Mary Guthrie House is a 30 bed inpatient unit for persons aged 16-64 who suffer from severe cognitive and psychiatric disability and/or "major neurocognitive disorder" as currently defined in DSM-V.
Given the diverse problems faced by this client group, the unit is split into two areas that provide different focus and expertise:
This is a 10 bed secure ward for persons who need preferrential focus on their psychiatric or "behavioural" disability, rather than their physical disability. It is approved for involuntary psychiatric treatment and staffing includes psychiatry, nursing, allied health, recreation and PSO's (psychiatric service officers). Clients who have additional funding packages may also receive input from external providers, so long as these providers have honorary approval and comply with workforce requirements of Austin Health.
Entry into the unit requires prior assessment by the the BDP Community Team and further discussion at the BDP admissions panel that meets weekly. Such scrutiny is useful for several reasons including:
Admission length is variable depending on the individual's clinical condition and their broader circumstances. It is unusual to get the full benefit of admission in under three months, and most people find that they need 6 to 18 months to engage and meet reasonable goal targets.
Discharge is a planned process that involves the client and family/carers, while follow-up typically involves the BDP Community Team, GP, disability care providers and the client's Area Mental Health Service when required.
|Wattle Protea Unit|
Wattle Protea is a 20 bed secure ward for persons who need preferrential focus on their physical or cognitive disability, rather than their psychiatric disability. It is classified as a nursing home which has several implications, including:
Staffing includes medical, nursing, allied health, recreation and PSO's. Like the Heath Unit, clients with additional funding packages also receive input from external providers, and active attempts are made prior to admission to secure such packages when none exist.
Admission process into Wattle Protea is similar to Heath, though length of stay is typically longer due to the added level of disability seen in this client group. Nevertheless, discharge planning starts early and remains an active item on the client's care plan throughout their admission since the aim of all BDU clients is rehabilitation rather than residency into the unit.
An indicative list of similarities and differences between Heath and Wattle Protea is tabled below:
|Brain impairment criterion||Unrestricted & can include clients with neurodegenerative disorders||Unrestricted & can include clients with neurodegenerative disorders|
|Nature of disability||Focus more on mental health||Focus more on physical disability|
Typically 10-20% of referrals
Typically 10-20% of referrals
|Desired length of stay||3-18 months||6-24 months|
|Legislative compliance||Victorian Mental Health Act||Commonwealth Aged Care Act|
|Accreditation compliance||NSQHS, NSMHS||NSQHS, NSMHS, Aged Care|
|Funding||State||Commonwealth (with State topup)|