On 20 August Nous Principal Ian Thompson chaired a CEDA panel discussion on mental health policy reform in Australia. Joining him on the panel were David Coleman MP, Federal Assistant Minister to the Prime Minister for Mental Health and Suicide Prevention, and Bronnie Taylor MLC, NSW Minister for Mental Health, Regional, Youth and Women. Here are some key insights from that discussion.
Last December the National Federation Reform Council responded to the Productivity Commission’s latest report on mental health. In its response, the Council agreed to collaborate on systemic, whole-of-governments reform to deliver a coordinated, consumer-focused and compassionate mental health and suicide prevention system. This was to be achieved through a new national agreement negotiated through the Health National Cabinet Reform Committee by November 2021.
But there is a long way to go before the Productivity Commission’s recommendations are in place. Our panellists identified some priorities.
Early intervention is a vital component of optimising the mental health system; we must get better at prevention, education and screening.
Federally, $1.4 billion is being invested in delivering better early intervention care. This includes 57 new multi-disciplinary health centres encompassing adult Head to Health centres, Headspace youth centres and Head to Health kids’ centres.
“Head to Health will become a major network of centres across the country where people can go to get help,” Mr Coleman said. “Multidisciplinary teams will be kept in these centres to keep people out of hospital, reduce wait times and help people connect with the services they need.”
In NSW, a reduction in suicide over the past decade is a testament to the improvement in services’ effectiveness. Investment in services like perinatal and parenting services and the very effective school nurse program, along with sports programs like the partnership with the National Rugby League, have contributed. Myriad services contribute in different ways, as different things work for different people.
The highest ever number of calls to Lifeline in the previous month is a testament to the growing awareness of such services’ accessibility. This has resulted not only from service availability but also from “decades of breaking down stigma about mental health stigma”, according to Ms Taylor. Although we don’t want to rejoice in so many ringing Lifeline, “isn’t it fantastic that they feel that they can, and what a huge change in our approach to mental health”.
Peer support is also valuable. Just like cancer patients at the beginning of treatment seek the lived experience of others who’ve gone through it before, so people experiencing mental ill health can benefit from such support.
Although early intervention is crucial, currently there is also a ‘missing middle’ in the system, where those with mental ill health who are not sick enough for acute care but too sick for primary care may be missing out. Young people, adolescents and increasingly children are at particular risk.
These ‘missing’ consumers need more care than is traditionally available but do not yet require acute care access. As Mr Coleman explained, $800 million has been spent federally on this issue, including $487 million to establish a network of Head to Health centres, $280 million for the expansion of Headspace, more clinical places and multidisciplinary, team-based care.
As consumers increasingly turn online for services – particularly during the COVID-19 pandemic – mental health services must similarly make even more of the digital opportunity, as argued by the Productivity Commission.
Head to Health is doing just that. As Mr Coleman explained, the Australian Government is “investing in a major digital platform under the Head to Health brand so that people can get help online. In time this platform will become a central part of our mental health system.”
Australia’s mental health system must be better connected. It must treat people with care and compassion and have a single, relentless focus: consumer outcomes. An individual should only have to tell their story once and follow one path, with no maze to navigate and no wrong door to enter.
Just like people with other chronic conditions, mental health consumers may go back into the system after exiting it: when this happens, their information should be there. Ultimately, an individual doesn’t care which body or level of government is giving the service – they just want a seamless system that works and delivers clear and compassionate care.
To achieve this, major structural reform is needed. The federal, state and territory governments must work together closely. Different location-specific models of care, data and outcomes must be shared. There must be agreement on everyone’s roles and responsibilities within the system, with reduced duplication and fragmentation and increased clarity and focus.
Consistency in the standards used for consumer intake and assessment is central to a new, more coordinated system. This includes consistency of the response provided by different services and continuity of care supported by improved information sharing between providers. Cooperation on how services are selected for funding, so that every dollar works as hard as it can, is also vital.
Over the 30 years since Australia’s first mental health strategy, significant progress has been made – but challenges in accessing services and care continue.
Increased focus and effort at all levels of government are a promising sign of things to come as we continue to strive for a more coordinated, integrated and consumer-centred Australian mental health system.
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