Showcasing: Buduwa Step-Up Step-Down Service

Central and Eastern Sydney

Lead agency
New Horizons in partnership with Sydney Local Health District, Community Mental Health

Living Well domain

Providing the right type of care

Program Overview

The Buduwa Step-Up Step-Down Service is a collaborative partnership between Sydney Local Health District (SLHD) and New Horizons that provide community-based support in a welcoming residential environment to assist with relapse prevention and recovery of people experiencing mental health issues as a hospital alternative.  

“Buduwa is the missing link to prevent unnecessary hospitalisation. A place to step up and recover, or step down out of hospital into a more comfortable and cost-effective facility.”


People living with mental health issues at times require a higher level of support than can be traditionally offered in the home or through community mental health services. Generally, when this higher support is needed people are admitted to hospital. However, an admission to a mental health inpatient unit isn’t always what people need and may not be the best environment to support a person’s recovery.

Considering this, a gap in service was identified for people who required a higher level of support but do not require an acute inpatient admission. Additionally, long admissions to an inpatient unit are not always the best option for people to support recovery. A shorter admission in addition to community based residential support may better support a person’s recovery and assist them to live well in the community. 


Based on the Adult Prevention and Recovery Care (PARC) model  that has been successfully used in Victoria since 2003, the Buduwa program offers a short-term recovery focused residential support and treatment service for existing mental health clients of SLHD. It is provided in a least restrictive and supportive community environment. Length of stay is on average between 22-23 days and up to 28 days if required. 

Buduwa is staffed 24-hours 7 days per week and is based on a mixed staffing model with community support workers, a team leader employed by New Horizons, and clinical staff employed by SLHD. 
The clinical staff also includes a part time psychiatrist and psychiatric registrar. 


Buduwa is jointly funded by New Horizons, SLHD and The NSW Ministry of Health (Community Living Supports funding) and provides an effective partnership through shared care. 

The impact and ongoing development of the program is continually measured using outcome measures, twelve monthly service evaluations and by residents completing the Your Experience of Service Survey. Feedback from the program has identified that Buduwa offers effective support in a least restrictive environment. It allows freedoms of community living, while still offering a high level of psychosocial and clinical support when needed.

Next Steps

Buduwa will continue to be a main stream program in the area to support people in the community and being discharged from hospital. 

A long-term goal, similarly to the PARC model in Melbourne, is to see this model expand across NSW so such care is provided to other Local Health Districts. The service aims to continually demonstrate its value within the community, as well as identifying further funding and properties for expansion across further sites.



1Victorian Government Department of Health 2010, Adult prevention and recovery care (PARC) services framework and operational guidelines, Mental Health, Drugs and Regions Division, Victorian Government, Department of Health, Melbourne, Victoria,