The National Review of Mental Health Programmes and Services report was a controversial document even before its release on 16th April 2015. The final report was provided to the Commonwealth Government on 1st December 2014.
On 17th April a communique from the COAG Health Council stated that the Federal and State and Territory Health Ministers welcomed the announcement made by Sussan Ley to reject the recommendation to move a billion dollars of mental health funding out of public hospital services. The Ministers agreed to work cooperatively with the Commonwealth on a national approach in light of the review.
There has been no shortage of media coverage following the document’s release, with Federal Health Minister Sussan Ley acknowledging that the report painted a “disturbing picture” or mental health care in Australia.
Sussan Ley was quoted by Fairfax Media “The review shows that fragmentation in the system is seeing far too many people still slipping through the cracks,” she said. “We cannot continue to place band-aids on the mental health system and expect it to heal itself.”
The National Mental Health Commission has made 25 recommendations, with the three key components being:
- Person-centred design principles
- A new system architecture
- Shifting funding to more efficient and effective “upstream” services
The initial responses of industry bodies to the report has been varied.
Australian Psychological Society response
Australian Psychological Society (APS) Executive Director Prof Lyn Littlefield said that the APS “fully supports the intent of the report to improve the delivery of Australia’s mental health services and programs. There are many substantial recommendations in the report which could improve services for consumers if implemented.”
Prof Littlefield also said that “We commend the Minister’s intention to establish an Expert Reference Group and engage in consultation to inform the Government’s implementation of reforms to the system.”
The Royal Australian & New Zealand College of Psychiatrists response
The Royal Australian & New Zealand College of Psychiatrists (RANZCP) President Elect Prof Malcolm Hopwood said that although the mental health sector welcomes the spirit of reform contained in the report, there are some concerns.
Prof Hopwood welcomed the recommendations that psychiatrists have pushed for, including the prioritisation of early intervention, a person-centred approach, Aboriginal and Torres Strait Islander mental health, and investment in early childhood and family care.
However, Prof Hopwood said that there are concerns about the absence of a clear funding model for these much needed systemic changes. He said that “The assumptions of savings in disability pensions and clinical services cannot be guaranteed in the short-term.”
Prof Hopwood also said that “The recommendation that a minimum of $1 billion in Commonwealth acute hospital funding be reallocated from 2017 into community-based services completely ignores the massive gap in current service delivery by public hospitals. Public hospitals are already experiencing excessive demand for their mental health beds and emergency departments, and the existing shortfall costs lives.
Indeed, with even fewer adequate hospital beds available emergency departments are likely to have a larger role in containing mental health patients at the most acute stage of their illness in an environment that is entirely unsuitable and inappropriate. This would be a contradiction of the intent of the strategic plan.”
Mental Health Australia response
Mental Health Australia CEO Frank Quinlan said that “Now is the time for the Federal Government to work with state and territory governments, people living with mental illness and their carers, service providers, and NGOs to build the mental health system Australia expects.”
Mental Health Australia believes that reform will only be successful if all the relevant players are included in the process. Governments at all levels must:
- set targets for system performance
- agree on who is responsible for what, including who funds different parts of the system
- listen to the voices of those with a lived experience of mental illness and their carers, and
- hold all in the system accountable by reporting accurately on how the system is performing
More articles on My Health Career:
- APS, RACP, RANZCP, and RACGP all call for children to be released from detention
- Polio Australia: Improving health outcomes for Australia’s polio survivors
- The private practice psychologist – wearer of many hats
Image: Martin Howard – flickr