MiSalud Health’s Post

A couple of weeks ago I received a Freedom of Information request from the Department of Health (Vic) releasing the Hospital in the Home evaluation. I was part of an excellent evaluation team that looked at this trial program run in Barwon Health and Orygen Youth Health. The evaluation was provided in October 2022, but it was never released, so I personally FOI'd it for our collective learning & benefit. Releasing this here in my personal capacity. A couple of headline findings: 💠 People (consumers & carers) preferred a HitH admission to an inpatient admission, they were very clear with me on this 💠 The costs at first were more expensive than an inpatient admission, but as the program matured, the costs were getting dramatically better 💠 One of the biggest reasons for people's preference for HitH was that being in a home environment rather than hospital environment redressed power imbalances - for many (others might feel different) it was less institutionalising 💠 Generally speaking, consumers had more choice and control over their treatment 💠 Workers - LE and non-LE - had really positive experiences working in HitH 💠 Still, both services showed little-to-no understanding of their legal obligations to seek informed consent, meaning they risked regularly breaching the Mental Health Act 2014 and there was no evidence of compliance with the Charter 💠 Non-lived experience workforces had issues with understanding the value of and ability to engage with, critical lived experience perspective workers. The report provided considerations (aka recommendations), to consolidate the good and remedy the imperfect above + reaffirmed recommendation 11 of the Royal Commission into Vic's MH System to expand HitH by the end of 2022. To date, there's been no evidence provided by the government that this has been expanded. From my personal perspective, I don't want to overstate the innovation here. A lot of the benefits came from being outside the four walls of hospitals that transform people into objects. There remain several issues with HitH. BUT those are an expression of ongoing systemic, cultural, human rights and lived experience organisational readiness factors within designated mental health services and government policy. My view is that no single extra bed should be added to any inpatient unit, when we have a less restrictive and less institutionalising option here, alongside other (arguably more impressive) initiatives like the Healing Place (a lived experience led service). These are less harmful alternatives than the status quo. You can also find it on my website here: https://lnkd.in/gdZwaMRE What do you reckon? Take a read of the eval yourself.

Therapists, let’s commit to being radically honest with graduate students and aspiring private practice clinicians... 1️⃣ Private practice isn’t for everyone. If you try it and find it’s not for you, that’s not a failure—it’s a realization about what works best for you. A career in mental health care is and can be so much more then sitting across from someone providing therapy. 2️⃣ Private practice is easier without major financial burdens. Therapists who can live rent-free with family or split expenses with roommates have a significant advantage when starting out. 3️⃣ Private practice is easier if you have reliable childcare or a partner who can share the load. 4️⃣ Private practice is easier when your partner has a stable job with benefits. This can alleviate financial stress while you grow your practice. 5️⃣ Private practice is easier with a social circle that respects your priorities. Friends who understand your business focus and emotional bandwidth are invaluable. 6️⃣ Private practice is easier with a strong support system. Supportive family, friends, or mentors can make all the difference. 7️⃣ Private practice is easier with financial literacy and resources. Having savings, good credit, or access to loans/grants can sustain you through the 1–3 years it might take to turn a profit. 8️⃣ Private practice is easier if you have time. Time to read, network, listen to podcasts, and grow your knowledge base is critical. ⭐ Private practice is, inherently, a privilege. ⭐ This isn’t to say success is impossible—but we must be upfront about the realities. Notice the word “easier.” Many hopeful therapists are sold the idea that private practice offers financial freedom or schedule flexibility. The truth? It’s a service-based industry where your income directly depends on the hours you work, and there are only so many hours in a day. That’s why many experienced therapists diversify their income streams over time. They supplement their love for the craft with teaching, consulting, or other ventures. I can’t stand seeing therapy influencers promise a six-figure income by simply following a formula. Yes, it’s possible—but not without acknowledging the privilege, effort, and sacrifices required. This messaging isolates those who struggle, making them feel like failures when they aren’t. If you’re struggling, it’s not your fault. Let’s be honest with our students and peers about what it really takes to succeed in private practice. Therapists, what would you like to add? #mentalhealth #privatepractice #mentalhealthcounseling #mentalhealththerapy #therapists #therapy #clinicalsupervision

Therapists, let’s commit to being radically honest with graduate students and aspiring private practice clinicians... 1️⃣ Private practice isn’t for everyone. If you try it and find it’s not for you, that’s not a failure—it’s a realization about what works best for you. A career in mental health care is and can be so much more then sitting across from someone providing therapy. 2️⃣ Private practice is easier without major financial burdens. Therapists who can live rent-free with family or split expenses with roommates have a significant advantage when starting out. 3️⃣ Private practice is easier if you have reliable childcare or a partner who can share the load. 4️⃣ Private practice is easier when your partner has a stable job with benefits. This can alleviate financial stress while you grow your practice. 5️⃣ Private practice is easier with a social circle that respects your priorities. Friends who understand your business focus and emotional bandwidth are invaluable. 6️⃣ Private practice is easier with a strong support system. Supportive family, friends, or mentors can make all the difference. 7️⃣ Private practice is easier with financial literacy and resources. Having savings, good credit, or access to loans/grants can sustain you through the 1–3 years it might take to turn a profit. 8️⃣ Private practice is easier if you have time. Time to read, network, listen to podcasts, and grow your knowledge base is critical. ⭐ Private practice is, inherently, a privilege. ⭐ This isn’t to say success is impossible—but we must be upfront about the realities. Notice the word “easier.” Many hopeful therapists are sold the idea that private practice offers financial freedom or schedule flexibility. The truth? It’s a service-based industry where your income directly depends on the hours you work, and there are only so many hours in a day. That’s why many experienced therapists diversify their income streams over time. They supplement their love for the craft with teaching, consulting, or other ventures. I can’t stand seeing therapy influencers promise a six-figure income by simply following a formula. Yes, it’s possible—but not without acknowledging the privilege, effort, and sacrifices required. This messaging isolates those who struggle, making them feel like failures when they aren’t. If you’re struggling, it’s not your fault. Let’s be honest with our students and peers about what it really takes to succeed in private practice. Therapists, what would you like to add? #mentalhealth #privatepractice #mentalhealthcounseling #mentalhealththerapy #therapists #therapy #clinicalsupervision