In early 2014, the Australian Government tasked the National Mental Health Commission with conducting a national review of mental health programmes and services. The focus of the review was on assessing the efficiency and effectiveness of programmes and services in supporting individuals and families affected by mental health conditions. The final 700 page report was released on 16 April 2015.
What did the Review find?
The Commission undertook one of the most detailed reviews of Australia’s mental health sector to date. Overall, the Commission found that our mental health system – while good – is not performing at its peak. Many people who experience mental health problems, and their families, have a poor experience of mental health care – current services aren't designed with people's needs at their heart, they often don’t meet people’s needs and are difficult to access. Also, suicide rates in the community remain stubbornly high.
What does the Review recommend doing?
The Review provides 25 recommendations for how Australia's mental health system can be improved. Some of the main changes proposed include:
- Increase investment in programmes to help prevent mental health conditions from developing in the first place. This would be done by giving people the information and skills needed to look after their own mental health, and promoting good mental health through early childhood settings, schools and workplaces. This means everybody can play a role in talking about and promoting good mental health.
- Ensure mental health services and supports are focused on the needs of individuals, their families and support people – rather than people with mental health problems having to organise themselves around service providers.
- Create a ‘stepped-care’ approach where people get integrated physical and mental health care matched to their needs. This would range from easy access to information, self-help programmes, peer support, or brief intervention from a trained professional, right through to comprehensive care provided by GPs, mental health specialists and non-government organisations that enable people to stay connected to family and friends, to get a good education and meaningful work.
- Make mental health supports and services easier to access and easier to use by linking telephone, online and face-to-face programmes and services through technology. This would also enable access for everyone across Australia regardless of where they live.
- Introduce a comprehensive approach to suicide prevention by bringing together in regions activities and approaches that are proven to work. A national framework would guide action by local community partnerships.
To support these changes, the Review recommends changing the way mental health services and supports are organised. The Commonwealth, State and Territory governments should work together to agree on their respective roles and responsibilities, which are currently blurred. New Primary and Mental Health Networks should be used to ensure that support and services are delivered in ways that respond to local community needs. People and families affected by mental health problems should always be involved in planning and decision-making.
The Review also argues that we need to get the most out of funding that is already available; although it acknowledges that additional funding may be needed. This means reducing duplication and waste, shifting funding to where it can make the most difference – such as prevention, early intervention and community-based care.
For example, the Commission reports that it costs on average $10,000 to treat one person for nine days in hospital, and the same amount to support someone to stay well in the community for an entire year.
It also means giving extra attention to people and communities who need it most, including Aboriginal and Torres Strait Islander people, people living in rural and remote areas, and children and families.
National performance and outcome targets need to be set – including reducing suicide rates by 50 per cent over 10 years – and programmes, people and supports should be required to measure how they’re improving people’s mental health and lives, to ensure that money is being well spent.
The Government is still considering the Commission’s findings, so we don’t know which recommendations will be implemented. However, if they are implemented as intended, we should all see changes for the better.
In the meantime, the Government has announced that an Expert Reference Group will help to advise it on the next steps it will take. Existing Commonwealth funding to mental health programmes and services has been rolled over for another 12 months, while the Government considers the Review findings and recommendations.
I currently use mental health services and supports – what does the review mean for me?
The Review is a report to the Australian Government right now. We don't yet know how the Government will respond to its recommendations and what it will implement. In the meantime all current services and supports have been funded to continue for another year.
If the recommendations are implemented, you should be able to access better-quality care, that is tailored to your needs, and planned and delivered in your community, through a process that gives you a say. You should also be able to make use of a suite of self-help, peer support and professional services delivered through integrated telephone, online and face-to-face channels.
What does the review mean for schools?
If the recommendations are implemented, schools will be resourced to build the resilience of students and their families, and support young people with emerging behavioural difficulties, distress and mental health difficulties. This will include:
- the continued roll-out of the KidsMatter and MindMatters programmes
- early childhood workers and teachers having access to training and continuing professional development in evidence-based approaches on mental health and wellbeing
- schools keeping track of their students’ mental health, so that we can make sure the system is working.
Children and young people affected by mental health problems, and their families, will be able to access quality support, that is tailored to their needs, and planned and delivered in their community. Linkages between schools and mental health support and services will be strengthened through a consultation and development process that enables regional level co-design and co-creation of a system-wide framework for child and adolescent mental health, with integrated models of support and care pathways.
Children, young people and their families should also be able to make use of a suite of self-help, peer support and professional services delivered through integrated telephone, online and face-to-face channels. Attention will also be given to limiting the impact of mental health problems on a young person’s education.
What does the review mean for workplaces?
If the recommendations are implemented, the Mentally Healthy Workplace Alliance (a group of national business, community and government organisations working together, including Beyond Blue) will be tasked with improving mental health safety and wellbeing, and reducing stigma and discrimination, within workplaces. This will include:
- increasing awareness of the importance of addressing mental health at work
- supporting businesses to create mentally healthy workplaces, including through the use of self-help resources
- encouraging workplace leaders, managers and staff to increase their knowledge and skills through evidence-based mental health training programmes.
Workers affected by mental health problems and their families, should be able to access better-quality care, that is tailored to their needs, and planned and delivered in their community. Linkages between workplaces and mental health support and services will be strengthened through a consultation and development process that enables regional level co-design and co-creation of a system-wide framework for mental health. Attention will be given to ensuring that people who have experienced mental health problems gain and retain meaningful employment. Such actions will benefit employees and assist employers to recruit and retain staff and increase productivity.
What does the review mean for Beyond Blue and our work?
The Review recommends that Beyond Blue continues our important work of increasing awareness and understanding of depression and anxiety and suicide prevention, and reducing stigma and discrimination. The Review’s recommendations to increase the focus on preventing depression and anxiety, and increasing access to self-help and early intervention services, aligns with Beyond Blue’s programmes and supports for all Australians, including:
- The Beyond Blue Support Service, which provides short-term, solutions-focussed counselling 24/7 via phone, web chat (3pm – 12am AEST) and email
- The KidsMatter Early Childhood, KidsMatter Primary and MindMatters programmes which support the mental health and wellbeing of children and young people
- Heads Up, our workplace mental health initiative
- NewAccess, our pilot early intervention service, which helps people to get their lives back on track
- The Way Back, our pilot service which provides support to people who have attempted suicide
Where can I find out more information?
The Review’s final report is available on the National Mental Health Commission’s website - https://www.mentalhealthcommission.gov.au/our-reports/our-national-report-cards/2014-contributing-lives-review.aspx