Download Leading Mental Health Reform in the Australian Context Eddie

Leading Mental Health Reform in the
Australian Context
Eddie Bartnik
Commissioner for Mental Health, Western Australia
International Initiative for Mental Health Leadership
Auckland, New Zealand
8th March 2013
Outline
• Functions and scope of the West Australian Mental Health
Commission
• Context for reform at national and state levels
• “Mental health 2020 : Making it personal and everybody’s business”
• Some key examples of personalisation, collaboration and coproduction to strengthen a community level response
• Reflection on progress with key reforms
• Key challenges ahead
Functions and Scope
• First MHC in Australia and established in March 2010
• A “Commissioning Commission” : Policy, planning and purchasing
functions, leads mental health reform across government and
tackles stigma and discrimination in the community
• Budget approx $600m for mental health and contracts with public
mental health, private and non government agencies
• Administrative umbrella for Mental Health Review Board, Council of
Official Visitors and Drug and Alcohol Authority, Ministerial Council
for Suicide Prevention and Mental Health Advisory Council
• Approx 46,000 people receive public mental health services and
8,000 through funded NGOs
• Commonwealth funds primary care and a range of NGOs as well
• WA population 2.4m people over 2.5m km2; approx 10% of nation
Image sourced from:
http://www.businessmigration.wa.gov.au
Reform Context
National level
• National health reform (NHRA, local health networks, Medicare
locals, Independent Hospitals Pricing Authority and Activity Based
Funding/ Nationally Efficient Price
• National mental health reform (New National Mental Health
Commission 2011 – National Report Card; COAG process and 10
year Roadmap for Mental Health and new Mental Health Working
Group; 4th National Mental Health Plan; national LIFE framework
• Federal budget initiatives $2.2bn over 5 years package in 2011/12 primary care, youth headspaces and early intervention for psychosis
centres, suicide prevention strategy, NPA with states/territories for
some and direct tenders for other services
• National Disability Insurance Scheme
Reform Context
State level
• Economic Audit report 2010 – citizen focus, collaboration, outcomes
and partnership themes: Premiers Partnership Forum
• Delivering Community Services in Partnership Policy – components
1 and 2 sustainability funding, procurement reforms
• Budget corrections and efficiency dividends for government services
• Review of the Mental Health Act 1996
• First Minister for Mental Health and Mental Health Commission
• Rapidly growing population and hospitals infrastructure
• Need for a clear and strong state mental health strategy to engage
the community and drive reform
•Get to know people
•Person Centred
Planning e.g.“The Big
Plan”
•Stokes Review
discharge planning
•Individual ised
Community
Living Support
•Personal
budgets
•Drug and
alcohol
•People with
Exceptionally
Complex Needs
•Housing
•Anti Stigma Research
•Youth – Music Feedback
•Act Belong Commit Campaign
•Schools – Aussie Optimism
•Child and Parent Centres
•New MH Bill
•Improved Governance
(MHAC; Consumer Peak)
•Planning and Infrastructure – closer
to home
•Clinical Services Plan
•Sector Development
•Assertive Community Response Children
•Self harm in schools
•New youth stream – Youth Axis
and Early Psychosis
•State wide specialist Aboriginal
MHS
•Looking Forward project
•Scholarships and
training
•DCSP policy and wages
Individual service design
•Peer workforce
•MCSP and One Life strategy
•Community action plans and
agency pledges
•Research Edith Cowan University
•Court Diversion – new
Childrens and Adults
•Police – co-response and
transport
Reflections
• Synergies between the national MHC “Contributing Life” and WA “A
good life in the community” frameworks that are building stronger
engagement beyond the health systems
• Problems built up over a long period and time needed to change
things
• Effective use of community engagement (eg MH2020 and MH Bill)
and independent reviews (eg Stokes, Henderson)
• Many building blocks in place
• Governance and advocacy (eg Minister for Mental Health, MHC,
Suicide Prevention Strategy, Mental Health Bill, new Statewide
Specialist Aboriginal Mental Health Service, new Consumer Peak
Association and Mental Health Advisory Council, strengthened
consumer and family leadership)
Reflections
• Joint purchasing framework and Clinical Services Plan with
Department of Health; engagement of a Consultant Psychiatrist
at MHC
• Increased range of new services and choice (eg more robust
NGO sector, first court diversion services in childrens and adult
courts, first subacute services, new youth early intervention for
psychosis program, new inpatient services closer to home, ICLS and
over 100 homes and personal recovery plans/ support packages
(demonstration of possibility) and new self directed care initiatives in
the non government sector
• Stronger community engagement and co production e.g.
Ministerial Council for Suicide Prevention and Suicide Prevention
Community Action Plans in more than 200 communities and 180
employers
• Strategic investments in workforce and peer support
Challenges
• Safeguarding mental health funding in the context of health reform
including data and measurement
• Ensuring a fair share of new NDIS and that the sector is ready
• Managing the transition from ED/inpatient focus to a community
focus in a climate of rapid population growth and new hospitals
development
• Keeping momentum / demonstration effect of self directed support
and whole of government and community engagement
• Delivering new services while major new service developments and
some projects funding running out
• Better integrated services require better joint commissioning with the
Commonwealth government and Drug and Alcohol Services as well
as service provider collaboration and individual coordination
Challenges
• Commissioning and decommissioning, sector development and
workforce
• Momentum and doing enough of the right things fast enough to
make the transition
• Strong values based leadership for reform
Contact details: www.mentalhealth.wa.gov.au