For many years, consumers and carers within the mental health sector have ben crying out for reform. In December last year, the Federal Government took the first steps in adhering to the need for change. Prime Minister Malcolm Turnbull and Health Minister Susan Ley announced the Federal government’s response to the National Mental Health Commission’s report into mental health programs and services.
One of the main points in the announcement was the reallocation of $350 million from Federal mental health programs to 31 primary health networks across Australia. CEO of WayAhead Elizabeth Priestley praised this initiative, saying it is a shift in the right direction
“It will enable people to access treatment in the local region through programs developed by the primary health networks (PHNs) with local needs taken into account.”
However, their remains a level uncertainty around what action will be taken with the diverted funds. There is little clarity on the direction the primary health networks will be taking in relation to mental health.
“It is still uncertain what roles consumers and carers will play in decisions on service delivery at a high level,” says Priestley.
“A shift to community organisations having an increased role in the management of mental illness should increase consumer and carer participation due to the number of consumers and carers working for these organisations.”
Many other areas of the mental health community also stand to be affected by the Government’s reforms.
Arafmi, a co-location partner of WayAhead, is the peak body for mental health carers, championing their rights and voice for over 40 years.
Arafmi CEO Jonathan Harms said that from his point of view, the Government’s reforms still left fragmentation in the system.
“The main problem I have with what the government is proposing is that the funding that they’re saying will be redirected towards a stepped care model… is coming out of existing programs such as ATAPS (Access to Allied Psychological Services) and Headspace.”
Many observers of the Government’s response are worried that the absence of any new money being spent in the mental health sector shows the Government may weaken some areas of the mental health sector to improve others.
“They’re just going to take $350 million from an inadequately resourced sector and spread it around a bit differently,” says Harms.
“I think that actually creates the potential for a lot more diversity of models and therefore a lot more potential for people to fall through the gaps.”
While Harms agrees that the mental health system needs to be primarily focused on the consumers, he is worried about the lack of support for carers.
“Carers have been more or less completely ignored again. The trouble we have in this sector is that mental health issues often mean that the consumer is in no position to research the market and source the services they need, which is why carers are so important.”
“That $350 million that will be redirected towards the PHNs… if that takes money away from the ATAPS program, where people receive psychological counselling through their GP, that would be a disaster for carers. Many carers need counselling for their own mental health due to the great stress they are placed under by their caring responsibilities.”
“They obviously don’t have a severe and persistent mental illness, but they do have anxiety and depression and other related problems which they can address through ATAPS.”
BEING is also a key partner of WayAhead, and advocates for those in NSW with a lived experience of mental illness. CEO of BEING Dr Peri O’Shea believes the reallocation of funds can be utilised to serve consumers more effectively.
“In terms of the money moving, there are some real positives. Local needs are different throughout the country and even throughout the states, people in regional areas have very different needs.”
“The PHNs actually need a lot of work to become more mental health savvy. The idea of strengthening a primary health network is a good one because it is easier to help someone manage their recovery from a localised network rather than a Federal network.”
Previously, the Federal Government only allowed 10 visits per year to a psychologist for mental health consumer. But this has now been reformed to benefit those with more severe mental illnesses. Dr O’Shea believes this is a good initiative, as it will assist consumers who require more specialist care.
“Now the Government has identified those who don’t need any visits and can just visit their website, whilst there are other people who need a lot more visits. So they are shifting the funding and it will be interesting to see its effects in the long run.”
Priestley says while the announcements have been positive, action is now needed.
“An ideal implementation is to have this compliment and relate to many of the States’ plans. We don’t want this implementation to not take into consideration the State initiatives.”
“It should be clear to us that State and Federal health departments are talking to each other and working on clear plans and outcomes together, reducing the confusion we have with duplication and who does what. If we are confused [about the reforms] how do you think those trying to access services feel?”
Harms proposes that greater transparency be applied across the different health sectors to allow for better access to information and care plans for a given individual.
“What would be great would be to set up a process whereby integrated care plans could be routinely shared across health sectors. So sharing between General Practitioners in primary health and the psychologists and the psychiatrists in specialist public mental health service. Each should be able to provide the service as required.”
“Anything the Federal Government can do to address that would be very helpful, because at the moment integrated care plans can’t be used effectively because we don’t share them with all the people who need to see them.”
Dr O’Shea believes the next steps for the Government should be to set measurable outcomes and goals for the proposed reforms, as well as some evaluation around how the PHNs will work with people with mental illness.
“It’s great that this discussion is out there and there’s conversation around these issues.”
Through Collective Purpose, a collaborative framework created by BEING, Arafmi & WayAhead, the three organisations are working together to ensure all those affected are aware of the future legislation surrounding the mental health sector.
Collective Purpose has already led to the three organisations establishing a broader range of shared services that are being used to the benefit of the mental health community.
Although the new reforms signal an array of changes, Priestley believes that WayAhead will continue to strengthen its commitment to mental health consumers and the Collective Purpose network.
“For WayAhead it does open up possibilities of forming partnerships with local PHNs. We may be able to expand our anxiety programs into more regional areas and also get more information to include on the WayAhead Directory.”
“The reforms will mean that we have to be proactive in engaging with local services, and if we are successful with this, it gives us an opportunity to be a real state organisation rather than Sydney centric. I think it is exciting for WayAhead if we take advantage of the opportunities that show themselves.”
Mental health system changes: What you need to know – ABC News: medical reporter Sophie Scott
Australian Government Response to Contributing Lives, Thriving Communities – Review of Mental Health Programmes and Services