Government response to the 2008 Senate Community Affairs Committee's inquiry into mental health services (PDF 425 KB)
Senator Claire Moore
Senate Standing Committee on Community Affairs
PO Box 6100
CANBERRA ACT 2600
Dear Senator Moore
I am writing in regard to the 2008 Senate Community Affairs Committee's Inquiry into Mental Health Services, and its Final Report Towards Recovery: Mental Health Services in Australia.
In particular I wish to provide you with information on key activities which have been announced and progressed since the tabling of the Report on 25 September 2008 and which address in whole or in part its recommendations, to finalise the Australian Government's consideration of the Committee's work. The delay in the Government's response to the Committee's Report is a result of the significant amount of mental health reform and health reform that has been underway and implemented since 2008.
I wish to acknowledge the significant and welcome interest of the Committee in improving the health and wellbeing of all Australians affected by mental illness, their families and carers. The Report provided an important resource that has contributed to the Government's thinking and decisions in respect of reforms to the mental health system.
Importantly, the Report's recommendations acknowledge the need for a long-term plan and vision for mental health, including:
- better coordination and integration of health and social support services (such as housing, income support, education and employment services)
- working collaboratively with state and territory governments to address systems gaps (such as step up-step down accommodation services) and
- better meeting the needs of particular groups (such as rural and remote communities, Indigenous populations, men, young people, and individuals with Borderline Personality Disorder).
Since the Report's release, there have been a number of Government investments and new initiatives relating to mental health and which form part of the wider national health, social and economic reform agendas. I am pleased to enclose a summary of these initiatives for the Committee's information.
Most significantly, the Government has delivered on its second term commitment to mental health with a number of initiatives consistent with the 2008 Report's recommendations through the 2011-12 Budget's Delivering National Mental Health Reform package.
Through this package the Government has provided the largest mental health investment in the nation's history with $2.2 billion being invested over the next five years to drive fundamental reform in Australia's mental health system.
These measures have been informed by extensive engagement with experts, service providers and consumers and carers that I undertook at the end of last year. Through this process, I received valuable insight and feedback and much of this feedback affirmed the Committee's findings. Top of page
The investments made as part of this $2.2 billion investment include initiatives across a number of portfolios including:
- $571.3 million for more and better coordinated services for people with severe mental illness and complex, multiagency needs who suffer significant disadvantage, and their families and carers. This measure will provide a single point of contact for people with severe and persistent mental illness and their families; it will expand the Day to Day Living and Personal Helpers and Mentors programs; and provide extra respite services and support for the carers and families of people with a mental illness
- $491.7 million for prevention and early intervention mental health services for children and young people to improve responsiveness to childhood risk factors when interventions are most effective and to ensure young people and their families get the support they need
- $220.3 million to strengthen primary care and better targeting of services for those in most need, such as those in low income areas, rural and remote areas and Indigenous communities
- $201.3 million to encourage the states and territories to invest more in mental health priority areas and address service gaps, including in accommodation support and presentation, admission and discharge planning in emergency departments and
- $2.4 million to increase economic and social participation for people with mental illness. This will be supported by $50 million for more personal helpers and mentors, plus approximately $26 million over three years to support the very long term unemployed with a mental illness thought the Building Australia's Future Workforce budget package.
The Government is also investing a total of $32 million to establish a National Mental Health Commission to increase accountability and transparency. The Commission will provide leadership and drive a more transparent and accountable mental health system in both the health and non-health spheres, and provide an Annual Report, through the Prime Minister, to Parliament.
Included in this record investment over the next five years is $1.5 billion in new expenditure and $624 million from the 2010 Budget and election commitments in mental health.
If the Government's mental health investments in sub acute care beds, the Health and Hospitals fund and in specialist training places are included the total investment in mental health over the next five years is in fact $2.5 billion.
These investments act on the advice of the millions of Australians who have experienced mental illness, their families, their carers and the experts. However, these investments also act on the advice of the Towards Recovery report.
The Delivering National Mental Health Reform package is a cross-sector reform package that recognises the diverse impact of mental illness throughout a person's lifetime and will build resilient kids, support teenagers and families dealing with the challenge of mental illness, improve access to primary care and target more community based services to people living with severe mental illness and their families.
The establishment of a new National Mental Health Commission to independently monitor, assess, oversee and report on how the system is performing will also provide cross-sectoral leadership in mental health, including for consumer and carer activities. Top of page
The Commission's functions, including through the production of an Annual National Report Card on Mental Health and Suicide Prevention, will strengthen public accountability and transparency by monitoring whether services deliver lasting outcomes for people experiencing a mental illness.
Importantly, the Government will work further with states and territories, mental health consumers, carers, experts, and leading advocates in the mental health sector on the detailed implementation of the 2011-12 Budget measures and in the preparation of a 10 Year Roadmap for Mental Health Reform.
The Roadmap will set out an agenda for long-term reform of the mental health system. It will signpost our efforts to reform the mental health system, ground investments in the advice of experts and stakeholders and commit the Government to ongoing action.
In addition to the investment in the Budget, the Government has also undertaken a range of other initiatives consistent with the 2008 Report recommendations. For example, the first ever national Expert Group has been established to provide advice to Government on better management of Borderline Personality Disorder (BPD) and funding has been provided to the National Health and Medical Research Council to develop a BPD clinical guideline for the Australian context.
Through the $274 million Taking Action to Tackle Suicide election commitment package, the Government has doubled funding for suicide prevention. This comprehensive package was designed to target those most at risk of suicide, including:
- providing more support for men through the beyondblue's National Workplace Program, increased capacity for men's helplines and other targeted campaigns
- more services to promote resilience and good mental health in young people and
- funding for community led suicide prevention activities for those most at risk of suicide including indigenous people, men, gay lesbian and bisexual people and families bereaved by suicide.
The report also recommended investment in step up-step down accommodation facilities and as part of the Governments $1.6 billion investment to expand sub acute care facilities in partnership with state and territory governments, step up-step down facilities are already being rolled out.
Further information about these measures and other mental health reforms can be found at: www.health.gov.au/mentalhealth
Thank you again for the important work the Committee has undertaken.
Mark Butler Top of page
Summary of Australian Government and other important mental health related initiatives, investments, consultations, inquiries and reports since 2008
- 10 May — Government announced in the 2011-12 Budget its Delivering National Mental Health Reform package and commitment to develop a 10 Year Roadmap for Reform.
- 10 May — Government announced in the 2011-12 Budget the Building Australia's Future Workforce package to build an educated and skilled workforce and ensure there are opportunities for all Australians to experience the benefits of work.
- May — release of 'Working with Australians to promote mental health, prevent mental illness and support recovery'. Evaluation of the FaHCSIA Targeted Community Care Mental Health Initiatives.
- March — release of a consultation paper for the development of a National Foundational Skills Strategy to improve foundation skills, such as numeracy, literacy and employability skills, of adult Australians. Submissions closed on 6 May 2011. The draft National Strategy is expected to be released at the end of 2011.
- 28 February — the Minister for Tertiary Education, Skills, Jobs and Workplace Relations, Senator the Hon Christopher Evans, asked the Standing Committee on Education and Employment to inquire into and report on mental health and workforce participation.
- 28 February — release of the Productivity Commission Draft Report on Disability Care and Support. Public hearings were held in April 2011. Written submissions closed on 30 April 2011. The final report will be forwarded to the Government on 31 July 2011.
- 13 February — COAG endorsed the National Disability Strategy.
- 21 January — the release of the draft inquiry report by Productivity Commission on Caring For Older Australians. Public consultation on the draft inquiry report was sought to inform further development. Submissions closed on 21 March 2011. The final report is due to be forwarded to Government in mid June 2011. Top of page
- December — the Prime Minister asked Minister Butler to establish the Mental Health Expert Working Group.
- November - December — Minister Butler attended national forums with mental health consumers and carers.
- November — Commonwealth tabled its response to the Senate Inquiry into Suicide Prevention, The Hidden Toll: Suicide in Australia report.
- November — release of Mental Health Carers Report by Mental Health Council of Australia. A follow-up report from Adversity to Advocacy: The Lives and Hopes of Mental Health Carers (October 2009).
- November — release of the National Mental Health Report 2010.
- October - December — discussion paper Towards a National Carers Strategy was released for public consultation, and consultations were conducted by FaHCSIA and DoHA across Australia in November and December 2010. The Strategy is due for release in July 2011.
- October — the Government established the Office for the Not-for-Profit Sector to drive and coordinate the policy reform agenda (supported by the Non-Profit Sector Reform Council). Establishment of the Office was one of several 2010 election commitments relating to support for the Not-for-Profit Sector.
- September, release of the revised National Standards for Mental Health Services, and three implementation guidelines for non-government community services, private office based mental health practices and public mental health services, and private hospitals.
- July – announcement of the Government's $274 million Mental Health: Taking action to tackle suicide package to boost frontline services and provide more services to those at greatest risk of suicide; for direct suicide prevention and crisis intervention; to provide more services and support to men who are at greatest risk of suicide; and to promote good mental health and resilience in young people to prevent suicide later in life.
- May – 2010-11 Budget package provided additional funding as an initial step to address gaps in mental health services including: $78.8 million for up to 30 new headspace youth friendly services and enhanced online counselling services; $25.5 million for an expansion of the Early Psychosis Prevention and Intervention Centre (EPPIC) model in partnership with interested States and Territories; $13 million for the employment of 136 extra mental health nurses under the Mental Health Nurse Incentive Progiam; and $58.5 million for delivery of flexible care packages to better support people with severe mental illness.
- May 2010 - the Department entered into a Memorandum of Understanding (MOU) with the NHMRC to develop a clinical practice guideline for Borderline Personality Disorder (BPD).
- April 2010 - the Minister for Health & Ageing, Nicola Roxon MP, gave approval for the development of an Australian clinical guideline on BPD using the United Kingdom's clinical guideline on BPD adapted to the Australian context and the establishment of an Expert Reference Group (ERG).
- March – New Disability Employment Services were introduced on 1 March 2010. For the first time, services are demand driven, meaning all job seekers with disability will have immediate access to assistance from an employment service that will help them gain and maintain employment. The new services also provide more support to employers employing people with disability and mental illness.
- February – paper released for public consultation to inform development of the National Volunteering Strategy. Submissions closed on 30 June 2010 and an online survey closed on 25 July 2010.
- February – publication of Outcomes and proposed next steps: review of the Access to Allied Psychological Services component of the Better Outcomes in Mental Health Care program. Top of page
In 2010 other Australian Government reforms include:
- December – Australia's Draft Initial Report under the Convention on the Rights of Persons with Disabilities.
- December – establishment of the Australian Government's Not-for-Profit Sector Reform Council.
- October and November – consultation and discussion paper for the development of a National Carers Strategy.
- September – establishment of the Joint Select Committee on cyber-safety.
- September – release of the Commonwealth Ombudsman report, Falling through the cracks: Centrelink, DEEWR and FaHCSIA—engaging with customers with a mental illness in the social security system.
- July – release of the discussion paper, Inclusion for people with disability through sustainable supported employment.
- June – release of the Progress and Action Plan: The Australian Government White Paper on Homelessness.
- May – release of Australia's First National Primary Health Care Strategy.
- May – release of A National Health and Hospitals Network for Australia's Future: Delivering better health and better hospitals.
- March - April – Treasury consultation on Unfair Terms in Insurance Contracts.
- February – release of Productivity Commission final research report on the Contribution of the Not-for-Profit Sector.
- January – release of the Social Inclusion in Australia: How Australia is faring. Top of page
- November — release of the Fourth National Mental Health Plan: an agenda for collaborative government action in mental health 2009-2014.
- November — Australian Health Ministers agree to the Framework for the National Perinatal Depression Initiative 2008-09 to 2012-13.
- October — release of Adversity to Advocacy: the Lives and Hopes of Mental Health Carers by Mental Health Council of Australia.
- September — release of the National Mental Health and Disability Employment Strategy.
- June — release of A Healthier Future for All Australians (National Health and Hospitals Commission Report).
- May — publication of the Post Implementation Review of the Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule (MBS) initiative.
- May — release of The Mental Health of Australians 2 — a report on the 2007 National Survey of Mental Health and Wellbeing.
- April — release of the National Mental Health Policy.
- December — release of The Road Home — The Australian Government White Paper on Homelessness.
- October — release of the 2007 National Survey of Mental Health and Wellbeing, Australian Bureau of Statistics.
- October — release of a discussion paper for the development of a National Disability Strategy for Australia.
- Release of the revised The Living Is For Everyone (LIFE) Framework. Top of page