Challenge 1: Helping plan youth mental health interventions

Challenge Statement: How do we intervene with young people who need mental health care needs to make sure that they are provided with fully-integrated services?

Supporting Mentors

Aoife Griffin, General Manager Networks HBF 

Pamela Whelan, Senior Clinical Advisor HBF 

Jake Parkin, Head of Analytics and Insights HBF 

Jasmin Sidhu, Analytics Translator HBF 

Lynne Walker, CEO Perth Clinic 

Rachel Whitely, Perth Clinic 

Potential Focus Questions 

This is a complex Challenge, and you may find it useful to consider the following questions when building out your prototype:

  • Could we identify the cohort at first presentation to either Primary care (GP clinic) or emergency department?
  • Could we visualise patient journey from first presentation and the subsequent hospital admissions that follow?
  • Could we identify patients and/or members of private health insurance who have repeated admissions or presentations to ED or GP clinics that could divert to an alternative treatment path if available?
  • Can we identify key diagnostic groups who experience higher rates of presentation than other diagnostic groups?
  • Are there identifiable triggers for mental health presentation for this cohort?
  • Is there evidence of an ‘ideal’ integrated care pathway?
  • How can we ‘activate’ young private health insurance members to consider their mental health?
  • What is the cost-benefit to providers, funders and individuals of effective integrated mental health care for young people?

Critical Concepts 

The percentage of people aged 16-24 years who experienced a mental health disorder in the previous 12 months has increased from 26% in 2007 to 39% in the period between 2020 and 2022. The increase over this time span is greatest for young females (from 29% to 46%) compared to young males (from 23% to 32%).

In 2019, there were 461 deaths by suicide among young people aged 15–24, a rate of 14 per 100,000 young people.

Some aspects of mental health care can be covered on private health insurance, including hospital admissions and psychology services. Private hospital insurance covers the cost of hospital accommodation and a portion of the medical fees. Unlike other pre-existing conditions, which normally require you to complete 12 months of membership before you can be covered for a hospital admission, psychiatric services and rehabilitation only require a 2 month waiting period, even if the condition is pre-existing. This means you can be covered 2 months after commencing a policy.

About 1 in 5 hospital claims for privately insured patients under 30 were for the hospital treatment and care of patients with psychiatric, mental, addiction or behavioural disorders (PHA).

In the year to 202, benefits paid by PHI for in-hospital mental health care claims totalled $628M, a 3.4% increase on the previous year (DoH). Under extras or ancillary cover (services for out-of-hospital medical care), PHI paid an additional $31.8M in total for member’s claims for psychology/group therapy services, a 0.2% increase on the previous year (APRA).

You may want to talk to your Challenge Mentors about the following ideas as you develop your prototype:

  • Current available pathways for this cohort.
  • Current models of care in public/private sector.
  • The legislation that determines the care that can be paid for in the private sector.
  • Predictive machine learning models for comparison.
  • Model validation methodology.
  • Outcomes of the machine learning model to be potentially applied in clinical care.
  • Alternative models of care that could be supported whilst also addressing the workforce shortage in this space i.e. Psychiatrists.
  • Alternative settings that would lead to early detection and intervention (can be little touch etc)

Supporting Data Sets 

The HBF Health Hospital Episodes data contains both patient demographic and diagnostic classification data for individuals who experienced a hospital episode and claimed for said episode through their HBF Health Insurance policy and includes data from July 2014 to August 2024. This data is real-world data and as such certain sensitive values, such as customer and hospital identifiers, have been hashed to ensure the privacy of our members. If any of you are unfamiliar with hashing this website is a great introduction.

The data set contains data covering a wide range of hospital admissions and not just the episodes relating directly to the question your team will be tackling, this is by design.  

Other variables include;  

  • Financial data on the hospital stay: 
  • Amount charged by Hospital 
  • Amount Charged by Specialist  
  • Amount paid by HBF 
  • Number of services received 
  • Allied health components  
  • Product Information: 
  • The Hospital product the patient held at admission  
  • The Extras product the patient held at admission 
  • Patient data: 
  • Age at admission 
  • Postcode at admission 
  • Sex 

 

Other data sources:  

Potential Solution Pathways

You are free to resolve this Challenge by developing your prototype in whatever means you may like. Our mentors, partners and organising team have thought of the following techniques as being viable methods to resolve the Challenge:   

  • Identify geographic, demographic or behavioural hot spots for service delivery 
  • Identify young individuals at risk of mental health issues 
  • Create tailored treatment plans based on individual patient data, including their medical history, preferences, and response to previous treatments 
  • Power a digital health platform 
  • Optimise the allocation of resources, such as mental health professionals and support services, ensuring that they are available where and when they are needed most 
  • Track the outcomes of different interventions and treatments, providing insights into what works best for different individuals