Environmental Scan of Mental Health Reform in Australia

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Table of contents,1 Executive summary 1,1 1 Introduction 1. 1 2 Purpose of the mental health environmental scan 1. 1 3 Summary of key findings of the environmental scan 2. 2 The context of mental health in Australia 6,2 1 Prevalence and cost of mental illness 6. 2 2 At risk populations for mental health challenges 8. 2 3 Key bodies with responsibility for mental health services in Australia 10. 2 4 Key mental health governance bodies in Australia 14. 2 5 Non veterans access and funding pathway to mental health services 16. 3 Summary of key Australian and international mental health reforms 19. 3 1 Introduction 19, 3 2 Overview of reform activity in Australia between 2013 and 2019 19. 3 3 Current Australian mental health reforms 21, 3 4 Mental health policies from international bodies 24. 3 5 Towards future reform in Australia 27,4 Key reform 1 Suicide prevention planning 29.
4 1 Suicide in Australia prevalence and need for reforms 29. 4 2 Suicide prevention strategies 31,4 3 National Suicide Prevention Trial 33. 4 4 Reducing stigma and discrimination 34,4 5 Suicide prevention research 35. 4 6 Tailored strategies for at risk groups 36, 4 7 Implications for DVA Key reform 1 Suicide prevention planning 39. 5 Key reform 2 Integrated service planning and delivery 42. 5 1 The need for integration 42, 5 2 PHNs and integrating regional service planning and delivery 42. 5 3 The National Disability Insurance Scheme 43, 5 4 Whole of system integration and the social determinants of health 45.
5 5 The stepped care model 47, 5 6 Implications for DVA Key reform 2 Integrated service planning and delivery 48. 6 Key reform 3 Improving quality of care 52,6 1 The need for reform in quality of care 52. 6 2 Safety and quality at the centre of mental health service delivery 52. 6 3 Early intervention and prevention 55, 6 4 Coordinating support for people with severe and complex mental illness 56. 6 5 Mental health workforce development 57, 6 6 Implications for DVA key reform 3 Improving quality of care 57. 7 Key reform 4 Effective system performance and improvement 61. 7 1 The need for reforms in system performance and improvement 61. 7 2 Digital mental health reforms 61,7 3 Data collection and outcome measure reform 63.
7 4 Implications for DVA Key reform 3 Effective system performance and improvement 66. Appendix A Budget documents 2013 to 2019 71, Appendix B Mental health policies from international bodies 77. Appendix C List of documents data and literature reviewed 80. Acronyms and abbreviations,ABS Australian Bureau of Statistics. ACSQHC Australian Commission on Safety and Quality in Health Care. ADF Australian Defence Force, AHMAC Australian Health Ministers Advisory Council. AHSSQA Australian Health Service Safety and Quality Accreditation Scheme. AIHW Australian Institute of Health and Welfare, Better Access Better Access to Psychiatrists Psychologists and General Practitioners. COAG Council of Australian Governments,DVA Department of Veterans Affairs.
ESO Ex Service Organisation, Fifth National Plan Fifth National Mental Health and Suicide Prevention Plan. GDP Gross Domestic Product,GP General Practitioner. HoNOS Health of the Nation Outcome Scales, LGBTI Lesbian Gay Bisexual Transgender and Intersex. LHN Local Hospital Network,LIFE Living is for Everyone Framework. LSP 16 Life Skills Profile,MBS Medicare Benefits Schedule.
NDIA National Disability Insurance Agency,NDIS National Disability Insurance Scheme. NGO Non Government Organisation,NMHC National Mental Health Commission. NSPS National Suicide Prevention Strategy, OECD Organisation for Economic Cooperation and Development. PaRIS Patient Reported Indicators Surveys,PBS Pharmaceutical Benefits Scheme. PHN Primary Health Network,PTSD Post Traumatic Stress Disorder.
NMHC National Mental Health Commission, The Mission The Million Minds Mental Health Research Mission. Open Arms Open Arms Veterans Families Counselling,WHO World Health Organization. WHO AIMS World Health Organization Assessment Instrument for Mental Health System. YES Your Experience of Service,1 Executive summary. 1 1 Introduction, Mental illness is a significant public health issue affecting Australians today it is complex. multidimensional and affects people s ability to fully contribute to society While the Australian. Government has placed considerable efforts into system reform to address mental illness. significant levels of mental ill health still exist which has widespread impacts across a range of. demographics, 1 2 Purpose of the mental health environmental scan.
1 2 1 Context of the report, While mental illness affects the general Australian population there are some population groups. that are at higher risk of or are more susceptible to mental health disorders Among these. population groups are Australian veterans Nearly half of Australian veterans who leave the. Australian Defence Force ADF within five years experience a mental health disorder 1 This. highlights the challenges associated with transitioning out of full time military service and into. civilian life 2 Of equal concern is that only 10 per cent of ex ADF members choose to seek access to. veteran health care services 3, Given the mental health challenges for Australia s population and specifically for the veteran. population EY has been commissioned to conduct an environmental scan of mental health reform. in Australia for the Department of Veterans Affairs DVA The purpose of the engagement is to. 1 Highlight the landmark developments in mental health programs and policy in Australia. between 2013 and 2019, 2 Identify opportunities for the DVA to better align their Veteran Mental Health Strategy 2013. 2023 and other mental health initiatives with the broader advancements in mental health. policy in Australia, 1 2 2 Approach to the environmental scan of mental health reform in Australia. The environmental scan of mental health reform in Australia is largely being undertaken through. desktop research considering key mental health policy and program developments in Australia. between 2013 and 2019 The report focuses predominantly on Federal programs and policies. though considers State and Territory government reform where relevant. The environmental scan also examines mental health policies from international bodies including. the World Health Organization WHO and the Organisation for Economic Co operation and. Development OECD to highlight some of the broader developments occurring in mental health. policy outside of Australia, The implications for the DVA are outlined at the end of each reform section providing.
recommendations that may be incorporated into the DVA s Veteran Mental Health Strategy. Australian Government Department of Veterans Affairs 2018 Mental Health prevalence and pathways to Care viewed. https www dva gov au sites default files files health 20and 20wellbeing research dev socialresearch TWRP. Summary Report PDF, Australian Government Department of Veterans Affairs 2019 Understanding the veteran experience viewed July 2019. https at ease dva gov au professionals client resources mental health advice book 11 understanding veteran. experience,1 2 3 Outline of the report,The structure of the report is outlined below. Section 2 Outlines the context of mental health in Australia focusing on the prevalence of. mental ill health cost and at risk populations The chapter provides an overview of the. Australian mental health system and explains the roles of key mental health service. organisations and governance bodies, Section 3 Provides a high level summary of key Australian mental health reforms between. 2013 2019 and considers mental health policy reforms from the OECD and the WHO. Sections 4 7 Examines key developments in Australian mental health policy across four. broad areas of reform, Section 4 describes mental health reforms in suicide prevention planning. Section 5 describes mental health reforms in integrated service planning and. Section 6 describes mental health reforms in improving quality of care. Section 7 describes mental health reforms in effective system performance and. improvement, 1 3 Summary of key findings of the environmental scan.
Setting the context of mental health in Australia,Prevalence. Almost four million Australians experience a mental illness in any given year. Mental illness contributed to the third highest group of diseases after cancer and. cardiovascular disease and is responsible for an estimated 12 1 per cent of the total. disease impact in Australia, At risk populations that have a higher prevalence of mental illness compared to the rest. of the general population include youth people with a disability males the Lesbian. Gay Bisexual Transgender and Intersex LGBTI community Aboriginal and Torres. Strait Islander people and veterans,Mental health services in Australia. The Australian health system is driven by coordinated action across Commonwealth and. State and Territory governments reflecting their respective legislative policy and. funding responsibilities, Service delivery is commissioned through Primary Health Networks PHNs and. delivered through Local Hospital Networks LHNs, The Medicare Benefits Scheme MBS is a schedule of fees for medical services set by.
the Australian Government It lists a range of medical consultations tests and. procedures that are funded by the Government Many of these services subsidised under. the MBS are delivered by GPs and specialist psychiatrists to meet mental health needs. Governance arrangements of key national reform is primarily led by the Council of. Australian Governments COAG Health Council with input from the Australian Health. Ministers Advisory Council associated Principal Committees and the National Mental. Health Commission NMHC to operationalise planning implementation monitoring and. Mental health care services are accessed via primary health care community based. organisations the public health system and the private health system each with their. own access pathways and funding mechanisms, There are several challenges for Australians in accessing timely mental health care. including the availability and costs of services, Summary of Key Australian and international mental health reforms. Key findings, Key strategies and plans laying the foundation for mental health reform in Australia. Roadmap for National Mental Health Reform 2012 2022 Roadmap 2012 2022. NMHC Contributing Lives Thriving Communities Report of the National Review. of Mental Health Programmes and Services Contributing Lives Thriving. Communities Review, The Australian Government s response to Contributing Lives Thriving. Communities Review, The Fifth National Mental Health and Suicide Prevention Plan Fifth National.
Broad areas of reform include integrated regional planning and service delivery suicide. prevention promoting a person centred and holistic approach to health care and. strengthening targeted early intervention activities. Developments in the international arena by peak bodies such as WHO and the OECD are. in line with Australia s policy development of mental health issues The WHO promotes. mental health in the context of human rights while the OECD approaches mental health. through the lens of economics and development, Enhancements in data collection will be used for international benchmarking to promote. global collaboration measuring progress and knowledge sharing. While Australia fares well internationally in terms of displaying advanced thinking in. mental health strategic planning policy development and national leadership some. areas of implementation are lagging which has resulted in limited improvements in health. Key reform 1 Suicide prevention planning,Key findings. While there have been ongoing suicide prevention efforts in Australia there has not been. a significant reduction in suicide rates over the last decade Current approaches to. suicide prevention have been criticised as being piecemeal with gaps in data on real time. suicide attempts and death and a lack of appropriate suicide prevention training for. health professionals,Recent reforms focus on, Systems based approach to suicide prevention across all levels of government. Suicide prevention strategies aimed at promotion prevention and early. intervention, Suicide prevention trials towards specific at risk populations. Initiatives aimed at reducing stigma and discrimination for those impacted by. mental illness, Investing in suicide prevention research including considering best practice.
interventions, Tailored suicide prevention strategies for at risk groups. Future planning for DVA, Areas for DVA to consider in future planning include. Elevating suicide prevention as a key focus area, Managing the risk of transition in relation to suicide prevention planning. Leveraging community networks as much as possible to provide coordinated care. to veterans and their families,Key reform 2 Integrated service delivery. Key findings, Integrated service delivery is being driven regionally by PHNs that plan and commission.
services to meet local needs, The National Disability Insurance Scheme NDIS provides non clinical support to assist. people with disabilities in their participation of day to day activities and acts as a conduit. The environmental scan of mental health reform in Australia is largely being undertaken through desktop research considering key mental health policy and program developments in Australia between 2013 and 2019 The report focuses predominantly on Federal programs and policies though considers State and Territory government reform where relevant

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