Chapter 17 - Recommendations

Chapter 17 - Recommendations

17.1      This report has demonstrated that there is much work to do in the area of mental health. There needs to be more money, more effort and more care given to this neglected part of our health care system. There is not enough emphasis on prevention and early intervention. There are too many people ending up in acute care, and not enough is being done to manage their illness in the community. There are particular groups, and people with particular illnesses, who are receiving inadequate care. Many of these findings have been confirmed by other organisations and reports in recent years.

17.2      The tremendous interest in this inquiry indicates that there may now be a preparedness to fix the problems identified and that this inquiry is timely. The committee was inundated with submissions not only drawing attention to the system's failings, but offering constructive suggestions on how to fix them. As the inquiry was being conducted, widespread media attention to the issue was matched by regular policy announcements by governments.

17.3      Most recently this groundswell of interest has resulted in a commitment by the Council of Australian Governments (CoAG) to look at mental health reform. Translating community concern and the opportunity presented by this committee's extensive inquiry into policy action, CoAG is looking to negotiate the delivery of new and better services for people with mental illness.

17.4      The committee wholeheartedly endorses steps being taken by governments in this direction. Much of what the committee has investigated is relevant to CoAG's deliberations. The committee wanted to ensure that its findings could help shape proposals that CoAG would consider. As the Chair has outlined in the Foreword to this report, it decided to do this by delivering this first report in time for governments to effectively take account of its recommendations as they worked toward agreement on reform. This concluding chapter draws together a number of key recommendations, largely focussed on those things the committee believes should be drawn to CoAG's attention, and which could be relevant to its deliberations.

17.5      As the Foreword explains, further detailed recommendations will be included in the committee's second report to be released in coming weeks.

Seeking CoAG agreement on more community care

Recommendation 1

17.6      The committee recommends that COAG initiates:

Note: evidence suggests that the mental health budget should, by 2012, reach between 9 and 12 percent of the total health budget and whilst significant investment is required in mental health in the short to medium term, it is anticipated that early intervention and community-based care would deliver savings in the long term.

Developing mental health strategies

17.7      The above recommendation lies at the heart of the committee's vision of a mental health care system that is more accessible, more community centred and better resourced. However, more coordinated and effective planning should also pay big dividends for mental health, including reforms to the National Mental Health Strategy, as well as developing concrete plans in some specific areas of mental health.

Recommendation 2

17.8      The committee recommends that the Australian Health Ministers agree to:

Recommendation 3

17.9      The committee recommends that the Australian Health Ministers agree to establish a timeline and implementation plan for the National Statement of Principles for Forensic Mental Health

Advocacy, monitoring and research

17.10         The committee heard extensive evidence of the need to strengthen consumer advocacy, improve mental health research, and create more rigorous monitoring of the implementation of mental health policy objectives. It is of the view that a range of organisations can contribute to achieving these goals. The following recommendation aims to spread a range of tasks across some existing, and some new, organisations that work on mental health and human rights.

Recommendation 4

17.11         The committee recommends that Australian Health Ministers agree to

17.12         The committee believes other measures should also be introduced that would strengthen leadership and consumer advocacy in mental health. Some of these will be outlined in the committee's second report, but others the committee believes should be considered immediately by governments

Recommendation 5

17.13         The committee recommends that Australian Health Ministers agree to recognise mental health as a designated ministerial responsibility in federal, state and territory departments of health

Recommendation 6

17.14         The committee recommends that state and territory governments agree to harmonise Mental Health Acts relating to involuntary treatment and admission 'sectioning', and establish inter-state arrangements for treatment where the strict application of state and territory responsibility can mean far longer distances must be travelled to access services than could be the case.

Recommendation 7

17.15         The committee recommends that all governments establish benchmarks for the employment of consumer and carer consultants in mental health services, including forensic mental health services, and that all service providers have formal mechanisms for consumer and carer participation.

17.16         Progress in mental health reform will rely on being able to assess the changing nature of mental health service provision, and on boosting the mental health research effort significantly. The committee believes that better information and research about mental health is something that could be a useful part of a CoAG package of reforms.

Recommendation 8

17.17         The committee recommends that the Australian Institute of Health and Welfare should collect comprehensive data on mental health service provision such as the number of people receiving treatment and the nature of that treatment, public and private, and on population wide indicators of mental health and wellbeing.

Recommendation 9

17.18         The committee recommends that the Australian Government increase funding to the National Health and Medical Research Council (NHMRC), to enable an increase in research funding on mental health from $15 million,[2007] at least doubling it to $30 million per year.

Other joint government initiatives

17.19         The committee heard about a host of other reforms and service delivery proposals that could deliver better mental health services. They have been discussed throughout the chapters of this report and some will also be addressed in the committee's second report. However the committee wanted to mention two that it believed would require cooperative action by governments and could be considered as part of the current CoAG process.

Recommendation 10

17.20         The committee recommends that Australian Health Ministers consider the creation of a national emergency 1800 telephone helpline, resourced to provide mental health crisis responses 24 hours a day, 7 days a week and staffed by personnel with expertise in mental health.

Recommendation 11

17.21         The committee recommends that Australian Health Ministers agree that funding for SAAP be increased overall, and that there be dedicated resources within that funding for clients with complex needs including dual diagnosis.

Recommendations for specific governments

In its second report, the committee will make a range of recommendations about specific issues and programs. Some of these will involve particular initiatives that look promising and warrant being expanded; others will involve practices and areas of neglect that need to be remedied. Given the current discussions going on in CoAG, however, the committee wanted to put some further recommendations forward that could be considered as all governments negotiate what the committee hopes will be a new deal for mental health.

Further recommendations for specific Australian Government action

Recommendation 12

17.22         The committee recommends that the Australian Government

Further recommendations for state and territory government action

Recommendation 13

17.23         The committee recommends that state and territory governments

17.24         The committee hopes this report will be a step forward in the process of improving mental health services in Australia. It looks forward to the adoption of the recommendations included here by CoAG and by all Australian governments.

Senator Lyn Allison

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