Hong Kong Mental Health Council Conference: “Building a better mental health system through engagement” GEORGIE HARMAN,

1. Hong Kong Mental Health Council Conference: “Building a better mental health system through engagement” GEORGIE HARMAN, ACTING CEO NMHC Australia 11 January 2014

2. Summary • Setting the scene • Who we are • Our approach • Our impact to date • Critical success factors

3. The Australian context

4. Mental health in Australia

6. How we came to be

7. “In a field where there has always been a wide range of views, the establishment of a mental health commission was one area where there was broad bi-partisan consensus.” Rob Knowles, Commissioner

8. Who we are • Australia’s first national mental health commission, established 2012 • Funded by Australian Government … but independent and have bipartisan support • 10 commissioners (including CEO) who bring different perspectives and experience,12 staff • Work across all sectors andalllevels of government • Use a partnership model to influence and drive positive change

9. What we do • Report to Government and the community on cross sectoral performance and reform progress • independent reporter through annual National Report Card on Mental Health & Suicide Prevention • independent adviser to government on where we are doing well and where we are not • collaboratorto widen our impact, influence and leverage change • New Government: New task – comprehensive review of mental health programs

10. What we don’t do • Run services, programs or hold funds • Implement policy • Not an apologist • Reinvent the wheel – we work with others • Get involved in individual cases or advocate for individual people - we’re an advocate for whole of life system improvementand better accountability “We’re a really small group and we don’t control the money. But we can be a catalyst, a collaborator and an influencer”Jackie Crowe, Commissioner

11. “People with mental health problems want the same things as everyone else. Even the most disadvantaged should be able to live a ‘contributing life’ – whatever that means for them – a stable home, a decent education, a job, family, friends and healthy relationships, good treatment and rights.” Commissioner Janet Meagher

12. A different model to drive reform: A Contributing Life

13. Report Card 2012 • Launched November 2012 • Anew narrative, a new view of mental health in Australia • Goes far beyond the clinical and the medical to the whole of life • Laid out our big picture view: • mental health must be a national priority for all governments and the community • agreeing on the right incentives to drive good services • providing ‘a complete picture’ of what’s happening and closely monitoring and evaluating change • analysing the gaps and barriers to achieving a contributing life and putting a framework in place that sets Australia’s direction • 10 recommendations for action

14. Report Card 2013 • Launched exactly one year later – November 2013 • Reported back on progress • 8 furtherrecommendations for action

16. Highlights: activities & success to date Promoting mentally healthy workplaces We established the Mentally Health Workplace Alliance, a national coalition of business, community and government leaders • What is important to a contributing life? • We regularly and systematically listened to people’s experiences of mental health Working to eliminate the use of seclusion and restraint We started an independent project to look at good practice approaches nationally and overseas Valuing lived experience and the expertise it brings We implemented a Paid Participation Policy & Participation and Engagement Framework Measuring success in a way that’s meaningful to people’s experiences In 2012 we called for national goals and targets to improve mental health and reduce suicide. We led a national consensus building process and provided a framework to governments in September 2013 We forged strong relationships across Australia and overseas International meeting which led to the Sydney Declaration, signed several MOUs

17. Critical success factor #1 • Build evidence, be honest and credible, “tell it how it is” • Strong leadership • Independent commentary and recommendations, especially in absence of legislative or regulatory powers • Constant presence: report back on progress • Focus on outcomes for people and families, not activity • Highlight gaps, good and bad practice • Whole of life approach • Broaden the evidence base – qualitative data

18. Independent recommendations & annual progress reports Recommendation 2: Increase access to timely and appropriate mental health services and support from 6-8 per cent to 12 per cent of the Australian population • 2012 Recommendation: • 2013 How we reported progress: • The Commission is DISAPPOINTED about the lack of leadership by our governments • The Commission is HEARTENED by the co-operative approach across the country to openly report public service seclusion rates as a first step • But the Commission is DISAPPOINTED that we remain distant from our target to end the use of seclusion and restraint and will continue to push for action Recommendation 3: Reduce the use of involuntary practices and work to eliminate seclusion and restraint

19. Independent recommendations & annual progress reports • 2012 Recommendation: • 2013 How we reported progress: • The Commission was ENCOURAGED by governments’ commitment to develop national targets and indicators for mental health reform • The Commission is DISAPPOINTED that while targets have been developed and submitted there is no commitment yet to adopt them Recommendation 4: All governments must set targets and work together to reduce early death and improve the physical health of people with mental illness

20. Critical success factor #2 Be relevant, don’t over promise and pick issues to drive the biggest system changes • Aspirational but also understand constraints, strong “internal compass”, clear values and priorities • Publicly available work plan • Make reform everyone’s business • Systemic transformation: • Improving life expectancy: physical health • Improving community understanding, tackling stigma and discrimination: seclusion & restraint, work opportunities • It’s about the economy, stupid: Mental wealth of the nation • National performance targets and indicators that the community will understand: streamlining data, outcomes focused, all of life

22. TARGET: better physical health and improved life expectancy • Physical health of people with severe mental illness • Indicator 1: Improve life expectancy of adults with a mental illness to achieve parity with adults without a mental illness. Focus on: • Reducing smoking rates of adults over 18 years with a mental illness by 30% in four years and 60% in 10 years • Increasing the proportion of adults over 18 with a disclosed mental illness who are screened every 12 months for physical and dental health issues by 40% in four years and 90% in 10 years

23. TARGET: Improve population wellbeing Population wellbeing Indicator 2: Increase the proportion of the population who report positive emotional wellbeing Wider determinants of mental health and illness Indicator 3: Increase the proportion of consumers and carers in safe, affordable, appropriate and stable accommodation to meet their mental health support needs Indicator 4: Reduce the number of 16-25 year old Not in Employment, Education or Training (“NEET” – OECD measure)

24. Critical success factor #3 • Relationships, relationships, relationships • First priority was to build relationships • Influence the actions, advocacy and behaviour of others, and not just the “usual suspects”: e.g. Business Council of Australia • Amplify the Commission’s efforts through key partnerships: e.g. with Australian state mental health commissions, Health Workforce Australia • Inside the tent: respectful relationships with government • International links – Canada, New Zealand etc

25. Recommendation 8: Increase the levels of participation of people with mental health difficulties in employment in Australia to match best international levels.

26. Critical success factor #4 • Genuine participation and engagement • Listening not just talking • Agile and non-bureaucratic • Ask people what works Recommendation 1: “Nothing about us, without us” – there must be a regular independent survey of people’s experiences of and access to all mental health services to drive real improvement

27. It’s not about “them”…but about us

28. Include us in decisions that affect us Support us to develop our own models of care for ourselves, our families and our community Listen to us Visit to Santa Teresa community, near Alice Springs

29. C:\Users\pmc5288\Pictures\join-the-conversation - Shortcut.lnk

31. Visit us at www.mentalhealthcommission.gov.au

32. The last word…Video: Reflections at the launch of the 2013 Report Card