Appendix 5
National Mental Health Commission – recommendations and findings
The Commission made nine findings and 25 recommendations in
its report Contributing lives, thriving communities – Report of the National
Review of Mental Health Programmes and Services, 30 November 2014. These
are extracted below.
Summary of recommendations[1]
1. Set clear roles and accountabilities to shape a
person-centred mental health system
Rec 1. Agree the Commonwealth’s
role in mental health is through national leadership and regional integration,
including integrated primary and mental health care.
Rec 2. Develop, agree and
implement a National Mental Health and Suicide Prevention Plan with states and
territories, in collaboration with people with lived experience, their families
and support people.
Rec 3. Urgently clarify the
eligibility criteria for access to the National Disability Insurance Scheme
(NDIS) for people with disability arising from mental illness and ensure the
provision of current funding into the NDIS allows for a significant Tier 2
system of community supports.
2. Agree and implement national targets and local
organisational performance measures
Rec 4. Adopt a small number of
important, ambitious and achievable national targets to guide policy decisions
and directions in mental health and suicide prevention.
Rec 5. Make Aboriginal and Torres
Strait Islander mental health a national priority and agree an additional COAG
Closing the Gap target specifically for mental health.
Rec 6. Tie receipt of ongoing Commonwealth
funding for government, NGO and privately provided services to demonstrated
performance, and use of a single care plan and eHealth record for those with
complex needs.
3. Shift funding priorities from hospitals and income
support to community and primary health care services
Rec 7. Reallocate a minimum of $1
billion in Commonwealth acute hospital funding in the forward estimates over
the five years from 2017–18 into more community-based psychosocial, primary and
community mental health services.
Rec 8. Extend the scope of
Primary Health Networks (renamed Primary and Mental Health Networks—PMHNs) as
the key regional architecture for equitable planning and purchasing of mental
health programmes, services and integrated care pathways.
Rec 9. Bundle-up programmes and
boost the role and capacity of NGOs and other service providers to provide more
comprehensive, integrated and higher-level mental health services and support
for people, their families and supporters.
Rec 10. Improve service equity
for rural and remote communities through place-based models of care.
4. Empower and support self-care and implement a new model
of stepped care across Australia
Rec 11. Promote easy access to
self-help options to help people, their families and communities to support
themselves and each other, and improve ease of navigation for stepping through
the mental health system.
Rec 12. Strengthen the central
role of GPs in mental health care through incentives for use of evidence-based
practice guidelines, changes to the Medicare Benefits Schedule and staged
implementation of Medical Homes for Mental Health.
Rec 13. Enhance access to the
Better Access programme for those who need it most through changed eligibility
and payment arrangements and a more equitable geographical distribution of
psychological services.
Rec 14. Introduce incentives to
include pharmacists as key members of the mental health care team.
5. Promote the wellbeing and mental health of the Australian
community, beginning with a healthy start to life
Rec 15. Build resilience and
targeted interventions for families with children, both collectively and with
those with emerging behavioural issues, distress and mental health
difficulties.
Rec 16. Identify, develop and
implement a national framework to support families and communities in the
prevention of trauma from maltreatment during infancy and early childhood, and
to support those impacted by childhood trauma.
Rec 17. Use evidence, evaluation
and incentives to reduce stigma, build capacity and respond to the diversity of
needs of different population groups.
6. Expand dedicated mental health and social and emotional
wellbeing teams for Aboriginal and Torres Strait Islander people
Rec 18. Establish mental health
and social and emotional wellbeing teams in Indigenous Primary Health Care
Organisations (including Aboriginal Community Controlled Health Services),
linked to Aboriginal and Torres Strait Islander specialist mental health
services.
7. Reduce suicides and suicide attempts by 50 per cent over
the next decade
Rec 19. Establish 12 regions
across Australia as the first wave for nationwide introduction of sustainable,
comprehensive, whole-of-community approaches to suicide prevention.
8. Build workforce and research capacity to support systems
change
Rec 20. Improve research capacity
and impact by doubling the share of existing and future allocations of research
funding for mental health over the next five years, with a priority on
supporting strategic research that responds to policy directions and community
needs.
Rec 21. Improve supply,
productivity and access for mental health nurses and the mental health peer
workforce.
Rec 22. Improve education and
training of the mental health and associated workforce to deploy evidence-based
treatment.
Rec 23. Require evidence-based
approaches on mental health and wellbeing to be adopted in early childhood
worker and teacher training and continuing professional development.
9. Improve access to services and support through innovative
technologies
Rec 24. Improve emergency access
to the right telephone and internet-based forms of crisis support and link
crisis support services to ongoing online and offline forms of
information/education, monitoring and clinical intervention.
Rec 25. Implement cost-effective
second and third generation e-mental health solutions that build sustained
self-help, link to biometric monitoring and provide direct clinical support
strategies or enhance the effectiveness of local services.
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