Responsibility: State and territory governments
Response:
ACT, NSW, SA, VIC, WA, NT: Accept in principle
QLD, TAS: Subject to further consideration
Australian Capital Territory
Response: Accept in principle
Status: In progress
What has been achieved to date
Canberra Health Services currently provides a mental health service for people with intellectual disability, and the development of specialised health and mental health services for people with cognitive disability is also being addressed through Canberra Health Services’ Disability Access and Inclusion Plan 2022-2025.
In September 2024 the Improving Mental Health and Wellbeing Outcomes for People with Intellectual Disability Position Statement was completed. The Position Statement supports the ACT Government’s actions against this recommendation by informing future planning and investment in the health system to improve the wellbeing of people with intellectual disability.
ACT government response July 2024
Canberra Health Services currently provides the Mental Health Service for People with Intellectual Disability. The ACT Disability Health Strategy 2024-2033 Improving Mental Health and Wellbeing Outcomes for People with Intellectual Disability Position Statement will also help inform future planning and investment in the health system to support the mental health and wellbeing of people with intellectual disabilities. The Position Statement outlines priority areas for best practice in improving the mental health and wellbeing of people with intellectual disabilities.
New South Wales
Response: Accept in principle
Status: In progress
What has been achieved to date
NSW has existing specialised health and mental health services for people with intellectual disability.
The NSW Intellectual Disability Health Service (IDHS) is embedded in local health districts and operates as a statewide service across NSW. The specialised service is made up of a network of 7 multidisciplinary teams and 8 clinical positions across NSW. The service provides comprehensive health assessment and recommendations for a person with intellectual disability who has a complex or chronic health need that cannot currently be met by their usual care pathways. The service sees a growing number of clients each year and saw 926 new clients in 2024. The service continues extensive work to build the skills of NSW Health staff providing care to people with intellectual disability. An independent evaluation of the NSW IDHS is expected to be completed by September 2025 and will inform ongoing service improvements.
NSW Health also funds the Statewide Intellectual Disability Mental Health (IDMH) Hubs and supports the NSW Health Intellectual Disability Mental Health (IDMH) Network, a group of IDMH clinicians and leads from all local health districts and specialty health networks.
The Ministry of Health commissioned an external evaluation of the IDMH Hubs over 4 years to report on implementation and outcomes and provide recommendations for future service development. The evaluation published in 2024, found that people who accessed this service presented to emergency departments 28 per cent less following support from the IDMH Hubs.
NSW government response July 2024
The NSW Government is committed to the provision of high-quality health care for all people with disability including people with cognitive disability.
Specialised health and mental health services for people with intellectual disability are in place and deliver a statewide service across NSW. These specialised services offer a clinical service as well as training and support that builds the capacity of other health providers.
The NSW Intellectual Disability Health Service (IDHS) provides a comprehensive health assessment, time-limited clinical service and recommendations for people with intellectual disability with complex needs. An evaluation of the IDHS is expected to be finalised by June 2025.
The NSW Intellectual Disability Mental Health Hubs (Mental Health Hubs) help people with intellectual or developmental disability and co-occurring mental health problems access specialised mental health assessment and care.
Further enhancement to health services for people with intellectual disability and cognitive disability will be informed by service evaluations, consideration of best practice approaches in other jurisdictions and consultation with people with disability.
Northern Territory
Response: Accept in principle
Status: In progress
What has been achieved to date
The Northern Territory Government continues to review all models of care in mental health services, including the assessment of cognitive disability in the Complex Behaviour Unit at the Darwin Correctional Centre.
NT government response July 2024
The Northern Territory is committed to ongoing work to ensure improved healthcare services for people with cognitive disability. Consideration will need to be given to the possible introduction of new services (internal or external), new streams of care within existing services or otherwise ensure existing services can provide specialised health and mental health services for people with cognitive disability.
Queensland
Response: Subject to further consideration
Status: Subject to further consideration
What has been achieved to date
Queensland Health has established the Queensland Centre of Excellence in Intellectual and Developmental Disability Mental Health (QCE IDD MH), delivered by Mater Research Limited.
QCE IDD MH’s new model of service has been co-designed alongside key stakeholders and people living with an intellectual and developmental disability to support and foster improved mental health. This builds on existing Queensland Health funded and delivered specialist services for people with cognitive disability.
QLD government response July 2024
The Queensland Government will undertake detailed consultation across a broad range of stakeholders, including clinicians, specialist services and colleagues in other states and territories to ensure health and mental health services are appropriate and accessible for people with cognitive disability, and to considering models that capture the aspects identified by the Royal Commission.
South Australia
Response: Accept in principle
Status: Further work required
What has been achieved to date
While the full scope of this recommendation is under consideration, South Australia already has a specialised health and mental healthcare service for people with intellectual disability, via the South Australian Intellectual Disability Health Service (SAIDHS).
SAIDHS notes that significant additional consideration and funding will be required to meet service gaps and implement this recommendation for people with cognitive disability.
SAIDHS eligibility criteria is for adults for intellectual disability only. With their resourcing, they support moderate to severe/profound intellectual disability and also provide advocacy and capacity building with mainstream services for less severe intellectual disability.
SA government response July 2024
The South Australian government is committed to ensuring that people with cognitive disability get high quality specialised health and mental health services. Additional consultation with key stakeholders is required to understand the gaps in services from a South Australian perspective to ensure the reform delivers quality improvements.
Tasmania
Response: Subject to further consideration
Status: Subject to further consideration
What has been achieved to date
The Tasmanian Department of Health is exploring the implementation of a Statewide operational service model to build on existing services and deliver enhanced quality of care for people with cognitive disability in Tasmania.
TAS government response July 2024
The Tasmanian Government needs to further consider what this recommendation means for Tasmania.
While recognising the importance of specialised health services for people with cognitive disability, the Tasmanian Government needs to undertake more work to understand how these services could be established.
Victoria
Response: Accept in principle
Status: In progress
What has been achieved to date
The Victorian Government funds a range of specialised health and mental health services for people with cognitive disability. These include but are not limited to the Centre for Developmental Disability Health, the Victorian Dual Disability Service, the Disability Liaison Officer program and forensic disability services. The impact of these services, as well as options for enhanced service provision, is assessed as part of ongoing commissioning and performance management processes.
VIC government response July 2024
We accept this recommendation in principle.
Our existing specialised mental health services include:
- the Victorian Dual Disability Service – specialised support for Victorians with intellectual disability and autism spectrum disorders who have mental health challenges
- Centre for Developmental Disability Health – specialised support for Victorians with intellectual disability and/or autism spectrum disorders
- Community Brain Disorders Assessment and Treatment Service – specialised support for Victorians with an acquired brain injury and mental health difficulties
- the Glaser Clinic – support for people with a cognitive disability who are in contact with the justice system.
However, we need to consider the detail of how we would provide:
- specialist assessment and clinical services
- training and support
- specialist roles and multidisciplinary teams
- access to statewide specialist services
- participation in a national network of specialised disability mental health services.
We also need to consider what we need to do to:
- improve and evaluate existing services
- deliver additional specialised services
- change existing models of care.
To do this, we need to collaborate and consult with stakeholders of our specialised mental health services.
We are also working to embed inclusive practices within Victoria’s mental health and wellbeing system. We are doing this by developing the Diverse Communities Mental Health and Wellbeing Framework. This framework aims to improve and promote the mental health and wellbeing of diverse communities, including people with disabilities.
Western Australia
Response: Accept in principle
Status: In progress
What has been achieved to date
The Western Australia Government remains committed to considering this recommendation further.
WA government response July 2024
The WA Government accepts in principle this recommendation and work is underway across the health system that meets the intent of the recommendation. This recommendation must be considered alongside any activities that are in-scope of National Health Reform Agreement (NHRA) public hospital services or align with reforms that are currently being considered for the 2025-30 NHRA Addendum. Implementation is subject to consideration of the best model for Western Australia.
What the Disability Royal Commission said in the final report
State and territory governments should establish and fund specialised health and mental health services for people with cognitive disability to provide:
- specialist assessment and clinical services, including preventive medicine, for people with cognitive disability and complex or chronic health and mental health needs
- training and support for health providers to build their capacity to provide safe, high-quality health care to people with cognitive disability.
These services should be delivered through a model that includes:
- specialist roles and multi-disciplinary teams embedded in local health service delivery
- statewide specialised services that can be accessed by people with cognitive disability and health professionals regardless of their location
- participation in a national network of specialised disability health and mental health services
- evaluation of the impact of specialised services and publication of evaluation findings.
Planning to implement specialised services in each jurisdiction should begin as soon as practicable and take into account existing services and needs in each jurisdiction. These changes should be introduced by September 2026.
More recommendations
View progress on other recommendations made by the Royal Commission.