Exactly what is the project seeking to provide?
The ACDC project is seeking to achieve positive outcomes for the people engaged by People Connectors, as well as project outcomes.
- Connecting with people who are disconnected and connecting them to services where needs are identified
- To build people’s capacity by providing them with information products to seek help
- To facilitate people’s awareness of their social and emotional well-being needs
- Mapping the needs of individual household and community
- Understanding the barriers and challenges of a community in relation to accessing mental health services and supports
- Building the capacity of People Connectors with respect to knowledge and skills for effective outreach to people in need
- Supporting community understanding on why individuals do not
- Supporting sector collaboration by encouraging communication between services to improve referral pathways for the community
- Producing training materials and tailored information packages for the community
- Research data to inform local and national mental health service planning
What is different about the ACDC Project?
The 2007 National Survey of Mental Health and Wellbeing found the prevalence of severe mental illness in the Australian community was 4.1%. and moderate mental illness was 6.6%. That survey showed that 64.8% of people with severe mental disorders and 40.2% of those with moderate mental disorders used services in the previous 12 months. Research also shows that help-seeking behaviour is very low in some communities.
ACDC is an exploratory project which offers a new and different “Direct Connection” or “Proactive Outreach” approach to linking people with services and assessing community needs. Rather than waiting for people to present themselves to services and ask for help, through the ACDC project each person or household engaged with will be offered the opportunity to be informed about, or where possible linked with, appropriate services.
Why is the ACDC Project taking this door to door approach?
Door knocking is a part of what we are calling the “Proactive Outreach” approach of the ACDC project. Going door to door in communities to engage with people where they live will mean that people are directly reached, and that information and linking is offered to people without their needing to ‘present’ or to assertively seek help. In this way ACDC brings potential access to mental health services directly to people, and at the same time will be able to measure the unseen mental health support needs in communities. Other forms of engagement would rely on people having information about where to go to seek information and assistance and making the time and effort to do so. ACDC seeks to eliminate these barriers to service access.
How will the door knocking be done?
The door knocking approach will be customised and will look different in each community. The draft door knocking guidelines will be co-designed through a project working group, which will have representation of significant stakeholder groups including consumers and carers, and as a part of this co-design stage, a more fit-for-purpose term for the ‘door knocking’ will be explored. Following this, an extensive process of co-design and consultation with local stakeholders will precede the door knocking at each site.
People Connectors are intended to operate in pairs with a diversity of gender and cultures if practicable. They will knock on every door unless there is a reason not to.
Have you considered that people may not want to answer the door or engage?
Yes, there has been a significant amount of discussion in relation to this. Ultimately, if people are not wanting to speak with a People Connector then of course their decision will be respected. ACDC has been designed with assumptions that some people will not wish to engage, or will not be engaged for other reasons, for example they may not be home, and project outcomes will still able to be achieved in this case.
The project team has been exploring what investments could be made to increase the likelihood that the People Connectors reach the right people at the right time, and to maximise the chance that people will choose to engage with them.
Prior to door knocking at each site, the ACDC team, in partnership with the Local Reference Group, will co-design and implement a pre-engagement and marketing strategy. A community level mapping exercise will inform the pre-engagement strategy, through which opportunities to introduce ACDC to the community will be identified. Pre-engagement strategies may involve the use of communication platforms such as local newspaper, radio and/or a letterbox drop, or a physical presence at community events.
The timing of the door knocking will be significant. Door knocking is intended to take place in the mid-morning, afternoons and early evenings, and if engagement with a People Connector is not preferred at the time the door is knocked, a rescheduled engagement by appointment will be offered. Similarly, if a door does not get answered, a ‘sorry we missed you’ appointment card will be left under the door with contact details and opportunities to reschedule at a time that suits the person.
Is there an openness or flexibility to other forms of Proactive Outreach?
The Proactive Outreach approach of the ACDC project has been funded and contracted by the NDIA and the door knocking activity is how the ACDC project will work. There will be some people for whom the door knocking approach will not be how they choose to engage, and there will be some people for whom door knocking will not be appropriate. Furthermore, there are risks of knocking on doors during the current COVID-19 pandemic. These concerns, and potential alternatives to Door Knocking, have been considered and the door to door approach is the best opportunity for the project outcomes to be achieved.
CMHA would like to explore whether ACDC could also be replicated through other direct connection methods, using social media, online or phone engagement. This may be possible within the scope of the ACDC project, or as a potential extension of the project.
What services will people be provided information about?
The information products distributed to individuals and households is a significant output of ACDC and investment will be made to ensure that these are relevant and accessible to the targeted audience. Information products may contain information about local and online mental health services, as well as other services such as services related to family violence or child protection.
Information products will be printed for distribution in different forms, for example a fridge magnet or a high quality booklet. A co-design process will be undertaken at the project level for the conceptualisation and initial design of information products, and further co-design will take place at the site level through engagement with Local Reference Groups to ensure relevance to meet the potential needs of each community.
What are the eligibility criteria for the ACDC Project?
There will not be an eligibility criterion for individuals or households with whom People Connectors engage. Rather, the ACDC project will design a selection criterion and use it to select communities within which the project will operate. These communities will be referred as ‘sites’, and People Connectors will be engaged at each site to knock on each door.
There will be three iterations of the project over three years between 2020 and 2022, and for each iteration there will be eight sites. A draft criterion for site selection has been distributed to the project Steering Committee and is able to be shared beyond this group for feedback and comment by request.
Will the ACDC Project target people who are in the court or corrections system?
Privacy and data management considerations mean that ACDC cannot expect, and will not ask, organisations to share names or addresses of people. ACDC is also designed to engage people who are not already known to services. For these reasons ACDC will not target people or households individually. Instead all doors at a selected site will be knocked, and targeting will be at the site level.
How will appropriate referral options for people be ensured?
A part of the site validation process will be determining the local service capacities for responding to needs of people identified through ACDC. This process will be a tailored each potential site, and potential sites which are identified as not having a minimum level of service capacity may possibly be excluded.
ACDC intends to build capacity amongst existing service providers to enable them to offer more effective connection with members of their community. Through the local community engagement at each site, organisations will be identified, and a relationship developed which will enable warm referral pathways.
How are the ACDC Project sites chosen?
Consultations are taking place at a national, state, and local levels with a range of organisations including universities, state and territory mental health peak organisations and selection criterion will soon be agreed. A shortlist of potential sites in each state and territory will be developed in partnership with research and evaluation partners and taken to the Steering Committee for feedback and advice. Once potential sites in each jurisdiction are identified, consultations with local communities to validate the sites will commence. Community stakeholder engaged in the site validation will include local councils, community leaders, service providers and the relevant state or territory mental health peak organisation.
How are you going to deliver ACDC in rural and remote areas where there are no services for the community?
As we all know, in many rural and remote areas there are a limited number of service providers, and large distances which people need to travel to access them. It is important that ACDC includes remote communities and other communities which have limited access to services. Indeed, one of the major objectives of the project is to identify unmet need to advocate for increased services infrastructure in these communities.
However, doing this will lead us into situations where we identify individual needs which may not be able to be immediately met by the existing local services infrastructure. We will be implementing considered risk-focused contingency strategies around this.
Firstly, during our site validation processes, and the initial community engagement, the ACDC team will seek to engage local services and, where required, services in neighbouring localities, to maximise potential support options PCs are able to provide households with. We will include local services in the localisation of the ACDC approach design of the project and the co-design of localised information products. These products will include contact details for telehealth and online mental health supports and our PC’s will talk through ways of accessing these with households. Where a significant need is identified, PC will follow standard protocols for identifying alternative support options and follow up with the household or individual to support a warm referral process where possible. Additionally, ACDC will work with each of our local areas to facilitate community self-help approaches and build capacity for self-advocacy and community-advocacy strategies.
How will you ensure the safety of people connectors?
There are inherent risks with the direct connection approach and these risks not just for our staff but also for people we are visiting. Safety planning will be a crucial activity in the project planning, co-design, and implementation. For the safety and wellbeing of People Connectors, ACDC will:
- Design and deliver training to all People Connectors on personal safety and how to recognise and respond to danger.
- Formalise contractual agreements with People Connector organisations which outline their requirements with regards to WHS of People Connectors; including buddy systems, check-in procedures and professional supervision.
- Arrange that People Connectors operate in teams of two for safety.
- Facilitate Communities of Practice which People Connectors will attend at least monthly.
- Require that People Connectors submit a report to the ACDC team at the end of each day with some data metrics as well as information about and incidents or risks.
- Respond to any risks or incidents promptly through liaison with management at the People Connector organisation.
Will ACDC really make a difference for people?
As far as we are aware, the “Direct Connection” or “Proactive Outreach” approach is largely untested in Australia. As such CMHA and our partners are very interested in measuring its efficacy, and a significant investment will be made in research and evaluation of the project.
Given the untested nature of the Direct Connection approach, and the diversity of communities within which the project with operate, the ACDC project will only be a success through strong partnerships and inclusive co-design processes with stakeholders at all levels. As such, CMHA has invested significant resources into building partnerships and into the co-design processes.
How will the outcomes, and the success of the project, be measured?
There are several intended outcomes of the ACDC Project, and some will be easier to measure and report on than others. Measurable objectives could include:
- Number of People Connector engagements
- Number of each information project distributed
- Number of referrals made
- Number of successful referrals made
- Number of community initiatives established.
A significant investment is being made in the evaluation of the ACDC project, which will report on the efficacy and the return on investment of the ACDC project, as well as how well the project met its stated objectives.
CMHA is currently consulting with universities and researchers to develop an evaluation approach and methodology.
What happens at the end of 2022?
The project is intended to conclude in November 2022. By this time People Connectors will have distributed information about local and national mental health services to up to 45,000 individuals and households and will have provided assistance to make referrals for those who required and consented to this.
Significant research, data analysis and the project evaluation will have concluded by this time, and final reports will be being prepared. Significant findings will have been shared at conferences, and an analysis of the return on investment of the direct connection approach will have been made available publicly. All personal data will be de-identified and destroyed in line with the terms of the ACDC data collection consent form.
The ACDC kit will be completed and made available publicly for adaption and use by any organisation in future iterations of the ACDC project.