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National Review of Mental Health Programmes and Services Report released

16 April 2015

The National Mental Health Commission’s review (released today) provides a strong, achievable and practical plan for modernising and reforming Australia’s mental health system and ultimately improving the lives of millions of Australians.

"Australia has a transformational opportunity to tackle the individual, social and economic costs of mental ill-health if it makes mental health a priority. This means investing in things that make a difference and empowering the sector to work with governments of all levels to rebuild a system around the needs of individuals and their families,” Prof. Allan Fels, Chair of the Commission said today.

"Despite many virtues and much dedicated and skillful effort by individuals and organisations, the system is in need of substantial redesign and repair. We can and must get better at catching people before they fall, so they are able to participate as fully as possible in their communities, in employment, and in stable accommodation, and avoid a lifetime of disability and poverty.

"The effect of our poorly planned mental health system is a massive drain on the wellbeing of people and families, and on Australia’s productivity and economic growth. The economic cost of mental ill- health is enormous. Estimates range up to $28.6 billion a year in direct and indirect costs, with lost productivity and job turnover costing a further $12 billion a year - collectively $40 billion a year or more than two per cent of GDP,” Prof. Fels said.

"Worthwhile, productive reform will take time, and consultation and a collaborative approach between federal and state and territory governments, and NGO and community organisations is essential, yet it should not be daunting.

"The reality is that there’s been broad agreement across the sector for decades that change is urgently needed, and broad agreement that a greater focus on early intervention is the key to reducing the need for crisis care and helping people live their lives to their potential.

The National Review of Mental Health Programmes and Services (the Review) was conducted by the Commission in response to Terms of Reference provided by the Australian Government in 2014 and it received more than 2,000 submissions. The Reviewprovides 25 recommendations across nine strategic directions which guide a detailed implementation framework of activity over the next decade. Taken together, Prof. Fels said, they form a strong, achievable plan for Australia’s mental health system.

The Commission has recommended a major overhaul of the mental health system to shift the focus of the system from crisis and acute care to community based services, primary health care, prevention and early intervention; and to better focus services on supporting individuals and families. It also proposes specific actions to improve the social and emotional wellbeing of Aboriginal and Torres Strait Islander people and the mental health and wellbeing of people living in regional, rural and remote Australia.

"Our recommended approach is to spend more money on services which prevent illness, support recovery, keep people well, and enable them to lead contributing lives. This will drive long-term savings by minimising the pressure on the hospital system and by increasing economic productivity through greater participation in education and employment. This shift towards prevention and early intervention is absolutely vital in driving sustainable, long term change.

“We are also proposing a realignment of the system on a regional basis to promote local planning, decision making, purchasing and delivery of services. This is not about taking money out of hospitals, and particularly not about taking money out of vital mental health services in hospitals, but rather about building up those services which prevent hospitalisation or enable people to be discharged earlier from hospitals into community based care.

"This is particularly important to our recommendations and proposed actions to prevent suicide through local community partnerships which co-create solutions using collaborative and integrated approaches. It is unacceptable that more than 2,500 people die from suicides each year, and these rates have not been coming down. We need sustainable, comprehensive, whole-of-community approaches aimed at halving suicides and suicide attempts over the next 10 years,” Prof. Fels said.

Prof. Fels said the Review also proposes funding outcomes rather than activity to ensure the Australian Government maximises value for taxpayers’ dollars within existing resources.

"Despite almost $10 billion in Commonwealth and nearly $4.5 billion in state and territory spending on mental health every year, the system still suffers from duplication, gaps in access and there are no consistent, agreed national measures of whether people’s lives are being improved", he said.

CEO of the Commission, Mr David Butt, said the Review received considerable worrying feedback that people were falling through the gap between GPs and primary health care on the one hand, and emergency departments and hospitals on the other.

"The Review’s findings reinforce concerns that the current system is not designed with the needs of people and families at its core, and that navigating the mental health system is complex and difficult, meaning people are unable to access the support and services they need.

"A central theme of the recommendations is a move to a model of person-centred care, where the system is designed to fit around the needs of people, not around what the providers of services have to offer.  The Commission sees this Review as providing a tremendous leap forward and strong foundation for the essential, ongoing conversation with consumers, the community, the mental health sector and governments about achieving better outcomes for individuals, families, communities and the Australian economy," Mr Butt said.

"Even the most disadvantaged Australians should be able to lead a 'contributing life,' whatever that means for them and this simple goal will be our touchstone and yardstick."

Chair Prof Allan Fels AO
National Mental Health Commission

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