social contacts (limited data) with parents and siblings Economic participation Proportion of clients who commenced paid work, volunteer work, education or training Between 0% and 28% participation across activities and current/former clients Health Proportion of current clients whose health improved (limited data) 87% felt their health had improved or remained the same, compared to one year ago Additional outcomes data available to the previous evaluation in 2010 related to: former clients’ housing situation – 89 per cent were living in stable accommodation, 81 per cent had a well-maintained physical environment, and 72 per cent paid their rent on time personal wellbeing – statistically significant increases were recorded in all areas of personal wellbeing for current clients since entry to the ISP. Other data presented in the outcomes section of this report is not included in the table above because it is descriptive. It relates to current clients’ health and criminal justice service use, and their self-assessed wellbeing. To assess the long-term effectiveness of the ISP, it would be important to obtain outcome data about former clients at intervals after their exit from the ISP. This data would show whether outcomes are maintained or even improved, and what the associated recurrent cost savings are, thus indicating ongoing benefits from ISP investment. Summary of economic analysis Over the three years 2011 to 2014, average Program cost per client per year was $274,000. This was a 15 per cent increase compared to the previous evaluation, probably due to more clients with high support needs in the ISP. Overhead costs decreased during the same three-year period. This evaluation found that Program expenditure has resulted in positive outcomes for many clients, including: reduced risk behaviour and use of health and criminal justice services; increased living skills and social contacts; slightly increased economic participation; and improved self-assessed health. Positive outcomes were consistent with the previous evaluation. Corrective Services financial data showed substantial cost savings once clients entered the ISP, due to fewer days spent in custody. Total costs for
Use of community services Making appointments Please describe how the client’s service use has changed from 1 January 2013 – 30 September 2013: Section 7 – Social and community participation At the moment how often would you say the client has contact with each of the following people? (please tick ) (1) = Daily (2)=More than once a week (3)=Weekly (4)=Every couple of weeks (5) = Monthly (6) = Every couple of months (7)=Yearly (8)=Every couple of years (9)=Never or NA Parents Partner Siblings or other relatives Children Carer Friends Other Please describe how the client’s service use has changed from 1 January 2013 – 30 September 2013: Please tick () the corresponding boxes relating to the clients social and community participation: What is the client’s marital status now? Married/de facto Single (never married) Divorced/separated Widowed Is the client in an intimate relationship at the moment? Yes No Don’t know
Julia (current client) Julia is 31 years old and at age 11 moved to Australia with her family. She contracted encephalitis at age 14, resulting in a brain lesion, and she has schizoaffective disorder and a personality disorder. Julia used various drugs (amphetamines, cocaine, marijuana, heroin, methadone and benzodiazepines), was repeatedly hospitalised for drug-induced psychosis and has had long-term rehabilitation stays in mental health facilities. Julia has not been able to sustain tenancies. Julia is a long-stay client in ISP and is not ready to leave. She receives case management and clinical support and vocational case management. Julia has also engaged in direct therapy throughout her time in ISP, but this has been difficult due to her limited concentration and impulsivity. Julia’ s mental illness causes behaviours such as substance abuse, impulsivity, poor emotional regulation, seeking admission to hospital or interaction with emergency services, inability to foresee consequences of actions, self harm and seeking sexual relations and affection from strangers. Her progress in ISP has recently deteriorated, and ISP is working with NSW Health to identify the cause and appropriate treatments. Meanwhile Julia is receiving a higher level of support. At this point, ISP has not been able to identify a funding source that would provide Julia the opportunity to exit to an appropriate model of support. She is not eligible for direct services provided by Ageing, Disability and Home Care. Community Mental Health have deemed that mental health services may not be appropriate because her challenges primarily result from brain injury and personality disorder. ISP is continuing to look for a funding source.