title: Innovations in primary mental healthcare.
abstract: OBJECTIVE
  We review the evidence on innovations in Tier 2 of the Access to Allied Psychological Services (ATAPS) program, which is designed to facilitate the provision of primary mental healthcare to hard-to-reach and at-risk population groups (including women with perinatal depression, people at risk of self-harm or suicide, people experiencing or at risk of homelessness, people affected by the 2009 Victorian bushfires, people in remote locations, Aboriginal and Torres Strait Islanders and children with mental disorders) and the trialling of new modalities of service delivery (e.g. telephone-based or web-based CBT). The primary focus is on the uptake, outcomes and issues associated with the provision of ATAPS Tier 2.
  
  
  METHODS
  Drawing on data from an ongoing national ATAPS evaluation, including a national minimum dataset, key informant interviews and surveys, the impact of ATAPS innovations is analysed and illustrated through program examples.
  
  
  RESULTS
  ATAPS Tier 2 facilitates access to, uptake of and positive clinical outcomes from primary mental healthcare for population groups with particular needs, although it requires periods of time to implement locally.
  
  
  CONCLUSIONS
  Relatively simple innovations in mental health program design can have important practical ramifications for service provision, extending program reach and improving mental health outcomes for target populations. What is known about the topic? It is recognised that innovative approaches are required to tailor mental health programs for hard-to-reach and at-risk population groups. Divisions of General Practice have implemented innovations in the Access to Allied Psychological Services (ATAPS) program for several years. What does this paper add? Drawing on data from an ongoing national ATAPS evaluation, this paper presents a systematic analysis of the uptake, outcomes and issues associated with provision of the innovative ATAPS program. What are the implications for practitioners? The findings highlight the benefits of introducing innovations in primary mental healthcare in terms of increased access to care and positive consumer outcomes. They also identify challenges to and facilitators of the implementation process, which can inform innovation efforts in other primary care contexts.
authors.affiliation: Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia. l.reifels@unimelb.edu.au
authors.forename: Lennart
authors.initials: L
authors.lastname: Reifels
authors.forename: Bridget
authors.initials: B
authors.lastname: Bassilios
authors.forename: Kylie E
authors.initials: KE
authors.lastname: King
authors.forename: Justine R
authors.initials: JR
authors.lastname: Fletcher
authors.forename: Grant
authors.initials: G
authors.lastname: Blashki
authors.forename: Jane E
authors.initials: JE
authors.lastname: Pirkis
mesh_terms: D000488:Allied Health Personnel / Q000592:standards / Q000639:trends; D001315:Australia; D003159:Community-Institutional Relations / Q000639:trends; D004059:Diffusion of Innovation; D055317:Evidence-Based Practice / Q000592:standards / Q000639:trends*; D006297:Health Services Accessibility / Q000592:standards / Q000639:trends*; D006801:Humans; D008507:Medically Underserved Area; D008605:Mental Health Services / Q000639:trends*; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000639:trends*; D012017:Referral and Consultation / Q000592:standards / Q000639:trends; D017216:Telemedicine / Q000639:trends; D035862:Vulnerable Populations