Study into the Barriers to Rehabilitation

The ADF Mental Health Lifecycle package seeks to introduce a range of strategic mental health initiatives to improve and integrate mental health across an ADF member’s lifecycle.  One of the studies specified in the package was a Study into the Barriers to Rehabilitation.

There were two objectives of the Barriers to Rehabilitation study.  The first objective was to determine whether there are systematic barriers to successful rehabilitation for DVA clients.  The second objective was to develop and trial mechanisms for ongoing collection of data to allow accurate monitoring of rehabilitation outcomes by DVA.  It was decided that the study would be divided into two phases to address these issues.

Phase 1 – A Study into the Barriers to Rehabilitation

Phase one of the project involved data being collected from a range of data sources which aimed to increase understanding of the rehabilitation process, explore how rehabilitation outcomes are measured,  examine how ‘success’ in rehabilitation is conceptualised, and identify perceived barriers to achieving successful rehabilitation outcomes.

Data was collected from a range of sources including:

  • Interviews with DVA clients;
  • Focus groups with DVA staff;
  • An online survey of rehabilitation service providers;
  • Interviews with key stakeholders; and
  • A review of a sample of DVA case files.

A number of themes emerged from the study. These included the need for improved communication, the importance of a holistic and flexible approach to rehabilitation and improvement of DVA’s administrative process.

For a copy of the full report see:

A Study into the Barriers to Rehabilitation – Phase One Final Report, June 2009

Phase 2 - Evaluating the Feasibility of a Routine Outcome Measure for DVA Rehabilitation Clients

Based on the findings in phase one of the study, phase two of the study addresses the key theme of measurement that would be relevant for all DVA rehabilitation clients.  The method of measuring success selected for the trial was Goal Attainment Scaling (GAS).  Under this approach, targeted goals with well-defined outcomes to be achieved within a specified time are determined for each individual.  A Life Satisfaction Questionnaire (LSQ) was also selected to be included in the trial.

General feedback from the study was positive and analysis supported the feasibility and potential usefulness more broadly of the GAS and LSQ.  The approach was seen by providers to support the client focussed model of rehabilitation and data that can be extracted from both the GAS and LSQ components of the process. GAS measures are potentially useful at a number of levels, including:

  • For the provider in their professional relationship with the client;
  • For Deputy Commissioner’s Business Group (DCBG) Rehabilitation Coordinators to assess the extent to which purchased services have met the needs of clients;
  • For DCBG Rehabilitation Coordinators to consider the extent to which providers are able to set appropriate goals and support clients to achieve them; and
  • For Executive reporting on the overall success of rehabilitation provided to DVA clients.

A number of key recommendations emerged from the trial, these recommendations will assist DVA to further develop rehabilitation service delivery arrangements.

For a copy of the full report see:

A Study into the Barriers to Rehabilitation – Phase Two – Evaluating the Feasibility of a Routine Outcome Measure for DVA Rehabilitation Clients

Evaluation of DVA’s Trial of an Electronic Needs Assessment

In response to phase one of the study, phase two included an evaluation of DVA’s electronic needs assessment (NA). It sought to explore the different factors that may impact the implementation of DVA’s electronic NA process. This evaluation reviewed the compliance and quality of information documented in the electronic NA forms.

A series of qualitative focus groups, interviews and online surveys with key stakeholders were used in the trial to evaluate the success of the electronic NA. General feedback from the study was mixed across needs assessors, managers and major stakeholders who were supportive of the trial but raised concerns about the tool used.

The key recommendations from the trial include:

  • DVA to further support NA staff by providing pre-written, template style paragraphs to use in client letters; thereby ensuring consistency in communication content and style.
  • DVA to investigate a more appropriate IT platform to support more efficient and effective delivery of NAs.
  • Expectations regarding depth of information to be sought in the NA to be made clearer to staff.
  • DVA to investigate the potential impact of the time taken to process (TTTP) key performance indicators (KPI) for liability assessment on early intervention for rehabilitation. Furthermore, DVA should consider developing formal KPI around time taken to commence (but not complete) a NA in combination with a KPI related to quality of the NA process and resulting letters to clients. An audit of NA forms and quality of letters should be routine practice.

Combined, these recommendations have the potential to help DVA provide a more effective and efficient NA process for clients, staff and major stakeholders.

For a copy of the final report see:

A Study into the Barriers to Rehabilitation – Phase Two – Evaluation of DVA’s Trial of an Electronic Needs Assessment, Final Report April 2011

Progress as a Result of the Research Study

    • A review of all Rehabilitation and Compensation letters has been completed by Determination Support & Review (DS&R) with the inclusion of template style paragraphs currently under consideration.
    • A simplified NA paper form has been put into practice nationally.
    • A MRCA/SRCA Needs Assessment Training Package has been implemented by DS&R.
    • Needs Assessment KPIs will be developed subject to completion of the KPMG Benchmarking Exercise of rehabilitation and incapacity payment workloads.