Annual Report - Outcome 11

Table of contents

Part 3: Management Arrangements

Part 4: Accountability Reporting

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Outcome Summary

Outcome 11 aims to ensure that people with a mental illness, their families and carers can access the support they need through prevention, early intervention initiatives, and improved mental health care. The outcome is also focused on an integrated approach to mental health care; and reducing the prevalence, disability and impact of mental illness and suicide in the community. The Department worked to achieve this outcome by managing initiatives under the program outlined below.

Program Administered Under Outcome 11 (Program Objectives in 2008–09)

Program 11.1 – Mental Health

Provide access to care for people with mental illness, and offer support for their families.
Promote mental wellbeing and prevent mental health problems where possible.

This chapter reports on the major activities undertaken by the Department during the year, addressing each of the key strategic directions and performance indicators published in the Outcome 11 chapters of the 2008–09 Health and Ageing Portfolio Budget Statements and 2008–09 Health and Ageing Portfolio Additional Estimates Statements. It also includes a table summarising the estimated and actual expenditure for this outcome.

Outcome 11 was managed in 2008–09 by the Mental Health and Chronic Disease Division.

Major Achievements for the Outcome:

Improved access to primary mental health care by: supporting psychiatrists, general practitioners and allied mental health professionals; and developed new, flexible and innovative service models to improve access to mental heath care for people living in rural and remote areas (see Improving Access to Better, More Integrated Primary Mental Health Care); and
Worked closely with the Victorian State Government and key stakeholders to develop and implement a mental health response to the Victorian bushfires in order to support psychological recovery for people affected by the fires (see Key Fact for 2008–09: February 2009 Victorian Bushfires).

A Challenge for the Outcome:

Continuing to improve mental health outcomes for people with severe and persistent mental illness, due to the variable levels of coordination and integration of mental health services around the country (see Reducing the Impact of, and Promoting Sustained Recovery from Mental Illness).

Key Strategic Directions for 2008–09 – Major Activities

National Mental Health Reform

Preventing mental illness and promoting early recovery will lessen the burden of poor mental health. Results from the 2007 National Survey of Mental Health and Wellbeing, conducted by the Australian Bureau of Statistics, and available at www.abs.gov.au, indicate that one in five people aged 16 to 85 years experience one of the common forms of mental illness (anxiety, affective or mood disorders, and substance use disorders) in any one year. Prevalence rates vary across the lifespan and are highest in the early adult years. In 2008–09, the Department focused on activities to develop a national, whole-of-government, whole-of-community approach to prevent the occurrence of mental illness, or reduce its impact through early intervention practices.

National Mental Health Policy

The Department worked to ensure that the community had access to a health system that can detect and, where required, intervene early to reduce the burden of mental illness. In March 2009, the Department, in conjunction with state and territory health departments and stakeholders published the National Mental Health Policy 2008 (available at www.health.gov.au). The policy is a step towards establishing a whole-of-government, whole-of-community approach to improve mental health outcomes for people with mental illness.

The policy works to create a mental health system that: detects and intervenes early in illness; promotes recovery; ensures that individuals with mental illness have access to effective and appropriate treatment; helps people with mental illness to participate in the community; and lessens the stigma often attached to mental illness. It identifies specific groups at risk of developing mental illness, including: people who are homeless or who experience other forms of disadvantage; those who have experienced traumatic events; and Aboriginal and Torres Strait Islander people who face unique challenges in social and emotional wellbeing. The policy provided the basis for the development of the Fourth National Mental Health Plan, which the Department expects to be finalised in 2009–10.
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National Mental Health Report

The Department also worked with state and territory stakeholders to produce the National Mental Health Report series as a key accountability mechanism for monitoring shifts in the way mental health services are delivered (available at www.health.gov.au). The 2007 report presented data on progress to achieve national mental health reform under the National Mental Health Strategy. The Department expects to release the 2008 report in late 2009, which will update all information available from 2006–08.

Key Fact for 2008–09: Contact Numbers to Use When in Need

Information numbers supported by the Department that may help people in times of need include:

Lifeline 13 11 14
Kids Help Line 1800 551 800
Mensline 1300 789 978

Providing Multidisciplinary Programs to General Practitioners, Mental Health Nurses, Psychologists and Psychiatrists

Preventing, or intervening early in any occurrence of mental illness can avert and/or reduce suffering in the community. Providing a skilled workforce to deliver services based on the best available evidence will improve the detection, prevention of, or intervention for, mental illness. In 2008–09, the Department aimed to achieve this by providing education and training opportunities in mental health to general practitioners, mental health nurses, psychologists, social workers, occupational therapists and psychiatrists.

Additional Education Places, Scholarships and Clinical Training

In 2008–09, the Department worked to increase the mental health workforce by implementing the Mental Health Nurses and Psychologists Scholarship Subsidy under the Additional Education Places, Scholarships and Clinical Training in Mental Health initiative. The scheme will provide up to 1,070 mental health nursing scholarships and 222 clinical psychologist scholarships between 2008–09 and 2010–11. Of these, 340 will be available to rural and remote recipients. Scholarships will be to the value of $15,000.

This year, the Department saw a total of 356 scholarships awarded to 244 mental health nurses and 112 clinical psychologists. Of these, 139 were for people in rural and remote areas.

Funding for the above activities was sourced from Program 11.1 – Mental Health.
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Reducing the Impact of, and Promoting Sustained Recovery from Mental Illness

The burden of poor mental health can be severe and reducing the effects of, and improving recovery from, mental illness will benefit people living with mental illness, their families and carers. The Mental Health of Australians 2: Report on the 2007 National Survey of Mental Health and Wellbeing revealed that over four per cent, or over 650,000 people, had severe mental disorders in the 12 months prior to completing the survey (available at www.health.gov.au). In 2008–09, the Department focused on: improving continuity of care between clinical and community care needs; consulting with stakeholders on the proposed Fourth National Mental Health Plan; and establishing the National Advisory Council on Mental Health.

Improved Continuity of Care

Ensuring that care is provided to people living with mental illness at the right time will reduce the degree of impairment associated with mental illness. In 2008–09, the Department worked with State and Territory Governments, and stakeholders, to progress the Council of Australian Governments’ (COAG) care coordination initiative, which aims to link clinical and community care for people with severe and persistent mental illness and complex needs. While all jurisdictions made progress during the year, there were variable levels of coordination and integration in mental health delivery around the country and further work is needed. The Department will continue to collaborate with the states and territories to improve the coordination and integration of the range of care needs for this vulnerable group, through both the implementation of the COAG National Action Plan on Mental Health and the Fourth National Mental Health Plan expected to be finalised in 2009–10.

National Mental Health Plan

Better planning and prioritisation leads to improved treatment outcomes and can reduce the impact of mental illness. In 2008–09, the Department supported the development and national consultation process for a Fourth National Mental Health Plan. The plan is expected to set health ministers’ agenda for collaborative government action in mental health. This whole-of-government approach acknowledges that many of the determinants of good mental health, and of mental illness, are influenced by factors beyond the health system.

The Department contributed to the plan’s drafting process by consulting and collaborating with all key stakeholders, including consumer and carer representatives, non-health sectors, and relevant Ministerial Advisory Councils. This collaborative approach will ensure that the final plan sets out meaningful objectives that can be undertaken across governments and sectors to improve the mental health system.

The draft plan sets five priority areas: social inclusion and recovery; prevention and early intervention; service access, coordination and continuity of care; quality improvement and innovation; and accountability. It also identifies links between health and other sectors, such as community and disability, housing, employment, education and corrective services. The Department will continue to work with State and Territory Government health departments and the mental health sector to finalise the plan in 2009–10.
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National Advisory Council on Mental Health

In 2008–09, the Minister established the National Advisory Council on Mental Health to provide timely, expert, balanced and confidential advice to the Government on mental health issues. The Department assisted the council to progress a range of activities which included: the provision of advice on the development of the draft Fourth National Mental Health Plan; a review of Australian Government mental health programs; and the development of a draft National Mental Health Report Card. In addition, the council facilitated national consultations with the community mental health sector around the roles and responsibilities of the different levels of government in the delivery of community mental health services, specifically for people with severe and persistent mental illness with complex needs.

Funding for the above activities was sourced from Program 11.1 – Mental Health.

Improving Mental Health for Women with Depression in the Antenatal and Postnatal Periods

Research indicates that each year around one in ten pregnant women in Australia experiences depression, and almost one in five experience depression in the weeks and months after giving birth. During 2008–09, the Department focused on improving the early detection of antenatal and postnatal depression, and providing better support and treatment for women with perinatal depression through the National Perinatal Depression Plan.

Antenatal and Postnatal Depression

To reduce the impact of ante- and postnatal depression, the Department worked closely with state and territory health departments, beyondblue, and consumer and carer representatives to develop the National Perinatal Depression Initiative Framework 2008–09 to 2012–13. This framework will be released in 2009–10. The framework will outline key areas for action to improve the prevention and early detection of antenatal and postnatal depression, and to provide better care, support and treatment for women experiencing perinatal depression. These areas will include screening for perinatal depression, the development of better care pathways and improving community awareness. The Department also worked with the Divisions of General Practice to increase their capacity to provide psychological services for women identified as having perinatal depression.

In 2009–10, the Department will work closely with State and Territory Governments, the Divisions of General Practice and beyondblue to bridge the gap between the identified need within the community, and to provide necessary treatment and support. The Department will also commence work to provide specialist telephone‑based peer support for women seeking assistance for perinatal depression.

Funding for the above activities was sourced from Program 11.1 – Mental Health.
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Providing Early Intervention Services for Children and Young People

An estimated 14 per cent of children and young people are affected by mental illness every year. Mental health problems and mental illness often first appear in adolescence or early adulthood and can seriously disrupt school, work and family relationships. This can have immediate and potentially long-term negative personal and social outcomes, such as substance abuse and behavioural problems. Assisting young people at the earliest point possible to get access to appropriate services is critical, particularly given the high prevalence of mental illness among young Australians and the associated negative social consequences. In 2008–09, the Department worked to promote mental health, and provide prevention and early intervention services to children and young people.

Services for Children

Complex mental health problems can appear in childhood and infancy, and can impact on early development and long-term mental health and wellbeing. Early identification and intervention can help minimise the severity and duration of the illness, and reduces the impact on the lives of those affected.

In 2008–09, the Department, through the New Early Intervention Services for Parents, Children and Young People initiative, supported early intervention for children who are at highest risk of developing mental health problems, or who are showing early behavioural signs or symptoms of mental health problems. It did this by promoting a number of initiatives under the KidsMatter suite of activities, including the rollout of the KidsMatter Primary School initiative in partnership with the Australian Psychological Society, Principals Australia and beyondblue. KidsMatter Primary is the first national mental health initiative developed specifically for primary school. The initiative utilises those who have a significant influence on children’s lives, such as parents, carers, teachers and the school community, to promote positive mental health during this important developmental period. It also supports schools to promote mental health, and develop strategies for prevention and early intervention.

The Department also worked with stakeholders to extend the KidsMatter initiative into preschool and long day care centres, to help children by providing resources and information to assist parents and preschool professionals to better understand mental health issues. The early childhood initiative will be piloted in over 100 locations in 2010 and 2011 (see www.kidsmatter.edu.au for further information).

Services for Young People

One in four young Australians aged between 12 and 25 years will suffer from mental illness in any one year and this can lead to alcohol and or drug abuse, and subsequent social problems.

In 2008–09, the Department, through headspace, the National Youth Mental Health Foundation, provided a national, coordinated focus on youth mental health, and related drug and alcohol problems to improve access for young people aged 12 to 25 years to appropriate services. The Department supported the provision of youth friendly allied health care to 13,754 young people in 30 headspace Communities of Youth Service sites. The allied health workers at these sites provided clinical care and played a key role in coordinating allied health care for young people, which supported them to remain in education, training or employment.

The Department worked with the Brain and Mind Research Institute, Orygen Youth Research Centre, the Australian General Practice Network, the Australian Psychological Society and the University of Melbourne, to establish headspace and put an appropriate governance system in place. The company will become fully operational in 2009–10. The Department will work with the new headspace company to support its efforts to build a sustainable service model and continue to achieve good outcomes for young people.

Funding for the above activities was sourced from Program 11.1 – Mental Health.
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Improving Access to Better, More Integrated Primary Mental Health Care

The effects and duration of mental illness can be reduced when people have access to a primary health care service that is well integrated and focused on good mental health outcomes. The 2007 National Survey of Mental Health and Wellbeing revealed that only one in three people with a mental illness sought professional help for their condition. In 2008–09, the Department provided Medicare-funded primary mental health services, access to allied psychological services, and increased accessible support and intervention services, for people with high prevalence mental illnesses such as depression and anxiety.

Medicare-eligible Primary Mental Health Services

The Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule initiative aims to improve community access to quality primary mental health care through a range of Medicare rebateable services for eligible people with a diagnosed mental disorder. In 2008–09, over one million people accessed almost 4.3 million Medicare subsidised primary mental health care services. This included around 300,000 people living in regional, rural and remote areas. Over nine million mental health services have been subsidised through Medicare since the initiative started in 2006.

During 2008–09, the Department monitored the uptake and expenditure of the Better Access Medicare items to ensure the initiative: targeted primary mental health services to those most in need; provided quality mental health services; and enabled people to access the high quality services appropriate to their needs. Figure 2.3.11.1, shows that the initiative is increasing community access to mental health services.

Access to Allied Psychological Services

To support the needs of people living with a mental illness in the community, the Department managed the Access to Allied Psychological Services initiative which provides flexible mental health care services and targets gaps for people who are unable to access Medicare rebateable mental health services. A major achievement for the Department in 2008–09, was the substantial number of general practitioners and allied health professionals who participated in this initiative by providing mental health services to clients who may not have accessed mental health services in the past. From 1 July 2008 to 31 March 2009, 26,022 individuals were referred to the initiative and 110,970 sessions of care were provided. The majority of referrals were for the treatment of high prevalence disorders such as anxiety and depression.

The Department supported 22 rural and remote Divisions of General Practice to participate in a trial of telephone-based cognitive behaviour therapy. It also provided funding to 19 Divisions of General Practice to establish and operate demonstration sites to help general practitioners with patients at risk of suicide and self harm. These trials will continue in 2009–10.

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Figure 2.3.11.1: Monthly Claims for Mental Health Care Items at the National Level

Source: Medicare Australia website, Medicare Statistics, 25 July 2009

Mental Health Therapies and Interventions

Telephone and web-based mental health therapies and interventions can complement face-to-face services and help alleviate the burden of mental illness. They can be of particular benefit for people living in rural and remote areas, where anonymity can be an issue, or for people who prefer to access services in a non-clinical setting.

In 2008–09, the Department increased timely and accessible intervention services and support for people with high prevalence mental illnesses, by supporting the development of evidence-based telephone and web-based therapies. During the new year, the Department will provide clinically supervised internet-based treatment for anxiety and depression through a new ClimateGP initiative, to supplement face-to-face service provision. This will involve a staged rollout of the initiative across all states and territories.

Funding for the above activities was sourced from Programs 11.1 – Mental Health and 5.1 – Primary Care Education and Training.
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Reducing the Incidence of Suicide by Supporting National Activities, with a Focus on High Risk Groups

The latest figures show that 1,881 deaths were registered as suicide in Australia in 2007 (3303.0 Causes of Death, Australia, 2007, Australian Bureau of Statistics, www.abs.gov.au). While this was significantly lower than the highest figure of 2,723 recorded in 1997 (3303.0 Causes of Death, Australia, 1997, Australian Bureau of Statistics, www.abs.gov.au), the numbers of people dying from suicide is still unacceptably high. The issues surrounding suicide are complex, however there is often a link to mental illness.

In 2008–09, the Department worked with 19 Divisions of General Practice to provide better support in the community for people who have harmed themselves, attempted suicide or contemplated suicide as a solution to their problems. Through this project, specially trained allied health professionals provided intensive psychological support to clients for a month following a suicide attempt and discharge from an accident and emergency ward, and 24 hour, seven day specialist allied health telephone support.

The Department supported the Australian Suicide Prevention Advisory Council, through secretariat services, to provide new governance arrangements for the National Suicide Prevention Strategy and obtain expert advice on priorities for suicide prevention. In 2008–09, the council advised on criteria for funding community-based suicide prevention activities, which the Department used to facilitate joint planning of future locally based suicide prevention initiatives with state and territory health departments. The council also provided advice on how best to target 2008–09 suicide prevention activities in communities experiencing suicide clusters and suicide hot spots.

Over 2009–10, the Department will aim to better align the working arrangements between the Australian and State and Territory Governments on suicide prevention. This will strengthen the emphasis on the integration of government suicide prevention activities through more formal joint planning processes, utilising existing frameworks such as the Living Is For Everyone Framework for Prevention of Suicide in Australia.

Funding for the above activities was sourced from Program 11.1 – Mental Health.

Key Fact for 2008–09: February 2009 Victorian Bushfires

A major achievement for the Department was the provision of an immediate response to individuals affected by the Victorian bushfires in February 2009. The Department provided additional funding to existing mental health programs to address the increased demand for psychological services from those people experiencing persistent mental health symptoms as a result of the fires. The Department also increased its investment in phone counselling to support people emotionally distressed by this tragedy.

The Department worked closely with the Victorian Department of Human Services, along with other key organisations, to establish ongoing specialised training and support for health professionals involved in the long-term management of trauma and grief. The Department, in conjunction with these stakeholders, worked to support the psychological recovery of communities over the longer term, by encouraging them to adopt appropriate mental health promotion activities, including a focus on children and people isolated by the bushfires.

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Performance Information for Outcome 11 Administered Programs

Program 11.1 – Mental Health
Indicator:	Increased number of people accessing information on mental health and crisis counselling. Measured by the number of calls answered by telephone counselling services and the number of hits to web-based support services.
Reference Point/Target:	5% increase in the number of calls answered by the Lifeline Australia phone counselling service. Improved services available for individuals following the implementation of the web-based and self help support component of the Telephone Counselling Self Help and Web-based Support Programs.
Result: Indicator met.
Lifeline Australia expanded and increased its call answer rates from 50% in November 2007 to 60% by a counsellor, and 95% by a call answer service in December 2008. Improved services were available via expanded phone and web-based counselling services used by the Kids Helpline, which effectively increased its hours of web-based counselling from 32 hours per week in March 2008 to over 40 hours per week in March 2009. The Department also funded professional web-based counselling (www.depressionservices.org.au), and information and support services, such as peer-to-peer support services.
Indicator:	All headspace – Communities of Youth Services are operational.
Reference Point/Target:	30 local Communities of Youth Services operational in 2008–09.
Result: Indicator met.
Thirty Communities of Youth Services sites were operational in 2008–09, through 20 funding agreements with the Divisions of General Practice. These sites employed allied health workers to facilitate access to a wide range of youth friendly health and social support services.
Indicator:	Number of people accessing Medicare-eligible psychological services. Measured by the use of new Medicare items.
Reference Point/Target:	Number of people accessing psychological services and using the new Medicare items.
Result: Indicator met.
In 2008–09, 1,077,237 people accessed 4,283,355 Medicare-eligible psychological services under the Better Access initiative. This compares with 849,980 people who received 3,243,106 services in 2007–08.
Indicator:	The extent to which Access to Allied Psychological Services support antenatal and postnatal depression specific services.
Reference Point/Target:	All Divisions of General Practice have the capacity to deliver services with antenatal and postnatal depression.
Result: Indicator met.
In 2008–09, all 109 Divisions of General Practice had the capacity to deliver antenatal and postnatal depression treatment and support services to the community. In addition to this service delivery, the Divisions of General Practice established linkages with local child and maternal health services, and primary mental health care services to ensure that women experiencing perinatal depression and their families can access appropriate resources.
Indicator:	The proportion of outer metropolitan and rural/remote Divisions of General Practice receiving increased Access to Allied Psychological Services funding.
Reference Point/Target:	50% of outer metropolitan and rural/remote Divisions of General Practice receive additional Access to Allied Psychological Services funding.
Result: Indicator exceeded.
In 2008, the Department provided additional funding to 64% (38 rural/remote and 14 outer metropolitan) of Divisions of General Practice for Access to Allied Psychological Services.
Indicator:	Development and implementation of a nationally consistent postnatal depression initiative, in partnership with the states and territories.
Reference Point/Target:	National postnatal depression initiative developed collaboratively with the states and territories in 2008–09.
Result: Indicator met.
The Department worked with the state and territory health departments and beyondblue to develop the National Perinatal Depression initiative in 2008–09. This included the development of an agreed approach to the training for health professionals, routine screening for antenatal and postnatal depression, improved support and care, and research and data collection. The initiative will be implemented in 2009–10.
Indicator:	Participation in the Mental Health Postgraduate Scholarship Scheme.
Reference Point/Target:	Up to 300 postgraduate scholarships in mental health nursing and clinical psychology are offered in the third round for the 2009 academic year.
Note: This performance indicator was amended in the 2008–09 Health and Ageing Portfolio Additional Estimates Statements, to reflect the announcement made in the 2008–09 Budget that an additional $35 million will be provided over four years to expand and redevelop this scheme. It now refers to ‘up to 300’ scholarships not ‘75’ which will be offered in the ‘third’ round for ‘2009’, not the ‘second’ in ‘2008’.
Result: Indicator exceeded.
A total of 356 mental health postgraduate scholarships were awarded in the third round of the 2009 academic year, consisting of 244 mental health nursing scholarships and 112 clinical psychology scholarships.
Indicator:	Increased number of activities focusing on suicide prevention in identified high risk groups. Increase the availability of resources aimed specifically at postvention services that support people affected by suicide.
Reference Point/Target:	Activities targeting high-risk groups increased by 10% in 2008–09. Develop and effectively disseminate resources appropriate for people bereaved by suicide.
Result: Indicator partially met.
The Department increased the funding for activities focusing on suicide prevention in identified high risk groups from approximately $10.2 million in 2007-08 to approximately $13.3 million in 2008–09. This represents an increase of approximately 30%. In 2008–09, this funding was provided to 59 local projects focusing on suicide prevention in identified high risk groups. With the addition of 19 sites providing support for people who have been discharged from hospital following a suicide attempt, the number of local projects increased by over 30% to 78 projects. The Department conducted a review of resources for people bereaved by suicide. The state-specific information and support pack for people bereaved by suicide and other sudden death circumstances is nearing finalisation and will be disseminated by the Department in early 2009–10. The Department will also develop responses to target people at an increased risk of suicide due to the effects of the economic downturn.
Indicator:	Members appointed to the National Advisory Council on Mental Health. Council meet no less than 4 times in each year. Development and implementation of the council workplan and research agenda. Research grants commissioned.
Reference Point/Target:	Membership appointment process commenced from May 2008. First meeting of the council held in July 2008. Council work plan and research agenda developed from July 2008. Research grants commissioned from February 2009.
Result: Indicator met.
Ten members were formally appointed to the National Advisory Council on Mental Health on 1 July 2008. The council met formally on four occasions: 27–28 August 2008 (Canberra); 15–16 October 2008 (Sydney); 12–13 February 2009 (Melbourne); and 17–18 May 2009 (Canberra). The council identified five priority areas to progress over a three year workplan: innovative service models; mental health workforce; mental health promotion and prevention; Indigenous mental health; and evaluation of the Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule initiative. The council also commenced development of a research agenda consistent with these priority areas, and undertook a number of research projects during the year, including a review of mental health programs and the development of a draft National Mental Health Report Card.
Indicator:	Post-implementation review of the Better Access initiative undertaken.
Reference Point/Target:	Review finalised by the end of the 2008–09 financial year.
Result: Indicator not met.
As at 30 June 2009, the Department was finalising the post-implementation review of the Better Access initiative. The review will complement a full evaluation of the Better Access initiative which the Department commenced in January 2009. The evaluation will provide a rigorous assessment of the extent to which the Better Access initiative has provided an effective response to the need for primary mental health care for people with high prevalence mental disorders. The Department expects to finalise this evaluation by the end of 2010.

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Performance Information for Outcome 11 Departmental Outputs

Output Group 1 – Policy Advice
Indicator:	Quality, relevant and timely advice for Australian Government decision-making, measured by ministerial satisfaction.
Reference Point/Target:	Ministerial satisfaction.
Result: Indicator met.
Ministers were satisfied with the quality, relevance and timeliness of advice provided for Australian Government decision-making.
Indicator:	Production of relevant and timely evidence-based policy research.
Reference Point/Target:	Relevant evidence-based policy research produced in a timely manner.
Result: Indicator met.
In 2008–09, the Department developed The Mental Health of Australians 2 using a comprehensive summary of the results of the 2007 National Survey of Mental Health and Wellbeing. The report was produced in a timely manner and is available in hard copy and electronic formats (www.health.gov.au).

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Output Group 2 – Program Management
Indicator:	Administered budget predictions are met and actual expenses vary less than 0.5% from budgeted expenses measured by comparison of actual expenses against budget.
Reference Point/Target:	0.5% variance from budgeted expenses.
Result: Indicator not met.
The actual Administered expenses for Outcome 11 were 1.7% less than budgeted expenses. Funds were underspent as not all fund holders were able to meet all contracted deliverables within 2008–09, resulting in a small number of payments that were not made in the financial year.
Indicator:	Stakeholders participate in program development through avenues, such as surveys, conferences, meetings, and submissions on departmental discussion papers.
Reference Point/Target:	Stakeholders participate in program development.
Result: Indicator met.
In 2008–09, the Department supported stakeholder participation in the development of the draft Fourth National Mental Health Plan, including consulting nationally with over 70 peak bodies, convening a national stakeholder forum and conducting a national online survey. The Department also sought stakeholder input to the review of the Access to Allied Psychological Services initiative by disseminating a discussion paper to stakeholders including the Divisions of General Practice Network, the Australian Psychological Society, the Royal Australian College of General Practitioners, beyondblue and relevant professional organisations representing allied health professionals. The Department received approximately 110 responses which helped to inform future policy directions for the service in 2009–10.

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Outcome 11 – Financial Resources Summary

	(A) Budget Estimate 2008–09 $’000	(B) Actual 2008–09 $’000	Variation (Column B minus Column A) $’000	Budget Estimate 2009–10 $’000
Program 11.1: Mental Health
Administered Items
Annual Appropriation Bill 1 (Ordinary Annual Services)	136,018	134,184	(1,834)	145,991
Special appropriations
Health Care (Appropriation) Act 1998 – Australian Health Care Agreements – Provision of Designated Health	14,984	14,268	(716)	-
Departmental Outputs
Annual Appropriation Bill 1 (Ordinary Annual Services)	12,490	11,832	(658)	13,297
Revenues from other sources	225	262	37	238
Subtotal for Program 11.1	163,717	160,546	(3,171)	159,526
Total Resources for Outcome 11	163,717	160,546	(3,171)	159,526
Outcome 11 Resources by Departmental Output Group
Department of Health and Ageing
Output Group 1: Policy Advice	6,513	6,195	(318)	6,993
Output Group 2: Program Management	6,202	5,899	(303)	6,602
Total Departmental Resources	12,715	12,094	(621)	13,535
Average Staffing Level (Number)	101	93	(8)	97

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