The Australian Mental Health System Nathan Smyth Mental Health and Workforce Division The Australian Government Department of Health and Ageing
Mental Health before 1992 • The population of the psychiatric hospitals declined from 29,500 in the early 1960's, (281 beds per 100,000) to 6,750 inpatients in 1992 (40 beds per 100,000) • This development became known as trans-institutionalisation
The National Mental Health Strategy • National Mental Health Policy • National Mental Health Plans • Mental Health Statement of Rights and Responsibilities • Medicare Agreements 1992-1998 and Australian Health Care Agreements 1998-2003 and 2003-2008
Three National Mental Health Plans 1992, 1998 and 2003 The three priority themes under the 1998-2003 Plan: • promotion and prevention; • partnerships in service reform and delivery; and • quality and effectiveness. The four key priority themes under the 2003-08 Plan: • promoting mental health and preventing mental health problems and mental illness; • improving service responsiveness; • strengthening quality; and • fostering research, innovation and sustainability.
Achievements • Extensive structural reform, shift to community-based service system • 73% real growth in government spending • Consumer and carer involvement • New community partnerships reduced historical isolation of mental health • Foundations laid for a primary care mental health system
Case for further reforms • Reports of nation-wide consultations on mental health further made the case for reform: • Mental Health Council of Australia’s ‘Not for Service’ Report (2005) • Senate Select Committee on Mental Health ‘From Crisis to Community Report’ (2005)
COAG Agreement • 14 July 2006, COAG agreed to the National Action Plan on Mental Health 2006-2011 • Individual Jurisdictional Implementation Plans • $4 billion attached to the plan over 5 years • Australian Government allocated$1.9 billion in new funding
Five Key Action Areas under the COAG Action Plan 1. Promotion and Early Intervention 2. Integrating and Improving the Care System 3. Participation in the Community and Employment, including Accommodation 4. Coordinating Care – Two Flagship Initiatives • Coordinating Care • Governments Working Together 5. Increasing Workforce Capacity
Implementation of the Commonwealth measures • Department of Health and Ageing is the lead agency for the delivery of the Australian Government’s package (13 of the 18 initiatives) • Department of Families, Community Services and Indigenous Affairs • Department of Employment and Workplace Relations • Department of Education, Science and Training
Key Commonwealth responsibilities under the package: • increasing access to primary health care • increasing the mental health workforce • providing more respite places; and • raising community awareness about link to illicit drugs and mental illness.
Considerations for Forensic Mental Health • Key Action Area: Integrating and Improving the Care System […] improving services for people with mental illness in the criminal justice system, including community-based forensic mental health services […] Pg 4: COAG National Mental Health Action Plan 2006-2011
States and territories are responsible for delivery of forensic mental health services. A number of states and territories are implementing COAG measures to enhance forensic mental health services.