Purpose:
Prevalent mental health problems such as anxiety and depression remain under-recognised in the palliative care setting. Mental illness and life-limiting physical health conditions often aggravate one another, and co-management of these requires specialist skills. This Level 6 Palliative Care Service is located within one of the most socially disadvantaged geographical areas of Australia, and large gaps exist in the recognition and management of mental health problems at end-of-life. This project aimed to address these gaps.

Methodology
Collaborative care networks were developed to build service delivery capacity. Psychology services were sourced through a brokerage agreement with a local non-government agency. Thus specialist mental health skills were integrated into an established palliative care multidisciplinary team.
Following the introduction of pain and distress screening tools across the service, a pathway of care was developed to meet identified mental health needs of patients and their families. Direct clinical work was provided by psychology and up-skilled members of the multidisciplinary team. Clinical services were designed to be applicable to all patients regardless of site of care.

Results
Previously mental health needs, when identified, were met by a general psycho-social team or through referral to external agencies where wait-times were often in excess of 4 weeks and office based. Following this re-orientation of service delivery, 137 referrals were made within the first year, 87 receiving interventions within a week. All were able to choose the venue of appointment.
Education and Trainings sessions were held across 8 community palliative care teams (2 metropolitan and 6 rural).
SMIP was the winner of the 2011 S.A. Health Ministers Award for Innovation.

Conclusion
The development of this sustainable, integrated and collaborative service delivery model is a promising foundation for improving the mental health of families in receipt of palliative care. Future directions include extension to an early intervention focus