Mental health reform has been a longstanding priority for all governments, commencing with the endorsement of the National Mental Health Strategy by Australian Health Ministers in 1992. Through various changes in government at the federal, state and territory levels, the Strategy has continued as a bipartisan reform agenda and the National Mental Health Report series has been maintained as the prime vehicle for monitoring reform progress. Continuation of the report was mandated in the Fourth National Mental Health Plan and its scope broadened to incorporate reporting on progress against the outcome indicators and actions agreed in the Plan. The Fourth Plan also required the report to be endorsed by all Health Ministers.
The current report is the twelfth in the series. It summarises the system level changes that have taken place in mental health between 1993 and 2011. As such, the report provides a view of trends and performance at the national and state and territory levels over the period spanning the first, second and third National Mental Health Plans and the first two years of the Fourth National Mental Health Plan. The time series and breadth of coverage of the report is unparalleled internationally.
It is clear from the information presented in this report that much has changed over the course of the National Mental Health Strategy. All governments have increased their reform efforts in recent times with significant investments in clinical and community support services. A key finding of the report is that government spending on mental health has outpaced overall health spending growth in recent years, with the result that mental health as a proportion of health expenditure in 2010-11 was the highest (7.7 per cent) recorded since the National Mental Health Report series commenced in 1993.
Readers of previous National Mental Health Reports will know that the report only tells part of the story. While the focus of the report on resources and high level indicators is essential, it does not tell us about what it is like to experience services from the perspective of those that they serve. For this we need different reporting arrangements that give greater transparency to the performance of mental health services from the perspective of people with a lived experience of mental illness, their families and carers. The recent addition of the annual National Report Card on Mental Health and Suicide Prevention, prepared by the National Mental Health Commission, serves this function and adds an important complement to the National Mental Health Report.
Despite the achievements made over the course of the National Mental Health Strategy, consumers, carers and other stakeholders rightly emphasise that much remains to be done to build a modern, responsive mental health system in Australia. It is important to note in this context that all governments renewed their commitment to further mental health reform with the endorsement and release by the Council of Australian Governments (COAG) in December 2012 of the Roadmap for National Mental Health Reform 2012-2022. The Roadmap outlines the directions that will be taken by governments over the next ten years and sets out new governance and accountability arrangements designed to directly engage stakeholders and ensure that governments are held to account. These new arrangements include the establishment of a COAG Working Group on Mental Health Reform that is required to develop, by mid-2014, a successor to the Fourth National Mental Health Plan that will set out how the Roadmap will be implemented.
Alongside the release of the Roadmap and pending development of a new National Mental Health Plan, states and territories have developed their own mental health plans that reflect the goals and principles of the national approach, but have been tailored to meet local requirements. Jurisdictions' own plans remain the key documents for setting out the specific details of how they will work towards achieving the objectives agreed under the National Mental Health Strategy.
On behalf of Australia's Health Ministers, I am pleased to endorse this twelfth National Mental Health Report, prepared by the Australian Government Department of Health and Ageing. These reports entail considerable work by many people including consumers, carers, service providers and the mental health units of various state and territory health administrations. I wish to extend my thanks to all who have contributed to the report.
The Hon Michelle O'Byrne MP
Standing Council on Health