RECOMMENDATIONS
Mental health policy and
forward planning
Chapter 2
Recommendation 1
2.53 The
committee recommends that the Australian Government, in consultation with state
and territory governments and mental health stakeholders, develop a new
national mental health policy document to succeed the National Mental Health
Plan 2003–2008. The policy document should provide a clear vision of the
services required in a community-based, recovery-focussed mental health system
in Australia to 2015, including, but not limited to, mental health promotion
and mental illness prevention and early intervention services, community-based
clinical and psychosocial services, step-up and step-down transition services,
crisis and acute services, as well as accommodation, education, training,
employment and other community support services for people with mental illness.
The policy document should include service, funding and consumer outcome
benchmarks in each of these identified areas.
Recommendation 2
2.55 The
committee recommends that the National Advisory Council on Mental Health be
funded to establish standing committees in each of the following areas:
- monitoring human rights abuses and
discrimination against people with mental illness;
- advancing
community awareness of mental illness and destigmatisation;
- monitoring service adequacy and progress towards
an effective community-based, recovery-focussed system of mental health care.
The committee recommends that each standing committee report
directly to the National Advisory Council. In addition, the committee
recommends that the National Advisory Council table the reports of the three
standing committees in Parliament on an annual basis.
Enhancing and developing
the COAG Action Plan on Mental Health
Chapter 3
Recommendation 3
3.17 The
committee recommends that each state and territory COAG Mental Health Group
include consumer, carer, non-government organisation and private sector
representatives within its membership. The committee further recommends that
each COAG Mental Health Group make publicly available a quarterly progress
report outlining the work undertaken in the state or territory against each
commitment in the National Action Plan on Mental Health
2006–2011.
Recommendation 4
3.57 The
committee recommends that FaHCSIA track unspent funding under National Action
Plan community initiatives rolled out through NGOs. The committee recommends
that any underspent funds in sites selected for National Action Plan programs
be quarantined for use in those areas and distributed through other mental
health programs or direct purchase of services from public health or other
providers.
Recommendation 5
3.76 The
committee recommends that COAG review the progress of the Care Coordination
initiative in each state and territory prior to the completion of the National
Action Plan on Mental Health 2006–2011, including an assessment as to
whether allocated funding is needed to enable the aims of the initiative to be
achieved.
Recommendation 6
3.77 The
committee recommends that each state and territory government include in its
reports to COAG the number of people in the Care Coordination target group that
have actually been offered a clinical coordinator and community coordinator.
Chapter 4
Recommendation 7
4.46 The
committee recommends that in purchasing non-government organisation services
for future mental health initiatives, Australian, state and territory
government departments do not rely exclusively on open tenders but also develop
other procurement models such as collaborative and select tenders.
Recommendation 8
4.47 The
committee recommends that the following issues be considered in future funding
rounds:
- the
weighting given to local knowledge and linkages when assessing tenders;
- opportunities
to increase collaboration;
- reducing the information burden associated with
tendering for multiple programs; and
- addressing
sustainability of services.
Chapter 5
Recommendation 9
5.29 The
committee recommends that the Government give high priority to expanding the
coverage and location of Personal Helpers and Mentors services across areas of
unmet need in Australia.
Recommendation 10
5.45 The
committee recommends that the Department of Health and Ageing, the Department
of Education, Employment and Workplace Relations, the Mental Health Council of
Australia and consumer representatives be funded to work together to develop a
consumer-run training package for mental health workers focussed on the lived
experience of mental illness. The committee recommends that the training be in
a modularised format so that components can be delivered within existing NGO,
vocational and professional training.
Recommendation 11
5.51 The
committee recommends that FaHCSIA in conjunction with selected Personal Helpers
and Mentors providers as a matter of urgency develop and promote best practice
methods for managing demand for the Personal Helpers and Mentors program.
Recommendation 12
5.60 The
committee recommends that FaHCSIA develop and publish an evaluation framework
for the Personal Helpers and Mentors (PHaMs) program. The framework should pay
particular attention to who is accessing the program and to consumer outcomes.
The committee further recommends that all evaluations of the program be made
public. Such evaluation should not however delay the expansion and further
rollout of PHaMs services.
Chapter 6
Recommendation 13
6.82 The
committee recommends that the post-implementation review of the Better Access
initiative gives particular attention to the referral pathways in the Better
Access initiative, whether consumers are effectively moving between the
providers involved and whether any structural changes or additional funding are
required to improve care management and coordination.
Recommendation 14
6.104 The
committee recommends that as part of the post-implementation review of Better
Access a working group be established to simplify arrangements by which NGO
employed psychologists and other eligible allied health professionals can use
Better Access Medicare items.
6.105 The
committee further recommends that the Australian Government fund a series of
information workshops for relevant NGOs, explaining the outcomes of the working
group and the available mechanisms for NGOs to make use of the Better Access
Medicare items.
Recommendation 15
6.133 The
committee recommends that the post-implementation review of the Better Access
initiative consider the concerns and issues about the initiative listed in this
report (paragraph 6.132). In particular, the committee considers that
assessment of the outcomes for consumers using the initiative is paramount. The
committee further recommends that the findings of the post-implementation
review be made publicly available.
Addressing service gaps
and shortfalls
Chapter 8
Recommendation 16
8.20 The
committee recommends that state and territory governments substantially
increase funding to establish more long-term, step-up and step-down
community-based accommodation for people with mental illness that is linked
with clinical and psycho-social supports and rehabilitation services.
Recommendation 17
8.62 The
committee recommends that the Australian Government strengthen mental health
consumer representation, through funding consumer-run organisations to provide
independent advocacy at state, territory and Commonwealth levels and to provide
peer support, information and training to their members.
Recommendation 18
8.73 The
committee recommends that Centrelink develop Mental Health Consultative
Committees, modelled on the Western Australian Centrelink Mental Health
Consultative Committee, within each of the other states and territories. The
committees recommends that the Centrelink Mental Health Consultative Committees
include consumer and carer representatives, representatives of the state and
territory community mental health peak bodies, state and territory specialist
employment services, the Commonwealth Rehabilitation Service, ACE National
Network, state Centrelink offices, the relevant state government department of
employment and the Australian Government Department of Education, Employment
and Workplace Relations.
Recommendation 19
8.86 The
committee recommends that the Australian Government provide funding for a
public awareness program focussed on psychotic illnesses, to be targeted to
adolescents and young adults, their peers, parents and teachers.
Recommendation 20
8.115 The
committee recommends that in negotiating the next Australian Health Care
Agreement, the Australian and state and territory governments agree on
mechanisms to ensure that community-based mental health services are
prioritised in state mental health spending.
Recommendation 21
8.153 The
committee recommends that the Australian, state and territory governments
develop as a matter of priority a framework for evaluating the consumer
outcomes achieved by the National Action Plan on Mental Health 2006–2011.
Recommendation 22
8.154 The
committee recommends that the Australian, state and territory governments
jointly fund and establish a Mental Health Institute to foster research as
recommended by the Senate Select Committee on Mental Health and to conduct
ongoing monitoring and evaluation of mental health services across Australia.
Recommendation 23
8.157 The
committee recommends that in reviewing the National Action Plan on Mental
Health 2006–2011 and developing future mental health policy, the
Australian, state and territory governments give priority to addressing the
shortfalls that currently exist in community-based mental health services,
housing, education and employment for people with mental illness, comorbidity
services, acute care and workforce supply to the mental health sector.
Chapter 9
Recommendation 24
9.67 The
committee recommends that the National Advisory Council on Mental Health be
funded to convene a taskforce on childhood sexual abuse and mental illness, to
assess the public awareness, prevention and intervention initiatives needed in
light of the link between childhood sexual abuse and mental illness and to
guide government in the implementation of programs for adult survivors. The
committee recommends that the taskforce report its findings by July 2009 and
that COAG be tasked with implementing the necessary programs and reforms.
Recommendation 25
9.68 The
committee recommends that the Australian, state and territory governments,
through COAG, jointly fund a nation-wide Borderline Personality Disorder
initiative. The committee recommends that the initiative include:
- designated Borderline Personality Disorder
outpatient care units in selected trial sites in every jurisdiction, to provide
assessment, therapy, teaching, research and clinical supervision;
- awareness raising programs, one to be targeted
at adolescents and young adults in conjunction with the program in
Recommendation 19 (Chapter 8) aimed at improving recognition of the disorder,
and another to be targeted at primary health care and mental health care
providers, aimed at changing attitudes and behaviours toward people with
Borderline Personality Disorder; and
- a training program for mental health services
and community-based organisations in the effective care of people with
Borderline Personality Disorder.
The committee recommends that a taskforce including specialist
clinicians, consumers, community organisations, public and private mental
health services and government representatives be convened to progress and
oversight the initiative.
Recommendation 26
9.102 The
committee recommends that through COAG the Australian, state and territory
governments coordinate and develop mental health plans and fund specific
additional mental health services that address the existing shortfalls for
Indigenous Australians, culturally and linguistically diverse communities,
youth, aged and people in rural and remote communities.
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