Over the last decade, under the direction of the Australian Health Ministers Advisory Council (AHMAC) National Mental Health Working Group, the National Mental Health Strategy has provided national direction and leadership for quality improvement in mental health services. Commitment to the implementation of the National Standards for Mental Health Services and national initiatives to implement routine consumer and carer outcomes measurement in mental health services continue to be supported nationally. This Plan is designed to complement and extend these and other quality improvement initiatives.

It is also important to acknowledge the changing nature of mental health care delivery that is increasingly, and appropriately, provided in the community. Acute inpatient psychiatric care is now being provided in general hospitals along with other health care, rather than just in stand alone psychiatric hospitals separate from the mainstream health system. Public specialised mental health services need to be integrated and include inpatient care and community care services. Private mental health facilities treat a wide range of mental health conditions, and provide more than two-thirds of all same-day mental health services. A significant and increasing proportion of mental health care is provided by the primary health care sector rather than specialist mental health services. These changes in the delivery of mental health care, combined with increasing awareness of mental disorders and the chronic, disabling and episodic nature of some mental disorders, present a variety of new demands on the health system.

National Mental Health Plan 2003-2008
Australian Health Care Agreements
Australian Council for Safety and Quality in Health Care (now Australian Commission on Safety and Quality in Health Care)
Safety and Quality in Mental Health Partnership Group

National Mental Health Plan 2003-2008

Strengthening quality is a key theme of the National Mental Health Plan 2003-2008. Safety is a key component of quality and relates to minimising potential harm from mental health care. The National
Mental Health Plan 2003-2008
specifically focuses on increasing the safety of consumers, carers and families, staff and the community and reducing adverse incidents.

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Australian Health Care Agreements

The Australian Health Care Agreements 2003-2008 have been signed by each State and Territory Government with the Australian Government. The Agreements include the objectives of improving the focus of public hospitals and mental health services on safety, quality and improved patient outcomes, as well as increasing the responsiveness of services for people in need of mental health services. The Agreements commit governments to the ongoing implementation of the National Mental Health Strategy, including consolidation of the reforms undertaken over the last decade, along with additional areas of focus as identified by stakeholders.1 No such similar agreement exists between the Australian Government and private sector mental health facilities.

Australian Council for Safety and Quality in Health Care

The Australian Council for Safety and Quality in Health Care (now Australian Commission on Safety and Quality in Health Care) was established by Health Ministers in 2000 to lead the improvement of the safety and quality of health care, with a particular focus on minimising the likelihood and effects of error.

The Council is funded by the Australian Government and all State and Territory governments and is answerable to all nine Health Ministers. Its task is to oversee a national approach to the improvement of the safety and quality of the health system to minimise the numbers of adverse events and to reduce harm from adverse events that do occur. It aims to develop and sustain a culture of safety and to build skill and capacity for change.

The development of a culture of safety requires strong and visible leadership with a commitment to learning and to improving systems rather than blaming individuals inappropriately. It is a long-term task and relies on building effective incident reporting systems which support the measurement and analysis of data and opportunities for system improvement.

To support this approach, Council has focused on five priority areas:
  • Supporting those who work in the health system to deliver safer patient care
  • Improving data and information for safer health care
  • Involving consumers and the community in improving health care safety
  • Redesigning systems of health care to facilitate the culture of safety and
  • Building awareness and understanding of health care safety.
The Council has to date focused on safety in acute services and their activities are also relevant for acute mental health services. A compendium of Council publications is at appendix 2.

Safety and Quality in Mental Health Partnership Group

The AHMAC National Mental Health Working Group established the Safety and Quality in Mental Health Partnership Group to facilitate a safety focus in mental health, as part of a broader role of providing advice on improving the quality of mental health services. The Partnership Group initially oversaw a consultancy that aimed to examine the quality and safety activities in mental health, the activities of the Australian Council for Safety and Quality in Health Care, and to identify gaps and opportunities for improving the safety and quality of mental health services (see appendix 3 for a copy of the recommendations of this report). The Partnership Group continues to play a key role in the safety and quality agenda.

Footnotes

1 See Clauses 8(c), 8(f ) and 14. The Australian Health Care Agreements 2003-2008 are available at the Department of Health and Ageing website (www.health.gov.au).

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