Improving outcomes for people with severe and debilitating mental illness

Up to Budget 2011-2012

Table of contents

There are around 60,000 Australians currently living with severe, persistent and debilitating mental illness who have complex needs and face significant obstacles participating in society and social or vocational activities. Meaningful activity and social connectedness are important to quality of life and recovery.

Many of these individuals primarily receive treatment and other services from state governments, but the Australian Government also provides some social support programs and underwrites some private-sector services for this group. Yet the system remains ineffective for too many of these vulnerable Australians, with the onus on them, their families and carers to seek out the services that are needed instead of the
services revolving around the individual.

The Australian Government will make structural changes to better link existing services for many people with persistent symptoms and complex needs, to help break the cycle of hospitalisation and unplanned readmission and the associated high costs of care. A flexible funding pool will help address gaps in service availability for these individuals. At the same time, the Government will increase its investment in the social support programs helping people with severe and debilitating mental illness in practical ways.

Budget Measure: Coordinated Care and flexible funding for people with severe, persistent mental illness and complex care needs - $343.8 million over the next five years

Currently the mental health system is confusing and people don’t know where to get help. What services they get – particularly the sickest who have the most complex needs – is a lottery and they often don’t get all the services they need.

This measure will provide a single point of contact – a Care Facilitator – for around 24,000 people with severe and persistent mental illness and their families. Care Facilitators will be responsible for ensuring all of the patients’ care needs, clinical and non-clinical, and as determined by a nationally consistent assessment tool, are being met.

The Care Facilitator will be part of a regional organisation identified through a tender process using Medicare Local boundaries. Eligible organisations are expected to be drawn from Medicare Locals and other non-government organisations. Care Facilitators will have access to a flexible pool of funds to help fill service gaps, but the majority of services will come from existing Australian Government and state
programs, such as Medicare subsidised psychiatric consultations, the Personal Helpers and Mentors (PHaMs) services and state specialist mental health services.

The nationally consistent assessment process and multi-agency agreements for individuals with severe and debilitating mental illness will be developed as part of this measure to bring the different Government funded agencies together to provide coordinated care to these Australians. This will mean that, for the first time, there will be a single consistent way of measuring an individual’s needs which will link to an integrated and coordinated care experience to support people to get the services they need when they need them.

The Australian Government’s existing commitments to ‘Flexible Care Packages’ will be redirected to the flexible funding pool to be held by Care Facilitators under this new measure (excluding 2011-12 funding for the original ‘Flexible Care Packages’ which will still be rolled out through the first Medicare Locals).

Budget Measure: Expanding the Support for Day to Day Living program to meet demand for services - $19.3 million over the next five years

The Australian Government’s Support for Day to Day Living in the Community program is targeted to assist people with severe and debilitating mental illness that profoundly affects their ability to work and care for themselves. The program is delivered through non government organisations and is very successful at reducing social isolation through structured and group based activities designed to improve skills for independent living.

Currently, this program assists approximately 11,000 people per year, although demand for places is now exceeding supply. Through this Budget the program will deliver additional services to 18,000 people over five years.

Budget Measure: Expanding community mental health services – more Personal Helpers and Mentors and respite services - $208.3 million over the next five years

The Australian Government will invest $154 million over five years for community organisations to employ 425 new personal helpers and mentors. Personal Helpers and Mentors (PHaMs) services provide intensive, one on one support for people with severe and persistent illness to support recovery, reduce social isolation and improve employment outcomes.

Personal helpers and mentors provide practical assistance to people with severe mental illness, to set and achieve personal goals such as finding employment, improving relationships with family and friends, and managing everyday tasks like using public transport or housekeeping.

As part of this expansion, $50 million will be allocated to provide personal helpers and mentors to specifically help people with mental illness on, or claiming, income support or the Disability Support Pension who are also working with employment services. Funding of $54.3 million for extra mental health respite services will also give about 1,100 families of people with a mental illness greater access to flexible respite and support services over the next five years.

Over five years an additional 3,400 people with severe mental illness and 1,100 of their families and carers have access to care coordination, respite and social rehabilitative support through a personal helper or mentor.

These significant investments will provide the foundation for our longer term vision, where all individuals with severe and debilitating mental illness are supported through the provision of the right mix of services regardless of their contact point with the mental health system.

The Australian Government will also engage with states and territories to work collaboratively on addressing service gaps. Improved coordination of and availability of services throughout the primary and acute health care, non clinical, and education and employment sectors will better support individuals to recover in the community and remain (or return) to education or employment.

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