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The National Review of Mental Health Programmes and Services

23 Apr 2015

The National Mental Health Commission has been meeting with stakeholders this week to discuss the National Review of Mental Health Programmes and Services and the urgent need for mental health reform, following the official release of the Review on 16 April 2015.

One theme that has emerged from our conversations is the need for all of us to be speaking with a clear and consistent voice about what needs to change and why, and how we can help drive reform.

The Commission believes that it is vital that we stand together to ensure that mental health remains a priority. Importantly, to achieve meaningful reform we need to work together to co-design and deliver a mental system that wraps around the needs of people with lived experience, their families and support people, and helps them live contributing lives.

Chair of the Commission, Prof. Allan Fels has provided his thoughts in two contributions to media this week, which you can read in full below.

We encourage you to share this with your friends and colleagues.


Seven suicides a day: Time to stop them (Daily Telegraph)

Australia can and must do better when it comes to mental health. The reality is that we hear accounts every day about people falling through the cracks, people being left to a life of unemployment and poverty, and people dying.

Many excellent services, and people who work in the sector, are overburdened. An overhaul of “the system” is long overdue, widely supported, and certainly achievable within a decade if we start work on it now.

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 many stakeholders and mental health organisation who have come out in support of reform since the Commission’s report to government was released is evidence that people are impatient to be part of change.

The challenge for all of us involved in the sector is to ensure that people with mental health difficulties, and their families and support people, are front and centre of every conversation we have on mental health in the coming weeks and months.

This is ultimately not about us, it is about them.

Every day that reform of the mental health sector continues to be delayed, or postponed because other pressing issues come to the fore, is another day that we are letting everyday Australians down. It is unacceptable that seven Australians, on average, continue to lose their lives to suicide each day, and a further 30 people will attempt suicide.

Meanwhile, many other people are struggling to access the support they need or to find gainful employment.

The current situation, this waste of human potential, is not good enough. It is bad for families, bad for communities and workplaces. It is also bad for Australia’s productivity and economy.

The Commission believes that significant, sustainable change is achievable, but it relies on making mental health a priority.

We must empower the sector, working with governments of all levels to rebuild a system around the needs of individuals and their families.

We must tackle the causes as well as the symptoms. We must get better at preventing mental illness and suicide in the first place, and we must provide timely support when things get tough.

This means investing in early intervention and in community-based supports and services that catch people before they fall and support their recovery so that they can enjoy a contributing life.


Prof. Allan Fels: Meaningful mental health reform can happen right now, together (Crikey Health Blog)

Now that the National Review of Mental Health Programmes and Services that the National Mental Health Commission provided to the Australian Government has been made public, we must overcome two potential barriers to meaningful reform that have thwarted the best efforts of others in the past.

The first is barrier would be to lose sight of the fact that this is about people with lived experiences of mental illness and their families and carers. Yes, it is about ‘the system’, but it is about a system being reoriented to focus on the need of individuals, families and communities, rather than supply as determined by funders and providers. Certainly it’s not about debating the merits of one service provider over another and it’s not about robbing Peter to pay Paul.

Millions of Australians are being let down by the current state of affairs in mental health. Individuals, their families and support people, indeed whole communities, are paying a heavy price. There’s no single answer to this problem, no silver bullet to fix it all in an instant.

The recommendations contained within the Commission’s report are significant and detailed, incorporating advice from more than 2,000 submissions and the results of ten months of comprehensive work.

We know that 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. But we should not be daunted by this process.

Every day that reform is delayed is another day that we are letting everyday Australians down. People are falling through the cracks, people are being left to a life of unemployment and poverty, and people are dying. We cannot afford to delay any longer. Our priority must be to meet the urgent needs of individuals, their families and support people.

We are not the first to say this. When it comes to mental health programmes and services, we’ve had more than 20 years of national planning, almost a decade of COAG planning and dozens of major inquiries. It’s widely understood that Australia can and must do better when it comes to mental health and suicide prevention.

The second barrier we must overcome is the temptation for individuals and sectional interests to commandeer debate to pursue their own agendas. This issue is bigger than any one group, and it requires a cohesive, integrated response. The Minister for Health, The Hon Sussan Ley MP has identified this, noting: “We cannot continue to place Band-Aids on the mental health system and expect it to heal itself.”

“Solutions” that serve the interests of a small section of service providers without care or consideration for the bigger picture are Band-Aids, and they are no solutions at all. We simply cannot afford to allow the discussion to be hijacked by those who are prepared to put self-interest ahead of the collective good and lose our chance to achieve sustainable, effective change.

Meaningful reform is achievable. The Commission has offered 25 deliberate, integrated recommendations across nine strategic directions that will work together to transform Australia’s mental health system over the next ten years.

A central theme underpinning these 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 service providers have to offer, with funding aligned to outcomes, rather than activity. Far from advocating for a reduction in services we are calling for better services that are, in fact, improving people’s lives.

We are also proposing a regional approach to improve equity of access to services, and to engage and empower communities in identifying priorities and developing local solutions – not having cookie-cutter models imposed on them from afar.

Those of us in the sector have an obligation to show leadership and work constructively together, and with government, to achieve better outcomes for individuals and their families and support people. If we pledge to work constructively and cooperatively to achieve the very best outcomes for those Australians who need our help, then we can final take advantage of the opportunity for meaningful, lasting reform.