Integrating Health in Local Government Mental Health It s Everybody s Business

1. Mental Health - It's Everybody's Business 1 Integrating Health in Local GovernmentMental Health � It�s Everybody�s Business October 16th 2003 Robyn Duffy Baw Baw Shire Council

2. Mental Health - It's Everybody's Business 2 Baw Baw Shire Council Rural Council located to the east of Melbourne Distance - reached within 1-1.5 hours car or rail Rapidly expanding towns of Drouin, Warragul, Yarragon and Trafalgar with a number of major subdivisions going through in recent years Population of approximately 35,000 which is expected to increase to 41,000 by 2011. 2nd highest growth rate amongst the Gippsland Councils Dairy, beef, sheep and timber industries

3. Mental Health - It's Everybody's Business 3 Background In 2002 the Baw Baw Shire Council began updating the MPHP; in the past this tended to be a fairly static document - written but left on the shelf Local service providers, community organisations and the general public were invited for input into the MPHP to determine which areas were of concern for these sectors and to determine which program could be developed from these health areas.

4. Mental Health - It's Everybody's Business 4 Background BBSC draft Municipal Public Health Plan listed the following key health areas Mental Health Drug & Alcohol Misuse Cancer Farm Safety Meningococcal Disease The first three were directly determined through the public consultation process; the last two were included by Council

5. Mental Health - It's Everybody's Business 5 Background Projected burden of disease data indicated that the dementia rate will increase in Gippsland faster than the general Victorian population; data indicated that BBSC adults & adolescents aged between 15 & 24 have a higher prevalence of social phobia; the community consultation process indicated the lack of support from family and friends as critical risk factors; and being safe in the home and neighbourhood as important protective factors for their health & well being.

6. Mental Health - It's Everybody's Business 6 Background Burden of Disease Report in 2002 indicated that the Disability Adjusted Life Years (DALY) ranking for Baw Baw Shire males were 54th and females 26th out of the (then) 78 Victorian Councils. For specific health conditions the following DALY rankings were listed Mental Disorders 24th (male) 35th (female) Injury 75th (male) 48th (female)

7. Mental Health - It's Everybody's Business 7 Background Of the injury ranking, suicide was responsible for a large percentage of the total rate, with the suicide rate for males within the BBSC being almost double that of Victoria. The VicHealth Mental Health Promotion Plan 1999-2002 states that people living in rural communities experience higher levels of poor mental health.

8. Mental Health - It's Everybody's Business 8 Background VicHealth research indicated that there are increasing numbers of young rural people seeking help from mental health services and that there are higher rates of suicide among young people in country Victoria In 2002 BBSC prepared a submission for funding through the Department of Human Services� Good Practice Project (which was prior to the MPHP being finalised)

9. Mental Health - It's Everybody's Business 9 Background The stated project aim in our submission was �To raise the profile of mental health issues within the community through advocacy, the engagement of service providers and the whole of Council and by the development and/or promotion of programs that are sustainable.�

10. Mental Health - It's Everybody's Business 10 Background This project aim was then further defined through a number of objectives and specific strategies through which the Committee planned to operate

11. Mental Health - It's Everybody's Business 11 Objective One To provide a coordinated approach to the management of mental health issues within the community To establish a Mental Health Committee consisting of local service providers and a community representative to manage the implementation of the Mental Health Program To develop and print a service provider directory for the community and key stakeholders

12. Mental Health - It's Everybody's Business 12 Objective Two To increase the feeling of belonging to and being a part of one�s community To develop a mental health program that assists in connecting the Koori community back to the land To undertake research that identifies groups within the community who are most at risk of isolation, both physically and emotionally To identify, develop and/or support programs that promote social integration and social support for these at risk groups

13. Mental Health - It's Everybody's Business 13 Objective Three To promote the impacts of poor mental health on the community To develop and have an ongoing community awareness program around key mental health issues

14. Mental Health - It's Everybody's Business 14 Proposed methodology [The BBSC�s Municipal Public Health Plan was formally accepted by Council at the start of 2003.] Development of the Mental Health Committee with representatives from local service providers and across Council services. We would then survey the communities to determine their perceived feeing of being socially disconnected; use focus groups to develop appropriate programs to address social disconnectedness;

15. Mental Health - It's Everybody's Business 15 Proposed program methodology Develop or refine skills within the community to �run with� identified programs. The Committee was to meet regularly, with minutes, motions and recommendations being documented. Establish the sub-committees to implement each of the strategies in the program proposal.

16. Mental Health - It's Everybody's Business 16 Program methodology The Chair of each sub-committee would report to the Baw Baw Health & Wellbeing Advisory Group at each meeting as to their progress Should the implementation of a strategy fall behind, the BBHAG will decide what action will be taken (eg expand what actions to be taken or provide more resources).

17. Mental Health - It's Everybody's Business 17 Priority population groups There were three proposed �at risk� groups to work with during the project Young males (due to high suicide rate within the BBSC community) Koori community Other - to be determined through research to identify further �at risk� groups within the community (thought that due to the geographical isolation that those living within the smaller outlying towns will be will be a focus of this third group)** ** this aspect of the project on hold due to time constraints

18. Mental Health - It's Everybody's Business 18 Key stakeholders Initial key stakeholders with the Good Practice Project were those involved with the development of the MPHP, namely Central West Gippsland PCP (includes the primary care service providers and local council members from Latrobe and Baw Baw Shire Council) Baw Baw Shire Council West Gippsland Health Care Group Aboriginal Cooperative Medical Officer of Health Central West Gippsland Division of General Practitioners

19. Mental Health - It's Everybody's Business 19 Key Stakeholders Upon formal adoption of the BBSC MPHP service providers and members of community organisations were invited to participate in the Mental Health Group which ultimately coordinated the various objectives of the Good Practice Project.

20. Mental Health - It's Everybody's Business 20 Key Stakeholders The Mental Health Committee (later renamed as the Baw Baw Health & Wellbeing Advisory Group) now has the following stakeholders West Gippsland Health Care Group, BBSC, Warragul Community House, Gippsland Child & Adolescent Mental Health, Department of Education, Warragul Police, Central Gippsland Aboriginal Co-op, Primary Mental Health & Early Intervention Services, Central West Gippsland Division of General Practice, Warragul & District Ministers Association, DHS (Regional Health Promotion) and the Central West Gippsland PCP.

21. Mental Health - It's Everybody's Business 21 The process The Mental Health Committee (now the Health & Wellbeing Advisory Group) was established in August 2002 which was after the project proposal and submission was accepted and funded. The new committee wished to review the proposed objectives of the project to determine the relevance with their brief (MPHP) and amend if necessary.

22. Mental Health - It's Everybody's Business 22 Project Process The revised objectives for the Good Practice Project were as follows:- To provide a coordinated approach to the management of mental health issues within the community To enhance the Koori community�s capacity to develop their sense of belonging To identify and develop programs that promote a sense of belonging for young males

23. Mental Health - It's Everybody's Business 23 Project Process The group wanted to set up the Young Males and the Koori sub-committees ASAP The BBHWAG had approximately 10 months in which to run the Good Practice Project The Koori sub-committee was set up using a pre-established and operational committee (Local Aboriginal Education Community Group) that wanted to achieve outcomes for the Koori community and in turn gave the project greater access to the Koori communities within the Council The Young Males committee was less successful as participants were more transitory (wasn�t able to link in with a pre-established working group)

24. Mental Health - It's Everybody's Business 24 Project Process The Koori Subcommittee met 6 times over the life of the project The Young Males Sub-committee met 4 times over the life of the project. The Young Males subcommittee became more of a project team that developed a project aim and sought outside expertise to achieve the aim(s)

25. Mental Health - It's Everybody's Business 25 Discussion Often difficult to get the various organisations together at any one time (suitable times and dates) Difficult to get the full commitment from Committee members due to their other work commitments Meetings may have been scheduled but absentees (apologies) for meetings caused some scheduled meetings to be cancelled Council commitment was provided for the project (and the MPHP) but the expectation is that it is an Environmental Health Unit issue to deal with rather than a whole of Council and community responsibility

26. Mental Health - It's Everybody's Business 26 Discussion There was some community involvement in the project but we hope that future projects have more community commitment. One possible reason is that the Good Practice Project was established before the MPHP was finalised possible lack of ownership with the project from the community viewpoint BBSC Environmental Health Unit represented by 2 staff - other staff had little involvement. Communication within Unit & Council as to the progress must be improved in future projects (have also had the additional problem that the 2 staff involved from the Unit have since left); creating a vacuum at present until other health staff take up the work with the committee

27. Mental Health - It's Everybody's Business 27 Project Outcomes ?Printing a service provider directory - the PCP was developing this as a website based directory; the BBHWAG did not wish to duplicate this Program pcpdirectory.health.vic.gov.au ? The Mental Health Committee was established now called to the Baw Baw Health & Wellbeing Advisory Group (BBHWAG) ? Koori and Young Males subcommittees were established although the Koori subcommittee was more successful.

28. Mental Health - It's Everybody's Business 28 Project Outcomes ? On-going interest in the existence of the BBHWAG ? Development of a funding application & assessment process for mini one-off projects funded through this Good Practice Project (i) Koori Culture Day at Warragul Primary School to encourage student acceptance and understanding of Koori culture and traditions; extend the reconciliation process between the school community and the local Koori community; raise profile of the local Koori community within the school community

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34. Mental Health - It's Everybody's Business 34 Project Outcomes

35. Mental Health - It's Everybody's Business 35 Project Outcomes (iv) Youth Information Card - card includes discount for some local business; contact details for support services. The card was launched locally to coincide with the National Youth Week April 2003. The card was designed with input from kid in the community. The card is available from Council offices, WGHCG, Quantum and local businesses.

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37. Mental Health - It's Everybody's Business 37 Project Outcomes (v) Musical workshop for the Koori community to enhance musical skills with instruments and song writing. Workshop involved Kooris from South Australia. (vi) Developed a training program for people involved in running focus groups to upgrade their skills in being effective group facilitators.

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39. Mental Health - It's Everybody's Business 39 Project Outcomes ? Funded the development of a training program for Koori Youth, to build their leadership skills, with specific input from Koori elders to develop their skills as future leaders within their community. The West Gippsland Indigenous Youth Leadership Program ran for six weeks with 11 Koori Youth. Two Koori elders were employed part time to assist with the program.

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42. Mental Health - It's Everybody's Business 42 Project Outcomes ? Parent Forum at the Warragul Regional College Young as part of the Young Males subcommittee project(s). A clinical psychologist was organised to conduct a forum for carers of adolescents. Open to parents, teachers, youth workers etc. General advertisement in local paper to promote the evening. Outstanding response with 110 people attending. Completed evaluation forms at the end of the evening were collected from 80% of those attending. Indications are that additional sessions like this evening would be valued by the community.

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44. Mental Health - It's Everybody's Business 44 Project Outcomes ? Just for Boys was a one off program funded with Good Practice Project funds. Held in conjunction with 80 year 9 male students. Workshop held to raise and discuss mental health issues faced by year 9 boys and present some strategies for dealing with these issues to provide partnership between BBSC, Dept Education and services available in the community to find out what the boys wanted/needed (within the mental health context). This workshop was not as successful as hoped for a number of possible reasons including it wasn�t considered �fun� to attend; most said they did not learn of ways to cope with stress.

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