CHAPTER 1
INTRODUCTION
Terms of reference
1.1
On 28 March 2007, on the motion of Senator Lyn Allison, the Senate
referred the matter of mental health services in Australia to the Community
Affairs Committee for inquiry and report by 30 June 2008. Following the commencement of the 42nd Parliament, the Senate readopted the inquiry on
14 February 2008. The terms of reference required the committee to
examine:
(1) Ongoing efforts towards improving mental health services in Australia,
with reference to the National Action Plan on Mental Health agreed upon at the
July 2006 meeting of the Council of Australian Governments, particularly
examining the commitments and contributions of the different levels of
government with regard to their respective roles and responsibilities.
(2) That the committee, in considering this matter, give
consideration to:
(a) the extent to which the action
plan assists in achieving the aims and objectives of the National Mental Health
Strategy;
(b) the overall contribution of the
action plan to the development of a coordinated infrastructure to support
community-based care;
(c) progress towards implementing the
recommendations of the Select Committee on Mental Health, as outlined in its
report A national approach to mental health – from crisis to community;
and
(d) identifying any possible
remaining gaps or shortfalls in funding and in the range of services available
for people with a mental illness.[1]
Interim report
1.2
On 19 June 2008 the committee tabled an interim report, outlining its
work on the inquiry to that point and providing a broad summary of the themes
arising in the evidence received. The interim report provided a succinct
summary of the progress made towards achieving the aims of the National Mental
Health Strategy and the recommendations of the Senate Select Committee on
Mental Health, and the service gaps and shortfalls that remain.
1.3
Given the scale of the reforms introduced in mental health, the
substantial evidence provided to the committee and the committee's heavy
workload with other concurrent inquiries, the committee undertook to provide a
final report to the Senate by 25 September 2008.
1.4
The interim report set out the context for this inquiry, which is not
repeated here. In particular the committee noted the findings of the comprehensive
inquiry undertaken by the Senate Select Committee on Mental Health, which
reported to the Senate in March and April 2006. As stated by the committee in
its interim report, this inquiry was not intended to repeat the comprehensive
examination undertaken by the earlier select committee. Rather, in accordance
with the terms of reference, the committee focussed on the Council of
Australian Governments' (COAG) National Action Plan and the progress made in
mental health service reforms and the service gaps and shortfalls that remain.
The COAG National Action Plan is discussed further in chapter 2 of this report.
Conduct of the inquiry
1.5
The committee advertised the inquiry in The Australian and on its
website. It wrote to many organisations and individuals inviting submissions to
the inquiry. The committee received and published 62 submissions, together with
a considerable volume of additional information received at and after public
hearings which is listed at Appendix 1. It also received a further nine
confidential submissions.
1.6
The major emphasis of the terms of reference referred to the COAG National
Action Plan on Mental Health 2006-2011. When the matter was
originally referred the Action Plan had been in place for only a short period
of time. The committee determined that the Plan needed time to be bedded down
before any worthwhile assessments could be made. The committee decide to seek
submissions and conduct a roundtable in 2007, deferring public hearings until
2008.
1.7
The roundtable discussion was held in Canberra on 10 August 2007 with representatives from a range of peak bodies, professional associations, consumer
and carer organisations. Prior to commencing the public hearings, the committee
received a briefing in March 2008 from the Department of Health and Ageing (DoHA)
and the Department of Families, Housing, Community Services and Indigenous
Affairs (FaHCSIA). During March, April and May 2008 the committee held nine
public hearings, across each of the state and territory capital cities. In August
2008 the committee held an informal meeting with a number of clinicians and
consumer representatives to discuss issues raised during the public hearing of 8 May 2008 and in a submission from the Coalition of Australian Mental Health National
Consumer and Carer Advocacy Peak Bodies.
1.8
Details of the committee's public hearings are referred to in Appendix
2. The public submissions and Hansard transcripts of evidence may be accessed
through the committee's website at https://www.aph.gov.au/senate_ca.
Australia/New Zealand Parliamentary
Committee Exchange
1.9
In April 2008 the committee was selected by the Senate President to
visit New Zealand as part of the Australia/New Zealand Parliamentary Committee
Exchange Program. This exchange, undertaken from 14–17 April, had a major focus
on mental health issues in addition to a number of other subject areas of
specific interest to the committee.
1.10
The committee met with Ministers and party spokespeople from across the
political spectrum, senior officers from relevant Departments and
representatives from NGOs. The committee was especially interested in meeting
with the New Zealand Mental Health Commission whose activities had been raised
during the earlier Senate Select Committee on Mental Health. The meetings held
during this exchange enabled committee members to gain a broad understanding of
the operation of mental health services in New Zealand, as a comparison and
contrast with Australia. Insights gained through the exchange have been
valuable to the committee in conducting this inquiry.
Structure of the report
1.11
The committee has not undertaken in this report to review every
initiative within the COAG National Action Plan on Mental Health. The report
focuses on those new initiatives about which the committee received most
comment, broader issues such as the policy context and coordination of the
reforms and the key areas where shortfalls and gaps remain. The report is set
out in 9 chapters. This chapter provides an overview of the conduct of the inquiry.
Chapter 2 describes the current policy context for mental health reform in Australia,
including the fit between the COAG National Action Plan on Mental Health and
the National Mental Health Strategy. Chapter 3 looks at coordination of mental
health service delivery; a major element in the COAG National Action Plan. Chapter
4 considers community-sector investment and initiatives. Chapter 5 looks at the
Personal Helpers and Mentors Program, which was the largest of the community-sector
initiatives funded in the COAG National Action Plan. Chapters 6 and 7 consider
two of the major initiatives in the COAG Plan aimed at improving access to
clinical care: the Better Access initiative and new funding for mental health
nurses. Chapter 8 identifies remaining service gaps and shortfalls and chapter
9 looks at specific population groups for whom services remain difficult to
access.
Acknowledgments
1.12
The committee again acknowledges and thanks all those who assisted with
its inquiry, by making submissions, attending hearings and giving evidence,
providing additional information and other forms of assistance. The generosity
with which they contributed to the inquiry reflects their commitment to
improving mental health services across Australia and to making a difference in
the lives of people who experience mental illness and those who care for and
support them. The committee acknowledges this commitment and ongoing effort. The
committee looks forward to the recommendations contained in this report being
adopted as part of the ongoing collaborative effort to improve mental health in
Australia.
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