To summarise, the following is a list of possible issues for consideration in order to progress the implementation of relapse prevention within continuing care for Australia's mental health care system.

For people who have been seriously affected by mental illness, the major issues relate to being empowered to incorporate relapse prevention as a tool within their own journey of recovery. These issues include:

  • having information and support to accept and understand their health condition in ways that are developmentally and culturally appropriate;

  • developing understanding of the following topics:

    • Early warning signs of relapse, including symptom and reality checks

    • Risk factors for relapse, including relapse triggers

    • Protective factors for relapse and wellness needs

    • Effective clinical services and approaches

    • Effective psychosocial and psychiatric rehabilitation services

    • Illness self-management tools;

  • being the central force in their own treatment planning and continuing care;

  • expecting services to engage them in continuing care planning that is regularly reviewed and comprises, as appropriate to the individual consumer's circumstances: discharge plans from acute and inpatient care; ongoing relapse prevention and wellness plans; crisis plans; as well as support to develop self-management plans; and

  • being fully involved in the planning and evaluation of mental health services and empowered to advocate for service development and quality improvement
Top of pageFor the families and carers of people who have been seriously affected by mental illness many of the issues are similar to those for consumers, but relate more specifically to their role in supporting the consumer while maintaining their own wellbeing. This includes:
  • having information and support to accept and understand the health condition of the consumer, and their role in supporting the consumer's ongoing wellbeing;

  • being involved in treatment planning and continuing care as appropriate and agreed by the consumer;

  • ensuring that appropriate continuing care planning takes place and is regularly reviewed and that their role in this is explicitly acknowledged and negotiated;

  • being able to advocate for service development and having their role in the planning and evaluation of mental health services recognised; and

  • having family and carer support services in place to maintain their own wellbeing.
For primary care services, including general practitioners, the major issues are related to:
  • understanding and negotiating their role in the continuing care of a person who has experienced mental illness, particularly their role in relation to recognition of early warning signs and agreed early intervention responses;

  • ensuring that the physical health needs of people who have been seriously affected by mental illness are met;

  • providing integrated and seamless continuing care pathways by working in effective partnership with specialist mental health services, other primary care services, allied health services, and providers of psychosocial and psychiatric rehabilitation services; and

  • being actively involved in discharge planning and continuing care plans.
For case managers, the major issues are:
  • coordinating the development of relapse prevention plans in collaboration with consumers and their families and carers and other relevant parties;

  • regularly reviewing plans;

  • ensuring that clients receive all the clinical, psychosocial and rehabilitation services they require to maximise their recovery;

  • providing integrated and seamless continuing care pathways by working in effective partnership with specialist mental health services, primary care including general practice, allied health services, and providers of psychosocial and psychiatric rehabilitation services;

  • identifying gaps in the services required to prevent relapse and advocating for the development of these services;

  • having positive attitudes that support a recovery orientation; and

  • keeping up-to-date with emerging evidence regarding the factors that reduce risk of relapse and enhance resilience.
Top of pageFor providers of non-clinical psychosocial and psychiatric rehabilitation support services, the main issues are:
  • providing a service response that is able to meet community demand for support services;

  • being recognised as an essential component of continuing care, and thereby included in relapse prevention planning;

  • providing integrated and seamless continuing care pathways by working in effective partnership with specialist mental health services, primary care, allied health services, and providers of other psychosocial and psychiatric rehabilitation services;

  • having positive attitudes that support a recovery orientation;

  • training workers to have the appropriate skills and knowledge to provide services that prevent relapse and support recovery;

  • removing any barriers to accessing disability and psychosocial support services for people with mental illness; and

  • developing a more coordinated, comprehensive and integrated set of community and non-government services.
For providers of clinical services, the main issues relate to:
  • making relapse prevention a routine component of treatment and continuing care;

  • prioritising consumer participation, and that of families and carers if appropriate, in treatment and relapse prevention planning;

  • ensuring continuity of care beyond the acute episode by providing integrated and seamless continuing care pathways through working in effective partnership with primary care including general practice, allied health services, and providers of psychosocial and psychiatric rehabilitation services;

  • implementing effective and comprehensive discharge planning to provide continuity of care through ensuring that the necessary pathways and appointments for follow-up care are in place prior to discharge; and

  • having positive attitudes that support a recovery orientation.
For service managers, workforce planners, and policy makers the issues relate to developing a mental health care system that can support relapse prevention initiatives and provide continuity of care across the course of an episode of illness, across the lifespan, and across service sectors. This means:
  • developing service responses that support early intervention by having a lower threshold for gaining access to services;

  • providing a diverse and appropriate mix of clinical, psychosocial and disability support services that can meet population needs;

  • providing developmentally and culturally appropriate services and ensuring that service providers are trained in developmentally and culturally appropriate approaches;

  • resourcing services, particularly the non-government sector, to a level that enables capacity to implement relapse prevention initiatives;

  • providing outreach and assertive community services to meet the needs of consumers who are most disadvantaged and least able to access services;

  • ensuring that all services work within a recovery orientation and that workers have a positive attitude toward people with mental illness, as well as their families and carers; and

  • implementing training programs to update workforce skills so that workers in all the sectors that are involved in continuing care are able to work within integrated care pathways that prioritise the needs of consumers and their families and carers and are based on current knowledge of the factors that affect relapse.
Top of pageFinally, the whole community has a role in preventing relapse. This includes:
  • understanding the impact of everyday actions, particularly stigma, on the wellbeing of people who have experienced mental illness and their families and carers;

  • refusing to allow discriminatory practices or stigmatising views of people with mental illness; and

  • becoming more accepting, inclusive and supportive of people with mental illness within our communities.