Tuesday, 21 April 2015

Mental health report and recommendations that the Abbott Government didn't want you to see until it had worked out how to pass the buck to the states

Australian Health Minister Sussan Ley has had the four-volume National Review of Mental Health Programmes and Services since 1 December 2014.

Despite the report being leaked to Crikey, she insisted on 15 April 2015 that; there was no sense in releasing the report before the Government had formulated a response.

On 19 April Crikey Insider sent out access links to all four volumes to its readers.

The Abbott Government has now released the full report which can be read at leisure on the Mental Health Commission website.

The report makes 25 recommendations:

Summary of recommendations

1. Set clear roles and accountabilities to shape a person-centred mental health system

Rec 1. Agree the Commonwealth’s role in mental health is through national leadership
and regional integration, including integrated primary and mental health care.

Rec 2. Develop, agree and implement a National Mental Health and Suicide Prevention
Plan with states and territories, in collaboration with people with lived
experience, their families and support people.

Rec 3. Urgently clarify the eligibility criteria for access to the National Disability
Insurance Scheme (NDIS) for people with disability arising from mental illness
and ensure the provision of current funding into the NDIS allows for a significant
Tier 2 system of community supports.

2. Agree and implement national targets and local organisational performance measures

Rec 4. Adopt a small number of important, ambitious and achievable national targets
to guide policy decisions and directions in mental health and suicide prevention.

Rec 5. Make Aboriginal and Torres Strait Islander mental health a national priority and
agree an additional COAG Closing the Gap target specifically for mental health.

Rec 6. Tie receipt of ongoing Commonwealth funding for government, NGO and
privately provided services to demonstrated performance, and use of a single
care plan and eHealth record for those with complex needs.

3. Shift funding priorities from hospitals and income support to community and primary health care services

Rec 7. Reallocate a minimum of $1 billion in Commonwealth acute hospital funding in
the forward estimates over the five years from 2017–18 into more community based
psychosocial, primary and community mental health services.

Rec 8. Extend the scope of Primary Health Networks (renamed Primary and Mental
Health Networks – PMHNs) as the key regional architecture for equitable
planning and purchasing of mental health programmes, services and integrated
care pathways.

Rec 9. Bundle-up programmes and boost the role and capacity of NGOs and other
service providers to provide more comprehensive, integrated and higher-level
mental health services and support for people, their families and supporters.

Rec 10. Improve service equity for rural and remote communities through place-based
models of care.

4. Empower and support self-care and implement a new model of stepped care across Australia

Rec 11. Promote easy access to self-help options to help people, their families and
communities to support themselves and each other, and improve ease of
navigation for stepping through the mental health system.

Rec 12. Strengthen the central role of GPs in mental health care through incentives for
use of evidence-based practice guidelines, changes to the Medicare Benefits
Schedule and staged implementation of Medical Homes for Mental Health.

Rec 13. Enhance access to the Better Access programme for those who need it most
through changed eligibility and payment arrangements and a more equitable
geographical distribution of psychological services.

Rec 14. Introduce incentives to include pharmacists as key members of the mental
health care team.

5. Promote the wellbeing and mental health of the Australian community, beginning with a healthy start to life

Rec 15. Build resilience and targeted interventions for families with children, both
collectively and with those with emerging behavioural issues, distress and
mental health difficulties.

Rec 16. Identify, develop and implement a national framework to support families and
communities in the prevention of trauma from maltreatment during infancy and
early childhood, and to support those impacted by childhood trauma.

Rec 17. Use evidence, evaluation and incentives to reduce stigma, build capacity and
respond to the diversity of needs of different population groups.

6. Expand dedicated mental health and social and emotional wellbeing teams for
Aboriginal and Torres Strait Islander people

Rec 18. Establish mental health and social and emotional wellbeing teams in Indigenous
Primary Health Care Organisations (including Aboriginal Community-Controlled
Services), linked to Aboriginal and Torres Strait Islander specialist mental health

7. Reduce suicides and suicide attempts by 50 per cent over the next decade

Rec 19. Establish 12 regions across Australia as the first wave for nationwide
introduction of sustainable, comprehensive, whole-of-community approaches to
suicide prevention.

8. Build workforce and research capacity to support systems change

Rec 20. Improve research capacity and impact by doubling the share of existing and
future allocations of research funding for mental health over the next five years,
with a priority on supporting strategic research that responds to policy
directions and community needs.

Rec 21. Improve supply, productivity and access for mental health nurses and the
mental health peer workforce.

Rec 22. Improve education and training of the mental health and associated workforce
to deploy evidence-based treatment.

Rec 23. Require evidence-based approaches on mental health and wellbeing to be
adopted in early childhood worker and teacher training and continuing
professional development.

9. Improve access to services and support through innovative technologies

Rec 24. Improve emergency access to the right telephone and internet-based forms of
crisis support and link crisis support services to ongoing online and offline forms
of information/education, monitoring and clinical intervention.

Rec 25. Implement cost-effective second and third generation e-mental health solutions
that build sustained self-help, link to biometric monitoring and provide direct clinical
support strategies or enhance the effectiveness of local services.

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