National mental health report 2013

2.6 Consumer and carer participation in mental health care

Page last updated: 2013

Key messages:

  • In 2010‑11, about half of Australia's state and territory mental health services had either appointed a person to represent the interests of mental health consumers on their organisational management committees or had a specific Mental Health Consumer/ Carer Advisory Group established to advise on all aspects of service delivery. However, one quarter had no structural arrangements in place for consumer and carer participation.
  • Significant proportions of state and territory mental health services also had some other arrangements in place for consumer and carer participation, although the extent to which organisations had established particular initiatives varied. Mechanisms for carer participation have been less developed than those for consumer participation, but the gap is closing.
  • In 2010‑11, there were 4.6 consumer and carer workers employed for every 1,000 full‑time equivalent staff in the mental health workforce. This figure has risen by 33% since 2002‑03, when it was 3.5 per 1,000.
  • In recent times, there have been a number of consumer and carer developments that have had an increased emphasis on social inclusion and recovery. For example, the recently established National Mental Health Commission has produced its first Report Card, identifying and reporting on several areas that are important to consumers' ability to lead a contributing life. Moves are also underway to establish a new national mental health consumer organisation, auspiced by the Mental Health Council of Australia, that will ensure that a strong and consolidated consumer voice can contribute to more responsive and accountable mental health reform.
Consumer and carer participation in Australian mental health services underwent rapid maturation over the course of the First National Mental Health Plan. Inquiries conducted in the period preceding the National Mental Health Strategy pointed to abuses of the rights of consumers and advocated forcefully on their behalf for action to correct these. Governments responded with a number of proposals for change and, more importantly, consumers began to speak for themselves.

Initial concerns driving the Strategy revolved around concepts of protection from human rights abuses, but these concerns progressively evolved to incorporate more contemporary concepts of consumer empowerment and participation. This required that consumers and carers be given a place in discussions about the planning, delivery and evaluation of services designed to meet their needs.

The Strategy has advocated strongly for this position. Underpinning this is a view that such participation can empower and inform consumers and carers, destigmatise mental illness and ultimately improve mental health outcomes by promoting a recovery orientation in service delivery. Additionally, accountability to consumers at all levels of the mental health system provides an avenue to identify and resolve deficiencies in service quality that, historically, compromised the rights of people with a mental illness.

The early steps taken to promote consumer and carer participation are regarded as one of the hallmarks of the National Mental Health Strategy. Under the First and Second National Mental Health Plans, states and territories were required to establish advisory groups to provide direct consumer and carer input to mental health policy and service development. The Third National Mental Health Plan promoted further development of opportunities for consumers and carers to take meaningful roles in building a better service system. The Fourth National Mental Health Plan has continued this direction.

At the national level, consumers and carers were included in all planning and advisory groups established under the Strategy. Considerable funds were allocated to strengthening their voice in mental health planning, policy and evaluation through representation on bodies such as the Mental Health Council of Australia.

Many other groups play important roles throughout Australia in representing consumers and carers in mental health. They have undertaken a substantial amount of work to increase participation by, and awareness of, the roles of consumers and carers in the mental health reform agenda.

The current report does not detail the contributions of all the individual parties, but focuses on updating previously published data on the extent to which mechanisms for consumer and carer participation have been established at the local service delivery level.