http://nova.newcastle.edu.au/vital/access/services/Feed ${session.getAttribute("locale")} 5 http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:11158 It is apparent that hospital-dominated health care produces limited health outcomes and is an unsustainable health care system strategy. Community-centred health care has been demonstrated to be a more cost-efficient and cost-effective alternative to hospital-centred care, particularly for prevention and care of persistent, long-term or recurrent conditions. Nevertheless, hospital-centred services continue to dominate health care services in Australia, and some state governments have presided over a retreat from, or even dismantling of, community health services. The reasons for these trends are explored. The future of community health services in Australia is uncertain, and in some states under serious threat. We consider lessons from the partial dismantling of Australian community mental health services, despite a growing body of Australian and international studies finding in their favour. Community-centred health services should be reconceptualised and resourced as the centre of gravity of local, effective and affordable health care services for Australia. A growing international expert consensus suggests that such community-centred health services should be placed in the centre of their communities, closely linked or collocated where possible with primary health care, and functionally integrated with their respective hospital-based services. What is known about the topic? Community-centred health care has been widely demonstrated to be a more cost-efficient and cost-effective alternative to hospital-centred care, particularly for prevention and care of persistent, long-term or recurrent conditions, e.g. in mental health service systems. A growing international expert consensus suggests that such community-centred health services should be placed in the centre of their communities, closely linked or collocated where possible with primary health care, and functionally integrated with their respective hospital-based services. What does this paper add? Despite this global consensus, hospital-centred services continue to dominate health care services in Australia, and some state governments have presided over a retreat from, or even dismantling of, community health services. The reasons for these trends and possible solutions are explored. What are the implications for practitioners? Unless this trend is reversed, the loss of convenient public access to community health services at shopping and transport hubs and the consequent compromising of intensive home-based clinical care, will lead to a deterioration of preventative interventions and the health care of long-term conditions, contrary to international studies and reviews. 2012-07-31T01:45:03.935Z ]]> http://nova.newcastle.edu.au/vital/access/manager/Repository/uon:4647 “Farm-Link: improving the mental health and well-being of people who live and work on NSW Farms ” is funded by the Commonwealth Government through the Department of Health and Ageing under the National Suicide Prevention Strategy to develop and test a model of suicide prevention focussed on pathways to care and appropriate for rural areas. It is coordinated by the NSW Centre for Rural and Remote Mental Health in collaboration with NSW Health’s rural Area Mental Health Services and the NSW Farmers’ Association. It was operational from March 2007 to January 2009. This unique partnership between a peak industry group, NSW Farmers Association, four rural Area Mental Health Services, and the University of Newcastle through its Centre for Rural and Remote Mental Health has enabled Farm-Link to engage the traditional agricultural workforce in high quality, focussed and relevant suicide prevention strategies for people who live and work on NSW farms. Farm-Link’s objectives were to identify target communities in collaboration with key stakeholder organisations through NSW Farmers Mental Health Network and Area Health Services, to develop Farmers Mental Health Networks in rural areas, improve access to effective mental health services for farmers and farm families and evaluation. Farmers’ Mental Health Networks, focussed on engaging both agricultural and mental health agencies in describing, defining and using pathways to care for farming people were established and expanded in Mudgee, Parkes/Forbes, Bourke, West Wyalong, Yass, Griffith, Inverell, Moree, the Upper Hunter and Casino/Kyogle. Improving the mental health literacy of front line agricultural workers was achieved through Farm-Link staff providing internationally recognised and widely respected Mental Health First Aid training to 220 front-line agricultural workers in rural NSW. Farm-Link established the conditions for successful cross agency networks to flourish in rural NSW. It developed a credible reputation in target communities and its staff emerged as service brokers, performing roles that included providing information about services, assisting with referrals, hearing of patient journeys in mental health services and building community confidence in making referrals. An external evaluation, including comparative service network analysis, has been completed and is submitted separately. 2010-04-27T04:57:36.875Z ]]>