Because mental health matters

1. Because mental health matters Dr Karleen Edwards Executive Director Mental Health, Drugs and Regions Division, Statewide PCP Meeting 3 June 2010

2. Presentation overview Victorian Mental Health Reform Strategy (MHRS) – vision, drivers, governance State Budget 2010-11 National Health and Hospital Reform MHRS and PCPs – our shared interests Our important partnership

3. Because mental health matters: Victorian Mental Health Reform Strategy 2009 - 2019

4. What gaps and problems is the strategy addressing? Access and focus of the specialist service system too frequently acute and crisis driven Lack of integrated local systems leads to gaps between services and difficulties navigating between services Wellness, sustained recovery and consumer/carer participation not consistently the basis of care planning Needs of many highly vulnerable groups too often unmet due to barriers between services and ambiguity about responsibility Potential to prevent mental health problems needs organised, larger scale efforts Children and young people not receiving the focus and breadth of attention required

5. Governance of the Mental Health Reform Strategy Coordination and partnerships across State Government

6. Further details on the Mental Health Reform Strategy www.health.vic.gov.au/mentalhealth/reformstrategy

7. Victorian 2010-2011 State Budget: Reform Measures • Two rural youth mental health teams: $4.9 million over 4 years • Community youth suicide support programs: $3.6 million over 4 years • Youth crisis response teams: 4-year allocation of $3.5 million • Training for teachers and early childhood educators: $2.5 million over 4 years • Mental health triage assessment enhancement: $2.7 million over four years • Intensive treatment in the home for older people with severe mental illness: $4.9 million over four years • Implementation of the new Mental Health Act: $36.6 million over four years

8. Wider policy context of Because mental health matters • Mental Health • COAG National Mental Health Action Plan 2006-2011 • National Advisory Council on Mental Health Discussion Paper • 4th National Mental Health Plan 2009-2014 Victorian Mental Health Reform Strategy 2009-19 interacts with State and National policies • Victoria • A Fairer Victoria • Charter of Human Rights • and Responsibilities • Victorian Alcohol Action Plan • Blueprint for Alcohol and • Other Drug Treatment Services • Victorian Integrated Housing • Strategy • Children’s service reforms • Blueprint for Education and • Childhood Development • National • National Health and Hospitals Reform • National social inclusion policy including White Paper on Homelessness • Preventative Health Taskforce

9. National Health and Hospital Reform Directions • April 2010 COAG agreement: • Establishment of a National Health and Hospital Network. • Commonwealth to: • fund 60% of public hospital services • assume full policy and funding responsibility for primary health services, including primary mental health for people with mild to moderate disorders. • Further work to be undertaken on the scope for additional mental health service reform, including future funding and administrative arrangements for specialist community mental health services. • Mental health investment of $176m nationally over four years.

10. Mental Health Reform Strategy: some initiatives relevant to PCPs • The Community Mental Health Planning and Service Coordination Initiative • Mental health promotion initiatives • Addressing the physical health needs of people with serious mental illness • Psychosocial Rehabilitation and Recovery Support Services reform and development, and • Our Mental Health Advice Line

11. Community Mental Health Planning and Service Coordination Initiative • Strengthening shared responsibility for, and monitoring of, mental health and associated outcomes across local health, community and social support services. • Promoting a population health approach to planning and delivery of mental health and related services, including prevention and early intervention. • Seeding and facilitating local innovation and shared problem solving, using an evidence-based process.

12. Community Mental Health Planning and Service Coordination Initiative - Key Features: • Addressing a small number of achievable service development and coordination priorities in selected areas of each DHS Region • A governance structure drawing on existing Regional partnerships and networks as much as possible • A range of stakeholders will be consulted to identify and develop planning and coordination priorities • Local area action plans will be developed for selected geographical areas, identifying mental health outcome priorities, outlining activities to address priorities, and describing how success will be measured.

13. Promoting mental health and wellbeing – Reform Area 1 Goals: • Leading an organised and collaborative effort to promote positive mental health in targeted community settings • Promoting a socially inclusive society to strengthen recognised protective factors for mental wellbeing Some current activity: • Formation of a statewide mental health promotion network • Workforce development • Promotion of evidence-based interventions • Mental health promoting workplaces: developmental work

14. Improving the physical health of people with severe mental illness • Physical health of people with a mental illness is considerably poorer than general population: • They die an average of 25 years earlier • Those with schizophrenia have a 51% higher premature mortality rate • They are 2-3 times more likely to die from cardiovascular disease • Have twice the prevalence of diabetes • Have much poorer dental health • Despite higher rates of smoking, do not have a higher cancer incidence, but one diagnosed 30% higher case fatality • Hospitalisation rate ratios for physical health problems are often lower than the corresponding mortality rate

15. Improving the physical health of people with severe mental illness Current work: • Physical Health MAC sub-committee • Improving access to primary health care services for people with serious mental illness project

16. Psychosocial Rehabilitation and RecoveryServices Reform and Development Plan • The Plan will provide a strategy and robust business case to guide future investment and service development over the next five years • Current activity: PDRSS survey & one day census, SWOT analysis, program reviews, policy roundtables. • Will strengthen interagency coordination between specialist mental health service sectors and broader health and social support sectors through improved referral pathways and standardised intake criteria.

17. Mental health advice line: Key features • State-wide, 24/7 mental health information advice & referral line: • Caller themselves or friend/family member • All mental health concerns • All ages • Staffed by mental health professionals • Access to interpreting services and the National Relay Service • Screening level assessment / triage • Provides mental health information, advice and referral

18. Mental health advice line: progress report • Data collection to analyse service usage and call-flows • General mental health advice and information • Triage • Emergency calls referred to ‘000’ • Urgent/high risk referrals: nearest ED or local AMHS • Low risk referrals: advised to see usual health care provider or referred to other services such as community/primary health • Stakeholder Reference Group established • Promotion/communication strategy • Website: www.health.vic.gov.au/mhal

19. Why PCPs are important partners in mental health reform? The Victorian Mental Health Reform Strategy has sharpened our focus on the need for: • more holistic community based treatment and support involving a spectrum of primary health, specialist mental health, rehabilitation and social support services • partnerships between health and human service providers and shared responsibility at the local level • improvements in system navigation and service access and strengthening of interagency coordination • taking mental health promotion to the next level