A new bottom-up method for the standard analysis and comparison of workforce capacity in mental healthcare planning: Demonstration study in the Australian Capital Territory

Mary Anne Furst; Jose A. Salinas-Perez; Mencia R. Gutiérrez-Colosia; Luis Salvador-Carulla

doi:10.1371/journal.pone.0255350

Peer Review History

Original SubmissionFebruary 15, 2021
17 Jun 2021 Decision Letter - Joseph Telfair, Editor PONE-D-21-05096 A new bottom-up method for the standard analysis and comparison of workforce capacity in mental healthcare planning: demonstration study in the Australian Capital Territory PLOS ONE Dear Dr. Furst, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. ============================== The Academic Editor reviewed the manuscript as a second reviewer and agreed that the following question needs to be addressed: "Are counsellors and psychotherapists a sub category of the professions you are listing? It wasn't clear why those professions are not included? For the international audience (which I am one of) possibly clarifying the inclusion of Occupational Therapists (which wouldn't necessarily be an included profession in the United States for mental health services) while not including some of the others might be helpful." Once adequately addressed, the manuscript can move forward for consideration for publication. Please ensure that your decision is justified on PLOS ONE’s publication criteria and not, for example, on novelty or perceived impact. For Lab, Study and Registered Report Protocols: These article types are not expected to include results but may include pilot data. ============================== Please submit your revised manuscript by Aug 01 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. 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Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Interesting study on resources and capacity of the mental health work force. Are counsellors and psychotherapists a sub category of the professions you are listing? It wasn't clear why those professions are not included? For the international audience (which I am one of) possibly clarifying the inclusion of Occupational Therapists (which wouldn't necessarily be an included profession in the United States for mental health services) while not including some of the others might be helpful. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0255350.r001
Revision 1
7 Jul 2021 Author Response Dear Reviewers, Thank you very much for reviewing our paper and we very much appreciate your feedback. Counsellors and psychotherapists are indeed key professionals in mental health care delivery, and you have highlighted a need for us to clarify how we have included this group of professionals, as well as why other professionals not always associated with mental health care, such as occupational therapists, have been included in our study. We have responded to your comments by adding some additional clarification in the manuscript as described below. Reviewer comment: “Interesting study on resources and capacity of the mental health work force. Are counsellors and psychotherapists a sub category of the professions you are listing? It wasn't clear why those professions are not included? For the international audience (which I am one of) possibly clarifying the inclusion of Occupational Therapists (which wouldn't necessarily be an included profession in the United States for mental health services) while not including some of the others might be helpful”. Response: With regard to counsellors, and psychotherapists: we have found that these occupational titles, like many others in mental health, are ambiguous, and may refer to someone from a range of professional backgrounds. A counsellor may be a clinical psychologist or they may have a diploma in counselling for example; a psychotherapist may be a psychiatrist or a psychologist, depending on the jurisdiction. This ambiguity in occupational titles is a huge limitation in any assessment of workforce capacity, as different professionals bring different skills and experience, and thus capacity, to their role (defining “capacity” as we have in the paper: “The term “capacity” follows the Talent Management Model [25] in human resource management as “the knowledge and skills, qualifications and entitlement of an individual to conduct a defined set of activities in practice that defines the maximum ability that exists at present in real world conditions”. It is characterised by the “power, ability or possibility of doing something or performing”) [26]. This concept is different to “capability”, which refers to the higher level of ability that could be demonstrated under the right or ideal conditions. Capacity is also different from current performance, as it takes into account the knowledge and skill set of the individual”). Thus it is important to know the professional background of the person undertaking the role of counsellor or psychotherapist in order to understand the real capacity of the role. For this reason, when identifying the workforce in each service, and where ambiguity exists such as with “counsellor”or “psychotherapist” we also identify the individual’s relevant professional background and include them in the data according to this. So a counsellor who is a clinical psychologist for example is identified as such, and counted as a “core health” professional; while a counsellor with a diploma level qualification in counselling for example, would be included in the data as a non core-health professional; similarly a counsellor with tertiary social work qualifications would be counted as “allied health”. With regard to occupational therapists: as the DESDE service classification system is based on a whole systems approach, we include all people providing direct care in services providing mental health support across all sectors. So although occupational therapists are less commonly employed in mental health care, where we have identified services employing them to provide direct support to a target population of people with mental health or psychosocial needs, they have been included as part of the “allied health professional” group. To clarify these important points in the paper, we have made the following revisions to the manuscript: 1. In paragraph 3 of the introduction, we have added “and counsellors” to the occupational umbrella terms described as ambiguous, so that this sentence now reads: “Umbrella terms such as “case manager” and “counsellor” describe roles which may be occupied by any of several different types of professional, each bringing quite different skill sets”. 2. In paragraph 6, the final paragraph of the methods subsection “Key models, terms and groupings”, we have modified the description of workforce groupings to read as follows: “In our study, we have included all people employed to provide direct support to the target population of each service, according to their professional background. This addresses the issues of ambiguity regarding occupational titles such as “counsellor”, “psychotherapist” or “case manager” where the position may be held by a range of different professionals, and provides a more accurate picture of the real capacity of the workforce accordingly. The “clinical health professionals” group included psychiatrists/registrars, other physicians, psychologists, and nurses; while “allied health professionals” refers to any tertiary qualified allied health professional employed to provide direct care to the target population, such as social workers, or less frequently, occupational therapists”. Attachments Attachment Submitted filename: Response to reviewers.docx https://doi.org/10.1371/journal.pone.0255350.r002
15 Jul 2021 Decision Letter - Joseph Telfair, Editor A new bottom-up method for the standard analysis and comparison of workforce capacity in mental healthcare planning: demonstration study in the Australian Capital Territory PONE-D-21-05096R1 Dear Dr. Furst, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. 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If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Thank you for clarifying the role definitions. If there are licensing or certifications linked to the different job titles that might help with international appeal and relatability. In America our mental health services are governed by licensing which drives specific completion of a degree (Ph.D, PsyD,. SWD, MS, etc). It would be interesting for this study to be duplicated in other countries. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No https://doi.org/10.1371/journal.pone.0255350.r003
Formally Accepted
19 Jul 2021 Acceptance Letter - Joseph Telfair, Editor PONE-D-21-05096R1 A new bottom-up method for the standard analysis and comparison of workforce capacity in mental healthcare planning: demonstration study in the Australian Capital Territory Dear Dr. Furst: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Joseph Telfair Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0255350.r004

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