mental health conditions and associated psychological disorders. Integrates with the provider’s portfolio of complementary psychosocial support programs.
  • Rationale: Service navigation/referral service

Psychosocial Physical Health and Wellbeing Initiative

  •  Funder: MPHN
  • Location:  Communities of Batlow, Boorowa, Coolamon, Cootamundra, Gundagai, Harden, Junee, Temora, Tumbarumba, Tumut, West Wyalong and Young.
  • Program Description: ​To develop an integrated multi-strategy approach to improve physical health care outcomes for people with severe mental health conditions accessing primary care, mental health and psychosocial support services across the Murrumbidgee region.
  • Rationale: Workforce development program

Mental Health Transitional Support Program (RRR)

  •  Funder: CCLHD
  • Location:  CCLHD
  • Program Description: ​The Resilience & Readmission Reduction initiative (RRR) is delivered by community partner, Uniting. The model harnesses expertise found in the CMO sector regarding the provision of psychosocial support.
  • Rationale: Not operating in 2022-23 financial year

Housing and Psychosocial Support Program

  •  Funder: CCLHD
  • Location:  CCLHD
  • Program Description: ​The Road to Recovery (R2R) Program is a partnership program delivered by CCLHD, Local Community Housing Provider, Pacific Link Housing and psychosocial support provider Neami National. The program provides transitional accommodation and support for people experiencing homelessness through the provision of tenancy and living skills support.
  • Rationale: Not operating in 2022-23 financial year

Broken Hill Safe Haven

  •  Funder: FWLHD
  • LocationBroken Hill (And all NSW LHDs)
  • Program Description: ​Non-clinical, lived experience approach to providing support to people who are in distress and at increased risk of suicide. The Safe Haven offers a safe, comfortable environment for people to self present as required.
  • Rationale: Suicide prevention focus

Far West SPOT (Suicide Prevention Outreach Team)

  •  Funder: FWLHD
  • Location:  Far West LHD (available in all NSW LHDs)
  • Program Description: ​A mobile team of 1 Clinician and 1 Peer worker who can provide a timely response to any person in distress or at increased risk of suicide. The team provides a service in a person’s home or community setting, in the hospital (ED, inpatient unit, recovery centre or general wards), and phone support to outreach areas.
  • Rationale: Suicide prevention focus

Face to Face Counselling contracted to Lifeline Direct

  •  Funder: HNELHD
  • Location:  HNELHD - Armidale and surrounds
  • Program Description: Provision of face-to-face mental health counselling. The service is non- clinical and operates 3 days per week (12 counselling hours) from a dedicated Lifeline counselling room. People using this service have been referred from the HNELHD community mental health, community organisations, GPs or are self-referred. Typically, consumers receive up to 6 counselling sessions.
  • Rationale: Clinical substitution service

Lifeline South Coast- Crisis Support Worker Training

  •  Funder: ISLHD
  • Location:  Statewide
  • Program Description:  Operates as part of the Lifeline Australia Network providing 24/7 suicide prevention and crisis support through the 13 11 14 phone line. Develop and maintain a highly skilled and supported crisis support worker team to provide suicide prevention and crisis support services through support worker training.
  • Rationale: Workforce development program

Next Steps Suicide Aftercare

  •  Funder: ISLHD
  • Location:  ISLHD and SNSWLHD
  • Program Description:  A four to 12-week psychosocial program for people who have presented in suicidal crisis to emergency departments or community mental health teams. The program is primarily staffed by skilled peer workers who work closely with the person around their drivers of suicide and goals to help reduce their risk and take steps towards the life they want. The person, along with the peer worker, will work collaboratively with a mental health clinician for the initial meeting and at four weekly reviews. Referrals come directly from ED or acute care team.
  • Rationale: Suicide prevention focus

Safe Haven Wollongong - Stride

  •  Funder: ISLHD
  • Location:  Wollongong LGA
  • Program Description:  Alternative to ED which provides a safe, supported environment for consumers experiencing suicidal ideation. Support is received from peer workers in a non-clinical environment
  • Rationale: Prevention service

Warminda Healing Counsellors program and women’s health project

  •  Funder: ISLHD
  • Location:  Shoalhaven District, with possible extension to Illawarra
  • Program Description:   Aboriginal Child Sexual Assault - healing counsellors program, provides culturally appropriate therapeutic services to Aboriginal Children, young people and women and their families who have experienced interpersonal violence and abuse, with a focus on sexual abuse. Services incorporate cultural healing framework and methodologies in individual and community setting.
  • Rationale: Unable to separate clinical supports from psychosocial

Illawarra Women’s Health centre

  •  Funder: ISLHD
  • Location:  ISLHD
  • Program Description: Free or low cost and affordable medical, allied and complementary health care as well as health and wellbeing programs, groups and education to improve women’s health.
  • Rationale: Not primarily psychosocial support

Shoalhaven Women’s Health centre

  •  Funder: ISLHD
  • Location:  ISLHD
  • Program Description: Provide clinical, health promotion/education and referral services to women in the Nowra area, across the life stages. Promote good emotional and social wellbeing, provide early intervention, improve responses to domestic, sexual and family violence.
  • Rationale: Not primarily psychosocial support

Community Transitions Team (CTT)

  •  Funder: JH&FMHN
  • Location:  Statewide (based in Sydney)
  • Program Description: Assertive multidisciplinary prison in-reach service that supports people to transition from custody into the community by arranging an array of biological, and psychosocial supports. The CTT operates out of prisons with mental health hubs in metro-Sydney in order to support people who have a diagnosis of severe and enduring mental health conditions, have a history of poor engagement with mental health services, receive mandated care in custody, are homeless and do not have access to NDIS psychosocial support programs when they come into custody.
  • Rationale: Primarily clinical service

The Forensic Hospital NDIS Transitions Clinician

  •  Funder: JH&FMHN
  • Location:  The Forensic Hospital
  • Program Description: Pilot project funded through a Department of Social Security Grant under the Australian Disability Strategy. Designed to reduce the risk of harm for patients living with disability by improving information sharing, cross system supports and establishing streamlined internal systems, procedures, and referral processes at The Forensic Hospital to ensure seamless transitions and dynamic identification of risk between systems including health, justice, family, child-protection, and the NDIS.
  • Rationale: Not primarily psychosocial support

Violence Reduction Program - Forensic Mental Health Forensic Hospital, JHFMHN

  •  Funder: JH&FMHN
  • Location:  Forensic Hospital, Long Bay Correctional Complex Community, Forensic Mental Health Services, LHDs with forensic beds
  • Program Description: The Violence Reduction Program- Forensic Mental Health (VRP-FMH) is an adapted high intensity treatment program for forensic patients with a history of violence, who also have significant mental health concerns. The program aims to collaborate with patients to reduce episodes of aggression and violent reoffending in inpatient and community settings. It has been endorsed to be facilitated across all forensic mental health settings in NSW, including the community. Multiple stakeholder involvement from JHFMHN and LHDs with medium and low secure settings including WS LHD, HNE LHD and WNSW LHD. It is an approximately 10 month program divided into 3 phases with validated assessments to measure change and treatment progress.
  • Rationale: Not primarily psychosocial support

NDIS Mental Health Officers (NMHO)

  •  Funder: JH&FMHN
  • Location:  Statewide
  • Program Description: The overarching aim is to improve the access to and experience of the NDIS for people with psychosocial disability in NSW. This is achieved by assisting people with psychosocial disability to get the supports they need to live well in the community; and working with mental health staff to improve their skills and confidence in assisting consumers with the NDIS.
  • Rationale: NDIS referral and access

NBMLHD Mental Health (Internal LHD employees) Peer Work Staffing Profile

  •  Funder: NBMLHD
  • Location:  NBMLHD
  • Program Description:  NBMLHD's Peer Workforce operates across the following Clinical Ambulatory Mental Health Services: Triage and Assessment Centre (TAC), Plains Access, Blue Mountains Access, Homelessness Mental Health Team, Safe Haven, Suicide Prevention Outreach Team (SPOT), Pathways to Community Living Initiative (PCLI) Stage 2.
  • Rationale: Integrated into clinical service

Anglicare Emotional Wellbeing for Older People

  •  Funder: NSLHD
  • Location:  NSPHN
  • Program Description:  Provides mental health services for older people who reside in Residential Aged Care facilities. This program aims to provide psychological and psychosocial therapies.
  • Rationale: Not primarily psychosocial support

The Way Back

  •  Funder: NSLHD
  • Location:  NSLHD
  • Program Description:  Non-clinical psychosocial support for people following a suicide attempt
  • Rationale: Suicide prevention focus

NSLHD Eating Disorder Service (EDS) - Care Navigation/Tranisitional Care Service

  •  Funder: NSLHD
  • Location:  NSLHD
  • Program DescriptionCommunity based psychosocial support to people with suspected or diagnosed Eating Disorder, and their families and carers. Aims to assist patients and families in accessing appropriate community eating disorder treatment, provides interim eating disorder support (e.g. psychoeducation information sharing, debriefing, skill development) until treatment accessed in the community. Also, offers support for people with an eating disorder who may be transitioning into and out of hospital for a smooth transition.
  • Rationale: Not primarily psychosocial support

Getting On Track In Time (Got It!)

  •  Funder: NSLHD
  • Location:  NSLHD (available across NSW)
  • Program Description:  School-based early intervention health program supporting children with their social and emotional wellbeing. The program assists parents and teachers to support children's emotional and social development.
  • Rationale: Not primarily psychosocial support

Mental Health Peer Support Workers

  •  Funder: SLHD
  • Location:  SLHD
  • Program DescriptionMental Health Peer Support, integrated into clinical services.
  • Rationale: Integrated into clinical service

Mental Health Peer Support Worker

  •  Funder: SLHD
  • Location:  SLHD
  • Program Description: Supports carers with understanding from lived experience perspective, service navigation and problem solving. Position includes systems advocacy work.
  • Rationale: Integrated into clinical service

Children of Parents with Mental Illness (COPMI)

  •  Funder: SLHD
  • Location:  SLHD
  • Program Description: Support for children of parents with mental health conditions, includes health promotion style activities and consultation with adult services.
  • Rationale: Supports children of people with mental health conditions

Holy Spirit Agreement

  •  Funder: SLHD
  • Location:  SLHD - suburb of Croydon
  • Program Description: Access to beds at Holy Spirit Nursing Home for older people requiring nursing home care. Modelled as transitional support, with patients transferred as appropriate to more suitable housing/ bed option.
  • Rationale: Not primarily psychosocial support

Gandangara

  •  Funder: SWSLHD
  • Location:  Liverpool LGA
  • Program Description: First Nations people presenting with a mental health conditions and alcohol and other drugs comorbidities impacting on positive social, emotional, spiritual and cultural wellbeing.
  • Rationale: Not primarily psychosocial support

Tharawal

  •  Funder: SWSLHD
  • Location:  Sputh West Sydney
  • Program Description: The program is designed to improve wellbeing outcomes of young people experiencing co-morbid AOD and mental health concerns.
  • Rationale: Primarily AOD supports

GROW

  •  Funder: SWSLHD
  • Location:  West Hoxton, South West Sydney
  • Program Description:  17 bed Long Term Rehabilitation Centre catering for both men and women over 18 years of age. Key focus on mental health and substance misuse disorder.
  • Rationale: Not primarily psychosocial support

Supported transfer of care (Peer-Stoc)

  •  Funder: WNSWLHD
  • Location: Dubbo and Orange (available across NSW)
  • Program Description:  Designed to provide peer-led and recovery focused supports by qualified peer workers to individuals with complex mental health needs during a 6- week period of transition to home or community after an inpatient admission. These positions are usually based in community mental health teams and provide in-reach support to people prior to discharge and in the initial period following discharge.
  • Rationale: Not primarily psychosocial support - clinical replacement service

Mental health- residential aged care partnership services

  •  Funder: OPMH
  • Location: MHACPI unit: NBM LHD; Specialist RACF: SLHD (2 SRACFs), WSLHD, WNSWLHD, NSLHD, HNELHD (under procurement)
  • Program Description:  Provide accommodation and support for older people with complex mental health needs and aged care needs in a residential aged care setting. Residential aged care facilities provide the accommodation and support, and LHD mental health services provide specialist clinical support to the residents/consumers and facility. NSW Ministry of Health provides top-up funding to the RAC provider to support additional, specialist aged care staffing, and LHDs have received additional funding to provide dedicated clinical inreach and partnership support. There are 2 MH-RAC service models: MHACPI transition units in residential aged care facilities (RACFs), and Specialist RACFs.
  • Rationale: Not primarily psychosocial support

Notes: A decision to exclude a program from this analysis is not a reflection on the benefits of the program but is based on the definitions and alignment with the NMHSPF taxonomy.

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