Prioritise Mental Health This Election: Responses
Posted on: 20th March 2019
The State election is on Saturday and MHCC has written to all major parties asking them to make community mental health a priority by committing to four investment priorities identified by MHCC. These priorities were developed in consultation with the sector, our members, people with lived experience, carers, families and service providers.
Here we publish the responses from the Coalition, Australian Labor Party, The Greens and Animal Justice Party.
Responded yes to all four priorities.
“The NSW Government supports the four priorities outlined in the document ‘MHCC Mental Health Priorities’.
NSW Government’s Living Well mental health reform
As you know, the NSW Government’s Living Well mental health reform promotes a greater focus on community care. In 2018-19, $100 million recurrent has been committed to strengthening mental health care through our 10-year mental health reform program. This brings our total investment in the reform to $310 million since 2014.
We are increasing specialist support for people with complex needs by growing specialist clinical mental health services in the community. In this year’s budget, in addition to the $100 million for our reform program, we committed $42 million for additional community-based mental health services and supports, and announced a $700 million infrastructure plan to enhance specialist beds in the inpatient and community setting.
Step-Up Step-Down Community Beds
As part of this capital investment, we will deliver up to 260 new ‘step-up step-down’ community-based beds to support the transition and recovery of long stay mental health patients from hospital into the community. These types of beds are new for the NSW mental health system. A procurement strategy is being developed and a partnership model explored between community-managed organisations (CMOs) and local health districts; this will ensure the best possible outcomes for consumers with a long-term mental illness transitioning from the public health system to community-based care.
This year’s $100 million investment to continue building the community mental health system in NSW includes several specialist clinical community-based programs:
- $9.4 million to assist long-stay mental health patients to transition to the community, providing support for up to 115 people to transition, including an additional $2 million for stage two of the Pathways to Community Living Initiative for additional clinicians to support people to live in the community
- More than $17.7 million for specialist community-based mental health services and programs for children, adolescents and families
- More than $7.2 million for specialist community-based adult mental health services and
- More than $7.7 million for specialist community-based older people’s mental health services.
The NSW Government also funds a number of other programs that support people with severe mental illness to live in the community, including:
- $48 million per year for the Housing and Accommodation Support Initiative (HASI) which delivers coordinated clinical, psychosocial and housing supports to people with severe mental illness. At least 1,135 people across NSW receive psychosocial support services through HASI.
- $21.35 million per year is invested in Community Living Support (CLS), which began in July 2016. As at December 2018, the CLS program provided clinical and psychosocial supports to a further 750 people with severe mental illness living in the community.
- $9.7 million to support 60 people in HASI Plus packages designed for people with especially high and complex needs who require 16 to 24 hours of daily support. The NSW Government is enhancing this investment to more than $10 million to deliver packages to assist people with intensive support needs to live in the community.
- In 2018-19, $2.4 million is being invested in the Youth Community Living Support Service, for young people aged 16-24 years with severe and complex mental illness, and their families.
- Funding of $9.3 million is provided over three years to maintain the Mums and Kids Matter program from 2016-17. The share for 2018-19 is $3.1 million. The Mums and Kids Matter Program supports mothers and their young children through short-term, non-acute accommodation with mental health and parenting care, and specialist care, provided in a person’s home. When needed brokerage funding for tertiary inpatient mother-baby unit and parenting centre admissions is available.
Further, under the Partnerships for Health reform, in 2018-19 the NSW Government is funding $23 million for mental health programs such as supported accommodation, family and carer support, non-residential day programs, Aboriginal mental health, clinical and education services, Lifeline Australia, and of course the MHCC.
LikeMind – community mental health hubs
The NSW Government is also supporting the community mental health hub model, investing $3.6 million in 2018-19 for LikeMind, which is an innovative, integrated community mental health service for adults with moderate to severe mental illness. It delivers person centred care through a single point of contact that coordinates triage, assessment, treatment, management of care and discharge planning. The LikeMind pilot has four sites across three local health districts.
Parramatta Mission operates the sites at Penrith and Seven Hills, while Aftercare operates the sites at Orange and Wagga Wagga. The four pilot sites were selected because they have an appropriate level of population need and have a sufficiently strong community-managed sector to manage the model. The sites also have mental health and drug and alcohol teams within the respective local health districts, which were considered well placed to provide the necessary supports and collaboration.
The Penrith, Seven Hills and Orange sites were launched in January 2015, October 2015 and October 2016. Funding for LikeMind is committed until 30 June 2019. To inform the effectiveness of this pilot and its ongoing potential, an independent evaluation is underway. Results of the evaluation will be available in early April.
National Disability Insurance Scheme
We are proud that unlike other states and territories, the NSW Government has chosen not to roll its community mental health supports into the National Disability Insurance Scheme and will continue to work with the National Disability Insurance Agency and the Commonwealth on minimising gaps in the service system.
We were also very pleased to announce $90 million for suicide prevention initiatives over the next three years, including strengthening community-based care. Your members may be interested in being involved with the rollout of these Towards Zero Suicides initiatives. The most recent information is available at www.health.nsw.gov.au/mentalhealth/resources/Pages/towards-zero.aspx
The NSW Liberals and Nationals Government has also committed $23 million in funding to expand capacity at Lifeline and Kids Helpline and $88 million to enhance mental health supports in schools over the next four years. Of course, CMOs are important partners in delivering these commitments.
Partnerships for Health and CMOs
The NSW Government strongly supports the development of the community managed mental health sector. As you know, NSW Health commissions CMOs to deliver mental health community support services, and these services are an important part of the overall system of care offered to people with lived experience and their families, carers and support people.
Under Partnerships for Health the NSW Ministry of Health is engaged in a three-year process to improve consumer value through changes to the way CMO services are commissioned. The Partnerships for Health reform moves NSW from historical grant funding towards a strategic competitive purchasing framework. Partnerships for Health commits NSW Health to greater transparency, accountability and alignment of funded services with strategic priorities.
The reform aims to strengthen partnerships and service outcomes, better align CMO services with the NSW Government’s priorities, enhance service quality, and improve effectiveness and value for money. Contestability has already been introduced to some mental health programs delivered by community managed services outside of Partnerships for Health. These include CLS, HASI, the Suicide Prevention Fund, and the LikeMind pilot.
Mental Health Workforce Plan
CMOs are considered a key partner in the NSW Strategic Framework and Workforce Plan for Mental Health 2018-2022, and I encourage you to lead the way in collaborating with the Ministry on implementation of this plan. Key actions relating to CMOs include:
- Conducting a mental health training needs analysis of NSW Health, CMO, and other partner workforces
- Continuing to embed the Your Experience of Service (YES) survey, including developing capacity for web based collections and a CMO trial implementation of YES, and
- Establishing the Mental Health Carer Experience of Service (MH CES) survey in NSW public mental health services and CMOs.
The NSW Government also recognises the excellent work the MHCC does in developing a professional workforce to respond to the needs of the CMO sector. I was pleased to approve an investment of close to $500,000 recently to establish scholarships for our frontline mental health workforce, and people experiencing mental health issues, to develop professional and life skills. This funding will be provided to the MHCC for 280 professional development scholarships and 80 transition-to-work and study scholarships over the next two years.
The Hon. Tanya Davies MP, Minister for Mental Health
Australian Labor Party
Responded yes to all four priorities.
Q. Expanding community based mental health services to support the recovery and economic and social inclusion of people living with mental health conditions
Q. Investing in Step Up, Step Down services to bridge the gap between hospital care and community living
Q. Supporting community mental health hubs with co-located services and peer support
Q. Implementing a Community Managed Mental Health Sector Development Strategy
“NSW Labor will continue to support existing health and hospital mental health programs but not enough is being done.
A Daley Labor Government will make improving mental health in NSW a priority.
We will work with key stakeholders to improve the state’s mental health system.
During the election campaign NSW Labor has already announced key elements of its mental health policy which include:
- Introducing nurse-to-patient ratios in mental health units in the State’s hospital system
- Open more mental health beds in NSW hospitals by investing an extra $40 million;
- Deliver 450 additional counsellors, psychologists and student support officers to all high schools;
- Hire an extra 30 clinical psychologists across NSW;
- Train and employ 50 mental health outreach workers in regional NSW, to support communities affected by the drought;
- Allocate an extra $20 million to partner with not for profit mental health groups in regional areas to complement existing services;
- Provide an extra $3 million for improved technology to support rural tele-health initiatives for local health districts to assist mental health workers and patients;
- Provide mental health first aid training to public school principals and senior staff to better assist students and colleagues;
- Provide $7 million to trial health screening and outreach in four Women’s Health Centres;
- Provide an extra $1 million to fund eating disorder treatment services in the Illawarra;
- Establish a public sector mental health charter to support the wellbeing and safety within the NSW public sector;
- Set up a NSW Legislative Council parliamentary inquiry into the NSW mental health system as there has not been a full and proper inquiry since 2001;
- Work with the NSW Health Care Complaints Commission and the Attorney General’s Department to ban the practice of gay conversion therapy in NSW – if there is not a national approach; and
- Double the funding for the NSW Police Workforce Improvement Program with an additional $12 million to provide frontline police officers with the support they need to respond to the stressful and challenging nature of the work they undertake. (Up to 250 police officers will suffer physical injuries a month and up to 50 officers will suffer a psychological injury a month.)”
The Hon. Walt Secord, MLC, Shadow Minister for Health
The Greens mental health policy advocates for increased funding for public mental-health services, including public hospital inpatient services, community-based outpatient and outreach services, and case managers, especially for patients with acute and pervasive mental-health conditions.
We see a need for improving hospital and community-based mental health services and continuity of care, with particular emphasis on addressing the high rate of homelessness among mentally ill people by establishing supported government-endorsed accommodation for people with mental illness, including crisis, medium-term and long-term accommodation with rehabilitation programs.
Similarly, the Greens want to increase support and respite services for carers/families that care for people with mental illness and provide appropriate treatment in public health facilities and in prisons and other correctional facilities for prisoners with mental health problems.
We would like to see increased resources for community based public services providing early- intervention programs for mental health issues and funding for additional public services, including specialist psychiatric services, to assist people who present with symptoms of mental illness at hospital emergency services.
The Greens would welcome additional funding available to allow the provision of public mental-health services within schools and other educational institutions.
I hope this adds clarity to the Greens policy position in this important area.
Dawn Walker MLC, Greens NSW spokesperson for Health
Animal Justice Party
“Mark Pearson MLC has worked in the mental health area and understands the difficulties around funding and advocacy. So in short, Mark and the Animal Justice Party supports your initiatives. As the opportunity arises in the new parliament, we will do what we can to help.”
The Hon. Mark Pearson, MLC