Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697645400957.pdf (Australia)
Mental Health and Suicide PreventionSubmission 144 • • • • • The Productivity Commission’s Inquiries Final Report provides a reasoned, holistic vision of systemic reform that will provide a solid foundation for a national mental health system, one that can guarantee not only the wellbeing of our nation, but also of our national economy.
The National Children’s Mental Health and Wellbeing Strategy provides a strategic blueprint that will increase access to prevention, early intervention, and treatment services for children, helping to shape the future wellbeing of the nation by improving the resilience of the adults of tomorrow.

The Royal Commission into Aged Care Quality and Safety included dozens of recommendations relating to mental health and wellbeing.
If implemented, these recommendations will provide for significantly improved access to mental health services for older people, with much-needed improvements in safety and quality of care through strengthened human rights protections and workforce upskilling and expansion.

The National Mental Health Workforce Strategy will support workforce development which is vital to mental health service delivery.
An expanded mental health system simply cannot function without an adequately sized, trained, and distributed workforce to deliver it.

Interim Advice from the National Suicide Prevention Adviser also provide key insights.

Suicide prevention presents not only a critical gap in current supports available to people in distress, but it also has the potential to generate economic returns on increased investment.
Recommendations The collective recommendations from these reports and strategies will be critical in building a national mental health system that it can respond to situations of both individual and communal crisis.

However, we acknowledge that implementing all recommendations at once poses significant financial and logistical challenges.
That is why a single long-term whole-of-government Implementation and Budgetary Plan is required to bring together and strategically plan for the implementation of the all the recommendations identified in the various commission, inquiry, and strategy reports.

As a part of this Plan, urgent implementation priorities should be identified, funded in the May 2021 budget, and fast-tracked.
Mental Health Victoria has engaged with its extensive stakeholder network (which includes consumer and carer groups, hospitals, community health organisations, medical colleges, professional association, unions, police, and emergency services) to identify nine time-critical initiatives that are crucial to building a solid foundation of reform for a mental health system.

These will support the mental health and economic recovery of the nation.
Mental Health and Suicide PreventionSubmission 144 We urge that the Australian Government: Finalise in 2021 a single, long-term, whole-of-government implementation and budgetary plan for national mental health reform, which combines the recommendations of the key commission, inquiry, and strategy reports, with priority given to urgent implementation of the following initiatives: 1.

Fast-track the Commonwealth’s Adult Mental Centre Program with a particular focus on the needs of Victoria.

2.
2.

Expand and develop youth specialist mental health services.

3.

Develop a National Digital Mental Health Platform to provide nationally consistent assessment, referral, and direct access to low-cost low-intensity evidence-based digital mental health services.

4.

Support the development of the mental health workforce by establishing a national association for peer workers.

5.
5.

Extend the Individual Placement and Support model to community mental health providers to ensure access for job seekers of all ages.

6.

Work with the states and territories to expand access to psychosocial support 7. services.

Implement self-determined strategies to support Aboriginal and Torres Strait Islander mental health, social and emotional wellbeing, and suicide prevention.

8.

Develop a new LGBTIQ+ mental health prevention strategy.

9.
9.

Develop a National Carer Strategy that can provide for the unpaid family and friend carers of people living with mental illness.

Finalise in 2021 a single whole-of-government Implementation and Budgetary Plan for national mental health reform, which combines the recommendations of the key commission, inquiry, and strategy reports.

We cannot fix a fragmented system through a fragmented approach to reform.
While prioritising recommendations for short-, medium- and long-term implementation is necessary, selecting only specific recommendations to invest in or implement will lead to further fragmentation and disconnect, threatening the system’s integrity and responsive capabilities.
A strategic approach to reform planning is crucial and the findings and recommendations from each of the key mental health reports (mentioned above) must be considered not only in relation to each other but also in relation to how they intersect with and influence other government portfolios and policies.
A strategic approach to planning and budgeting for long-term reform implementation can satisfy the need for time-sensitive reforms, capitalise on the benefits of economically beneficial reforms, and mitigate the risks that critical long- term reforms will be neglected.
Mental Health and Suicide PreventionSubmission 144 A single, comprehensive, long-term, and whole-of-government implementation and budgetary plan is therefore required to shape how each of the recommendations will be implemented in the short-, medium- and long-term.
The Plan should consider: • • • the recommendations for prioritisation made in individual reports and strategies with an emphasis on following the prioritises set by expert recommendations the urgency of reforms with a general prioritising of reforms which target critical areas of need.

the interdependency of reforms with a general prioritising of foundational improvements required to facilitate and monitor ongoing system reform.
• ongoing strategies to facilitate cooperation between government departments and across different levels of government.

While the following recommendations provide further, more specific suggestions for prioritisation, they must not detract from the need for long-term implementation and budgetary planning.

Only with long-term strategic reform can we create a mental health system that is cohesive, balanced, and stable enough to be capable of responding in an agile way to future disaster scenarios.
Short-term priorities of the long-term Implementation and Budgetary Plan 1.

Fast-track the expansion of the Adult Mental Health Centre Program with a particular focus on the needs of Victoria.

Hundreds of thousands of Australians are unable access the care they need.

Too often, Australians are told they are ‘too sick’ for primary care support and ‘not sick enough’ for specialist care.
This ‘missing middle’ presents a dire risk for the mental health system’s capacity to respond to rising need in times of crisis, and places unnecessary strain on other parts of the mental health system, as well as emergency services, first responders and the economy more broadly.

Adult Mental Health Centres (AMHCs) will be a critical part of Australia’s future system architecture, and already enjoy strong backing from communities.
We strongly recommend that the Australian Governments revolutionary AMHC program be fast-tracked to include more locations across Australia to ensure that everyone can access the care they need regardless of where they live.

This will take the pressure off the system, provide more scope for scalability in times of crisis, and ensure that people whose needs cannot be met by the primary or specialist systems of care have a place to go.
The rapid establishment of the 15 temporary Victorian HeadtoHelp Clinics in September 2020 has provided great support in this time of need and provided a solid foundation for future centres in Victoria.

We recommend that the HeadtoHelp Clinics be transitioned to permanent AMHCs from September 2021 and that some AMHCs be delivered by Aboriginal Community Controlled Organisations and LGBTIQ+ community health organisations.
Mental Health and Suicide PreventionSubmission 144 A jurisdictional approach like that undertaken to commission the Victorian HeadtoHelp Clinics is important to provide consistency in access and care quality across regions supported by a nationally recognisable brand.

2.

Expand and develop youth specialist mental health services.

Supporting young people to receive mental healthcare is a critical strategy for reducing demands and pressures within the mental health system.
Mental health issues often arise in these years and there is strong evidence that early intervention can significantly reduce the psychological, social, and economic impacts of mental ill-health in the long-term.

Despite this, many young Australians and their families still lack access to appropriate specialist mental health services, especially those with more complex needs.

There are considerable gaps in services, long waits and often a lack of continuity of care.
This is even more pronounced in specific population groups where mental health treatment is often only accessed when a young person’s mental ill health has become acute and requires hospitalisation.

Compounding these issues is the fact that there are not enough skilled professionals to meet demand for youth specialist services both now and in the future.
A comprehensive and evidence-based model and plan around youth mental healthcare is required to augment existing services and address the needs of young people with severe and complex conditions.

This plan should address local service demand and specifically focus on the needs of priority populations such as Aboriginal and Torres Strait Islander young people, LGBTIQ+ young people, and young people with comorbid mental health and alcohol and other drug issues.

3.
3.

Establish a National Digital Mental Health Platform to provide assessment, referral, and direct access to low-cost low-intensity evidence-based digital mental health services.

Many Australians can benefit from low-cost, low-intensity mental health services available through digital means.

However, too much of our mental health system currently relies on costly face-to-face interventions.
A National Digital Mental Health Platform would be a cost-effective way to enable people to more easily identify and access suitable treatment options, particularly in regional areas and out-of-hours.

Such a platform should be established urgently as it would provide quick and large-scale benefits to help Australians access timely care suitable to their needs.

It would also support efforts to manage fluctuations in demand and will bring economic returns which can be used to fund future reforms.
Mental Health and Suicide PreventionSubmission 144 4.

Work with the states and territories to expand access to psychosocial support services.

Psychosocial support services include a range of services to help people manage daily activities, rebuild and maintain social connections, build social skills and participate in education and employment.

These support services are essential to supporting people with psychosocial disabilities to maintain productive lives through connections to community.
However, as highlighted in the Productivity Commission’s Final Report, the delivery of psychosocial supports has been hampered by inefficient funding arrangements and service gaps with the transition to the NDIS.
Given the critical need for expanded psychosocial support services at this time, we support urgent prioritisation of the Productivity Commission’s recommendations that: • governments ensure that all people with psychosocial needs arising from mental illness receive adequate psychosocial support; • as contracts come up for renewal, commissioning agencies extend the length of the funding cycle for psychosocial supports from a one-year term to a minimum of five years; and • commissioning agencies ensure that the outcome for each subsequent funding cycle is known by providers at least six months prior to the end of the previous cycle.
5.

Support the development of the mental health workforce by establishing a national association for peer workers.

The mental health peer workforce requires significant expansion to capitalise on its considerable potential.

The Australian Government can nurture this valuable part of the sector with once-off funding to establish a national association of peer workers.

Once established, ongoing funding may be available through member and organisation fees.
A national association will provide crucial support for workforce development including by improving access to resources, training opportunities and communities of practice, promoting and clarifying the role of peer workers in the sector, and providing advocacy, support, and expert advice to support policy-making and implementation.

This funding is needed urgently to begin the process of workforce planning ahead of service development.
By establishing a national association of peer workers now, we can ensure that the expanding mental health system is supported by a robust workforce that can provide critical supports to people in times of need while reducing crisis-driven demand for more costly alternatives.

Mental Health and Suicide PreventionSubmission 144 6.

Extend the Individual Placement and Support model to community mental health providers to ensure access for job seekers of all ages.
Mental ill-health costs the economy a staggering amount of money in reduced productivity and income support payments.

However, studies show that supporting people with mental health issues through employment services can increase workforce participation rates by up to 30%.

In particular, Individual Placement and Support (IPS) programs have been found to be two-to-three times as effective as traditional vocational rehabilitation in getting people with mental health issues into work.
Given Australia’s post-pandemic priorities of both mental health and economic recovery, expanding IPS programs should be an urgent priority.

As noted in the Productivity Commission’s report, there is evidence that expanded IPS services could result in a net benefit of up to $437 million in savings in the costs of healthcare, employment supports, and Disability Employment Services.
While many young people may have access to IPS via headspace sites, people in other age groups currently have no access to IPS despite growing unemployment rates in the wake of the COVID-19 pandemic.

While MHV has welcomed the Government’s expansion of IPS services for young people through headspace, there is now scope to further expand IPS programs to include people of all ages who are experiencing unemployment.

7.
7.

Implement self-determined strategies to support Aboriginal and Torres Strait Islander mental health, social and emotional wellbeing, and suicide prevention.

The new National Agreement on Closing the Gap and ongoing reforms related to the Uluru Statement from the Heart have the potential to address many underlying social determinants that drive mental ill-health and distress among Aboriginal and Torres Strait Islander communities.
To complement these broad national reforms, we need specific strategies and initiatives that can respond to the culturally specific mental health, social and emotional wellbeing, and suicide prevention needs of Aboriginal and Torres Strait Islander communities.
The National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017–2023 has not been fully implemented despite strong support from the sector as well as the Australian Health Ministers’ Advisory Council, and recommendations for full implementation from both the Closing the Gap 10 Year Review and the Productivity Commission’s Final Report.
Similarly, a second National Aboriginal and Torres Strait Islander Suicide Prevention Strategy is required, accompanied by a fully funded Implementation Plan, as recommended by the National Aboriginal and Torres Strait Islander Suicide Prevention Conference in 2018.
Mental Health and Suicide PreventionSubmission 144 We recommend that: • an Implementation Plan and Budgetary Plan be developed for the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017–2023 • a renewed National Aboriginal and Torres Strait Islander Suicide Prevention Strategy be developed, led by Aboriginal and Torres Strait Islander people, and accompanied by an Implementation Plan and Budgetary Plan • dedicated resources be allocated for Aboriginal and Torres Strait Islander organisations to deliver the above recommendations.
8.

Develop a new whole-of-government LGBTIQ mental health prevention and response strategy.

Lesbian, gay, bisexual, trans and gender diverse, intersex, queer/questioning and other (LGBTIQ+) people experience significantly higher rates of mental ill health and distress, including suicidal behaviours.
Despite this well-known fact, there is a concerning lack of attention being paid to this group, including an absence from key reports and strategies, a lack of comprehensive data, deficits in inclusive practices and no dedicated funding for LGBTIQ+ mental health services.

We know that much of LGBTIQ+ mental ill-health is directly attributable to experiences of prejudice, abuse, invisibilisation, and stigma.
Current reform trends in mental health seem to be underscoring and perpetuating these drivers of mental ill heath, rather than addressing them.

For example, there are no references to LGBTIQ+ families or children in the National Children’s Mental Health and Wellbeing Strategy.

A new LGBTIQ mental health prevention strategy is urgently needed to address the significant complex drivers of mental ill health among this community.
While it would be beneficial here to note the proportion of the Australian community which LGBTIQ+ people represent to underscore the magnitude of the problem, even this data does not exist.
That is why a complete whole-of-government strategy is required to identify gaps and solutions, encompassing both mainstream and community-led mental health and related supports, and levers to support mental health promotion and prevention, to ensure that the reform of the mental health system does not leave LGBTIQ+ people behind.

9.

Develop a National Carer Strategy that can provide for the unpaid family and friend carers of people living with mental illness.
Unpaid family and friend carers perform a vital role in the Australian mental health system, with a report by Carers Australia revealing that carers contributed $77.9 billion in informal care in 2020.

This represents not only an incredible asset for the nation, but also an associated risk if carers do not have access to the support they Mental Health and Suicide PreventionSubmission 144 Mental Health and Suicide PreventionSubmission 144