Psychosocial Support Program (PSP) - Remote

Psychosocial Support Program - Remote Communities Online Referral

What is the Psychosocial Support Remote Program?

The Psychosocial Support Program (PSP) Remote, provides culturally responsive, trauma-informed psychosocial support for people aged 16 to 64 who are living with mental health concerns or a diagnosed mental illness. Our strength-based, participant-led approach, focuses on Social and Emotional Wellbeing (SEWB), helping people build their capacity and confidence to live a full life.

Support is available within Jabiru, Gunbalanya, Maningrida, Wadeye and Daly River Community.

TeamHEALTH actively promotes and supports an inclusive and diverse culture. We welcome all people, regardless of age, gender, race, ability, sexual orientation, faith, religion and all other identities represented in our community.

I consent to this referral/ verbal consent has been gained to complete this referral. I understand that this information will be stored on the TeamHEALTH system and that my details will be de-identified if they are used in reporting. I give permission for TeamHEALTH to discuss this information for the purposes of establishing and receiving supports.

TeamHEALTH uses personal information to assist in the coordination and provision of services. Individuals are not required by law to provide this information or consent to this proposed use and disclosure of information. The information provided to TeamHEALTH will be stored in accordance with the Australian Privacy Principles established under the Privacy Act 1998 (Commonwealth) and Northern Territory of Australia Information Act.

Northern Territory Primary Health Network (PHN) is the funder of this service and uses de-identified information for future planning of mental health services across the Northern Territory, as well as for quality improvement and monitoring service delivery.

If you provide consent, your personal information will be de-identified and shared with Northern Territory PHN. This de-identified information includes information such as your gender, date of birth, and the types of services you receive. De-identified infromation does not include your name, your address, or your Medicare number. To ensure your privacy is protected, only Northern Territory PHN staff who are authorised to see the de-identified information will be able to do so.

If you refuse consent, we will still provide this service to you. Your information will not be given to the Northern Territory PHN.

Please call TeamHEALTH on 1300 780 081 if you need any assistance completing this form.

TeamHEALTH will contact the participant or Public Guardian within two working days of receiving this form.