MENTAL HEALTH
CARERS ARAFMI
NSW INC.
Summary of the Australian Government Response to Contributing Lives, Thriving Communities –
Review of Mental Health Programmes and Services
Summary of Response
The National Mental Health Commission’s Review of MH Programmes and Services Contributing
Lives, Existing Communities highlighted the fragmentation and complexity of the mental health
system which formed a clear need for long term sustainable reform in Australia.
Key system wide problems highlighted in the review included:
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Fragmentation, inefficiency, duplication and lack of planning at a local level
Service delivery which is based on the needs of providers rather than on consumer choice
Intervention too late, with emphasis on acute crisis and disability rather than on early
intervention and prevention
A one size fits all approach rather than an individual and tailored response for consumers
Underutilisation of innovative approaches to use workforce and technology
The Commission highlighted the economic cost and social burden of mental illness, with estimates
up to costing Australian 40 billion annually, however this can be avoided if the right response is
ensured by the Government so that if people get help at the right time then they can lead a
productive life in the community and contribute to society and the economy. The Government has
looked at the problems raised by the Commission and is establishing a plan for action including the
establishment of an expert reference group to look at the implementation of the reviews
recommendations and collaborating with the mental health sector, including consultation with
experts on Indigenous issues and suicide prevention. (p.g.2)
This response presents a system-level change in the Governments role in funding and reform, which
is based on the following:
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Person centred care
Thinking nationally but acting locally
Delivering services using a stepped care approach
Early intervention and prevention
Making use of Australia’s world leading digital technology
Strengthening national leadership – facilitating systemic change at all levels (p.g.2)
The Case for Reform by the Commission
The Commissions review concluded that the current mental health system is poorly planned,
fragmented and lacks unity as a whole, resulting in poorer outcomes for health and social and
economic perspectives. The review found that the effectiveness (or rather ineffectiveness) of
services and programmes was impacted by poor policy design which then results in poor
implementation and outcomes, despite the best efforts of dedicated and hardworking individuals
within these services. Focus is on crisis and acute care rather than early intervention and prevention,
when people’s quality of life can be greatly improved if they had accessed the right services at the
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MENTAL HEALTH
CARERS ARAFMI
NSW INC.
right time. Some services and programmes are using the one size fits all approach, with people with
complex and severe mental health issues not getting the coordinated support that they need, with
lack of integration between clinical and broader social supports, and duplication across
governments. The review also found that focus around suicide in Australia is fragmented and lacks
focus, with people who have tried to commit suicide not getting the appropriate follow up or
support after their suicide attempt, which is a high risk period (p.g.5)
Immediate Action to Reform Programmes and Services
The Government is clear that immediate action needs to be taken for the reform of the mental
health system. Work will immediately commence on the following areas:
1) Locally planned and commissioned mental health services through Primary Health
Networks and establishment of a flexible primary health care funding pool
 Development of evidence based regional mental health plans
 Bette sharing of consumer history and information between service providers and
consumers
 Referral pathways to ensure consumers get the support that they need
 Strategies to target the needs of people in rural and remote areas and other under service
populations
 Development of region specific approaches to early intervention to support children and
young people
 Development of a new approach to suicide prevention (p.g.11)
2) Accessibility to a digital mental health gateway
 The gateway will provide consumers with the right tools and information they need to
navigate the mental health system and make informed choices about their care
 It will bring together existing evidence based information, advice and digital MH treatment,
using a centralised telephone and web portal.
 It will promote the use of low cost and evidence based interventions (p.g.12)
3) Refocusing primary mental health care programmes and services to support a stepped
care model
 The government will redesign existing programmes over a 3 year period to match different
levels of consumer needs by:
 Promoting the new digital mental health gateway
 Using new pooled flexible funding commissioned through PHNs to support the development
and delivery of cost effective low intensity services for people with mild mental illness
 Developing new funding models to support people with severe and complex mental illnesses
 Strengthening support to GPs in undertaking assessment to make sure that consumers are
referred to the best services for their needs (p.g.13)
4) Integrated support for children’s mental health
State Office Address:
Suite 501, Level 5, 80 William St
Woolloomooloo, NSW, 2011
ABN: 70 653 824 650
P: (02) 9332 0777
W: www.arafmi.org
E: admin@arafmi.org
Information & Support Line
1800 655 198 – Free Call
MENTAL HEALTH
CARERS ARAFMI
NSW INC.
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Single integrated end to end school based mental health programme
Easy access for children and young people to telephone and web based information, and to
stepped care arrangements through PHNs
A national workforce support initiative assisting clinical and non-clinical professionals and
services who work with children
Partnership approaches at a regional level between clinical and non-clinical support
services(p.g.15)
5) Integrated and equitable approach for youth mental health
 The government will undertake a trial of specialised employment support to assist young
people up to the age of 25 with mental illness in addressing their educational/vocational
goals, and professional employment specialists will be integrated into youth mental health
services
 Ensure headspace and other youth mental health services are integrated at a regional level
with primary care services through PHNs
 Exploring opportunities to use available youth mental health funding to provide early
intervention for a broader group of young people who present with a severe mental illness
or risk of this (p.g.16)
6) Integrated aboriginal and Torres Strait Islander mental health and social and emotional
wellbeing services
 The Commonwealth will increase access to culturally sensitive mental health services for
Indigenous people
 This will include seeking a better joined up approach to social and emotional wellbeing
support, mental health, suicide prevention and AOD services
 Mental health is a high priority within the implementation plan for the national Aboriginal
and Torres Strait Islander health plan 2013-2023 (p.g.16)
7) A renewed approach to suicide prevention
 National leadership and infrastructure including evidence based population level activity and
crisis support services
 Planned regional approach to community based suicide prevention
 Refocusing efforts to prevent Indigenous suicide
 Working with state and territory governments to ensure effective post discharge follow up
for people who have self-harmed or attempted suicide (p.g.17)
8) Improving coordination of care for people with severe and complex mental illness
 Phased implementation of funding models and payment options for which funding would
follow the consumers’ needs
 Enhancing services delivered by MH nurses
State Office Address:
Suite 501, Level 5, 80 William St
Woolloomooloo, NSW, 2011
ABN: 70 653 824 650
P: (02) 9332 0777
W: www.arafmi.org
E: admin@arafmi.org
Information & Support Line
1800 655 198 – Free Call
MENTAL HEALTH
CARERS ARAFMI
NSW INC.
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Enhancing regionally based clinical assessment arrangements and linking these to NDIS
assessment and referral to Local Hospital Network
Promoting use of a single e-health record
Implementing new arrangements to help support young people with a severe mental illness
or those who are at risk of developing one
Ensuring that the NDIS delivers on its promise as an advance in consumers having choice and
control
Learning from NDIS trial sites to ensure that people with psychosocial disability are well
supported
Ensuring continuity of support for people with a severe mental illness who may not be
eligible for the NDIS
Reviewing progress of the transition to full scheme NDIS to ensure that it is delivering on its
outcomes for people who have a psychosocial disability (p.g.17)
9) National leadership in mental health reform – the Commonwealth will:
 Continue to play a central role in leading the promoting, prevention and early intervention
initiatives and raise awareness of mental illness and ways that people can seek help, and
reducing stigma and promoting accessibility of the new digital gateway
 Provide the responsibility for ensuring the mental health of population groups such as
Indigenous people, humanitarian individuals who have experienced trauma and defence
personnel and veterans
 Promote usage of a single e-health record
 Enhance opportunities for consumer participation including through the development of a
consumer and carer participation framework
 Further develop the evidence base to support national policy and planning, and to improve
the outcomes of people who have a mental illness
 Coordinate data collections and evaluations required to inform system monitoring and
accountability (p.g.18)
What does this mean for Consumers?
Essentially what this means for consumers is what has already been discussed previously. This
includes consumer benefits from a local service system which is planned around their needs (moving
away from the one size fits all approach) including better communication between service providers,
better matched and targeted clinical services to match people’s needs, a new digital gateway which
will provide easy accessibility to information about mental health services, better support for
children with a mental illness or who are at risk including being supported by better informed
parents, teachers, professionals and services; young people who will be able to benefit from
integrated services including mental health and their ability to engage with education, employment,
and AOD problems; integration of services for Indigenous people and the ability to identify links
between MH problems, social and emotional wellbeing, risk of suicide and AOD problems; people at
risk of suicide to be better supported within their community including immediate post attempt
State Office Address:
Suite 501, Level 5, 80 William St
Woolloomooloo, NSW, 2011
ABN: 70 653 824 650
P: (02) 9332 0777
W: www.arafmi.org
E: admin@arafmi.org
Information & Support Line
1800 655 198 – Free Call
MENTAL HEALTH
CARERS ARAFMI
NSW INC.
follow up; and people with severe mental illnesses to benefit from new assessment processes,
services and coordinated support (p.g.19). Essentially the Government has already stated these key
points multiple times throughout their review, but worded differently every time that it proposes
the same key points.
Conclusion
In conclusion, the Government response to the Commissions review is repetitive and offers no real
action points or time frames for these points. Essentially it seems that the Government is agreeing
with the Commissions review of the mental health system, its downfalls, and key points of targeted
reform but are yet to see the exact planning of what and how these key aims will be implemented,
and exact timeframes for the propositions that it is asserting. The Government has proposed a basic
timeframe for some of the changes it wishes to implement, but whether these will be fulfilled come
the timeframe we are yet to see. Essentially the Government is proposing that the key areas for
reform will be reached by 2019 (within the next 4 years) (p.g.22)
State Office Address:
Suite 501, Level 5, 80 William St
Woolloomooloo, NSW, 2011
ABN: 70 653 824 650
P: (02) 9332 0777
W: www.arafmi.org
E: admin@arafmi.org
Information & Support Line
1800 655 198 – Free Call