List of recommendations

Recommendation 1

1.37
The Committee recommends that the Australian Government propose the appointment of a House Standing Committee on Mental Health, Suicide Prevention, and Social and Emotional Wellbeing, at the commencement of the next parliamentary cycle.

Recommendation 2

2.108
The Committee recommends that the Australian Government invest in research to determine the longitudinal impacts of compounding trauma and successive disasters including extreme weather events caused by climate change on the mental health, suicidality, and the social and emotional wellbeing of individuals and communities.

Recommendation 3

2.112
The Committee recommends that the Australian Government ensure that the Deputy Chief Medical Officer for Mental Health is present to provide advice and actively participate at all crisis meetings, and encourage states and territories to adopt an equivalent position, if they have not yet done so.

Recommendation 4

3.127
The Committee recommends that the Australian Government ensure the principle of accessibility is at the forefront of all policy and funding programs for the mental health and suicide prevention sector, with a focus on:
increased funding for specialist services, such as forensic, perinatal and autism services, to innovate, expand and meet demand
frameworks that include consumer co-design and community partnership requirements to ensure equitable access for priority populations
Indigenous-led and culturally appropriate models improving Aboriginal and Torres Strait Islander experiences with mental health and suicide prevention services.

Recommendation 5

4.77
The Committee recommends that the Australian Government review available digital technologies to identify and promote best practice options for mental health and suicide prevention professionals to:
increase access to rapid assessment for self-harm
coordinate with other service providers to reduce administrative pressures on professionals and improve the user experience
track outcomes of care to ensure that the right care is being offered.

Recommendation 6

4.80
The Committee recommends that the Australian Government make compliance with the National Safety and Quality Digital Mental Health Standards mandatory for all digital mental health service providers who receive Commonwealth funding.

Recommendation 7

4.100
The Committee recommends that the Australian Government ensure the next National Digital Health Strategy (2022-27) explicitly addresses barriers to digital access, and includes specific actions for reducing the ‘digital divide’.

Recommendation 8

4.114
The Committee recommends that the Australian Government commit ongoing funding for digital mental health research, considering the increased prevalence of mental health problems and rapid expansion of virtual mental health care.

Recommendation 9

4.117
The Committee recommends that the Australian Government embed and expand virtual mental health care in the next National Digital Health Strategy (2022-27).

Recommendation 10

5.35
The Committee has found that a workforce strategy is key to improving the mental health of all Australians and on this basis recommends that the Australian Government provide funding and other supports needed for the immediate development of a national workforce institute for mental health. The institute must:
include Aboriginal and Torres Strait Islander peoples and lived experience expertise
incorporate professional stigma and burnout reduction strategies
develop avenues for mental health supervision and debriefing for all participants in the mental health workforce.

Recommendation 11

5.51
The Committee recommends that the Australian Government leverage the existing Australian Rural Health Education Network by providing funding for clinical placements in regional, rural and remote university clinics, and using these clinics to trial multidisciplinary, hybrid mental health hubs that integrate digital services and face-to-face services.

Recommendation 12

5.69
The Committee recommends that the Australian Government led by Aboriginal and Torres Strait Islander representatives, engage with state and territory governments, education authorities, schools and tertiary institutions to increase visibility and promote careers in mental health and suicide prevention for Aboriginal and Torres Strait Islander peoples, including students at high school and tertiary institutions.

Recommendation 13

5.89
The Committee recommends that the Department of Health and the National Mental Health Workforce Strategy Taskforce include in the National Mental Health Workforce Strategy:
suicide prevention training standards for all health and allied health professionals and other professionals that form the suicide prevention workforce
national standardisation of suicide training in risk assessments and safety plans, to ensure consistency and evidence-based training delivery
specific references to the workforce development requirements for suicide aftercare and postvention.

Recommendation 14

5.115
The Committee recommends that the Australian Government work with the Medical Board of Australia and the Royal Australian College of General Practitioners to:
review the core competencies required in mental health and suicide prevention for all medical students
identify pathways for general practitioners in training to complete mental health and suicide prevention clinical placements that will expose them to the types of mental health presentations likely to be seen in practice
develop incentives for general practitioners to access General Practice Mental Health Standards Collaboration approved training and continuing professional development.

Recommendation 15

5.132
The Committee recommends that the Department of Health and the National Mental Health Workforce Strategy Taskforce engage with psychiatry peak bodies to develop a workforce strategy that maximises access to the expert skills of psychiatrists for those with complex and serious mental illness, including through:
increasing support for mental health nurses to provide pre- and post-appointment services
a multidisciplinary team or consultancy function, where other health professionals can quickly access psychiatry expertise.

Recommendation 16

5.155
The Committee recommends that the Australian Government appoint a chief mental health nurse to work alongside the Deputy Chief Medical Officer for Mental Health, and encourage states and territories to adopt an equivalent position, if they have not yet done so.

Recommendation 17

5.186
The Committee recommends that the Australian Government support the growth and diversity of psychology specialties by:
funding ongoing Australian research to compare outcomes across the nine areas of practice endorsement in the psychology profession, and using this research to inform future policy and funding decisions
increasing university master's level programs to improve distribution across the nine areas of endorsement, with at least one educational and developmental psychology program in every state and territory
dedicating a percentage of Commonwealth funded scholarships to psychology specialisations outside of the primary clinical psychology pathway
providing funding or tax incentives to registered psychologists:
to increase their capacity to offer placements to psychologists in training and ongoing clinical supervision
for continuing professional development.

Recommendation 18

5.202
The Committee recommends that the Australian Government consider continuing and expanding the Continued Dispensing arrangements, which have enhanced access to vital medicines and improved patient outcomes during the COVID-19 pandemic including for those living with mental ill health, especially in regional, rural and remote areas.

Recommendation 19

5.203
The Committee recommends that the Australian Government evaluate the efficacy of pharmacy mental health training programs and strengthen funding to support an expansion of best practice training in mental health and suicide prevention for all pharmacists and pharmacy staff.

Recommendation 20

5.219
The Committee recommends that the Australian Government review the existing self-regulated standards being used by the counsellor and psychotherapist peak bodies and use the results to determine appropriate terminology, national minimum standards for education, supervision, continuing professional development and oversight requirements.

Recommendation 21

5.274
The Committee recommends that the Australian Government strengthen the frameworks for allied health professions to be fully integrated into the mental health workforce, including by:
reviewing the regulation and oversight of allied health professions that contribute to the mental health workforce, and specifically the need to establish national boards supported by the Australian Health Practitioner Regulation Agency where they do not currently exist
providing funding or incentives to increase the availability of discipline-specific supervision to expand the number of places for allied health professionals wanting to specialise in mental health
recognising the full spectrum of allied health professionals, including physiotherapists, exercise physiologists and Dietitians, and their contribution to the mental health workforce as allied health professionals in the final National Mental Health Workforce Strategy and subsequent implementation plans
developing and implementing a strategy to promote the mental health related interventions that allied health professionals can offer. This should include information targeted at both consumers and other health professionals.

Recommendation 22

5.287
The Committee recommends that the Australian Government formally acknowledge the value of the volunteer mental health workforce, with consideration of its role, training, and standards included in the final National Mental Health Workforce Strategy and subsequent implementation plans.

Recommendation 23

5.323
The Committee recommends that the Australian Government support the development of the lived experience (peer) mental health and suicide prevention workforce by:
establishing a lived experience office within the Department of Health portfolio to support the growth of a safe and effective lived experience (peer) workforce, led by a National Lived Experience Officer
providing seed funding for the establishment of a national professional association for lived experience (peer) workers, with additional guaranteed funding for the first five years of operations.

Recommendation 24

5.352
The Committee recommends that the Department of Social Services, in consultation with the Department of Health, National Mental Health Commission and National Suicide Prevention Office, develop a national carer strategy that includes:
details on how and when unpaid carers are to be integrated into care teams
access to national standardised training for suicide awareness, risk and prevention for all carers
a clear pathway for engagement with carer representative bodies.

Recommendation 25

5.353
The Committee recommends that the Department of Social Services implement a fit-for-purpose respite care program that is flexible and includes access to educational components, counselling services and other supports to boost resilience.

Recommendation 26

6.73
The Committee recommends that the Australian Government provide legislative authority to strengthen the independence of the National Mental Health Commission, with a designated task being to monitor and report on compliance by Primary Health Networks and Local Health Networks against their commitments.

Recommendation 27

6.77
The Committee recommends that the Australian Government review the commissioning constraints on Primary Health Networks to ensure that the implementation of regional plans providing for regional mental health and suicide prevention services can reasonably be delivered.

Recommendation 28

6.80
The Committee recommends that, in line with stakeholder and the Productivity Commission Report recommendations, the Australian Government:
fund Primary Health Networks (PHNs) for mental health and suicide prevention services on five year cycles
transition mental health and suicide prevention services provided by non-government organisations to five year funding contracts
require PHNs to commission mental health and suicide prevention services on five year contracts
strengthen long- and short-term outcome reporting requirements to enable continuous service evaluation in response to increasing the length of contracts and funding cycles.

Recommendation 29

6.84
The Committee recommends that the Australian Government review the types of mental health and suicide prevention services that would be better delivered nationally, noting the importance of having strong national standards of care, quality, and evidence-based practice in service delivery, as well as reducing the burdens of unnecessary commissioning complexity.

Recommendation 30

6.146
The Committee recommends that the Australian Government’s evaluation of Better Access, and reform of the system, focus specifically on:
the viability of bulk-billing incentives available to general practitioners (GPs) being similarly made available to mental health practitioners for the treatment of mental illness, where there are patient affordability constraints
the two-tier system impacts on treatment access, appropriateness and affordability of psychological care
including psychologists with other areas of endorsement (non-clinical endorsement) on the higher rebate tier, noting that this will increase access to specialists, address non-clinical endorsement disincentives and support the diversity of the psychological workforce
the value of extending the annual cap on psychologist sessions, to ensure evidence-based delivery of care for complex presentations to increase affordability for people experiencing serious and/or complex mental illness
the GP referral system for psychological services, including a valid 12 month referral:
utilising digital services for treatment to track patient outcomes
with a limit of two GP review sessions – an initial Better Access assessment/ referral and another after session 10 (to assess if another 10 sessions with the current provider is appropriate).

Recommendation 31

6.148
The Committee recommends that the Australian Government reform the Medicare Benefits Schedule to ensure that the completion of mental health treatment plans and consultations by general practitioners for the management of mental illnesses have the same rebate value as chronic disease management plans and physical health consultations.

Recommendation 32

6.151
The Committee recommends that the Australian Government add Medicare Benefits Schedule items to support case conferencing in the treatment of mental illness for:
allied health professional attendance, for example psychologists, pharmacists, social workers, occupational therapists, exercise physiologists, and speech pathologists
health professional attendance, for example general practitioners, mental health nurses, and psychiatrists
mental health professionals to support the attendance of carers and families.

Recommendation 33

6.189
The Committee recommends that the Australian Government direct specific funding for LGBTIQ+ and sex and/or gender diverse community-controlled health services, community groups and programs to provide mental health and suicide prevention services that meet community needs.

Recommendation 34

6.193
The Committee recommends that the Australian Government formalise commissioning pathways for Aboriginal cultural programs, noting the significant relationship between cultural connectedness and Aboriginal mental health, suicide prevention, and social and emotional wellbeing.

Recommendation 35

6.200
The Committee recommends that the Australian Government:
consolidate its funding portfolios to Aboriginal Community Controlled Health Organisations (ACCHOs) within the Department of Health for Aboriginal mental health, suicide prevention, and social and emotional wellbeing
ensure that Commonwealth funding for Aboriginal services is redirected from Primary Health Networks to ACCHOs, where available
ensure funding is sufficient for the full and rapid implementation of the Gayaa Dhuwi (Proud Spirit) Declaration.

Recommendation 36

6.214
The Committee recommends that the Australian Government ensure:
under the Commonwealth Procurement Rules it is a condition for participation that any potential supplier demonstrate minimum standards of mental health support and care in their workplace
mental health and suicide prevention service commissioning activity requires services to reasonably demonstrate the inclusion of lived experience in service design and delivery.

Recommendation 37

7.42
The Committee recommends that the Australian Bureau of Statistics Standard for Sex, Gender, Variations of Sex Characteristics and Sexual Orientation Variables, 2020 be embedded into all health and social services minimum datasets, including coroners’ data and Census data.

Recommendation 38

7.49
The Committee recommends that the Australian Institute of Health and Welfare convene a cross-jurisdictional working group, including Commonwealth, state and territory authorities, researchers, clinicians, and service delivery organisations, to establish a national collection framework for data on mental health and suicide prevention. The national collection framework must include:
a central repository of current, harmonised and comparable data from all jurisdictions which is broadly available for research and service delivery planning
harmonised data reporting requirements for inclusion in service delivery contracts.

Recommendation 39

7.67
The Committee recommends that the Australian Government develop enabling legislation to make the National Mental Health Commissioner an independent officer of the Parliament with responsibility under the legislation for monitoring and reporting on outcomes of mental health and suicide prevention initiatives.

Recommendation 40

8.30
The Committee recommends that the Australian Government ensure the sixth National Mental Health and Suicide Prevention Plan acknowledges and addresses the social determinants of health and psychosocial supports needed in the treatment of mental illness and suicide prevention.

Recommendation 41

8.91
The Committee recommends that the Australian Government work with state and territory governments to:
conduct an independent evaluation on the effectiveness of existing programs that support wellbeing in schools, including the National School Chaplaincy Program, with a focus on the outcomes of children participating
implement an agreement to increase the ratio of school psychologists to a minimum of one full time equivalent on-site for every 500 students across all levels of school.

Recommendation 42

8.96
The Committee recommends that the Australian Government prioritise the needs of young people by implementing a national prevention and wellbeing strategy through the Australian curriculum, which includes upskilling staff and students.

Recommendation 43

8.113
The Committee recommends that the Department of Health and the National Mental Health Commission develop, define and promote a common mental health language that can be shared across the community, and especially vulnerable groups including Aboriginal and Torres Strait Islander peoples, other culturally and linguistically diverse communities, elderly, youth, and LGBTIQ+ people.

Recommendation 44

8.114
The Committee recommends that the Australian Government fund the development of training resources for the mental health workforce in the provision of culturally appropriate and sensitive services to Aboriginal and Torres Strait Islander peoples, other culturally and linguistically diverse communities, and LGBTIQ+ and sex and/or gender diverse individuals. Such training should be mandated through Australian Government funding agreements.

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