Mental Health Australia Policy Forum—Reflections from an Occupational Therapist
26 November 2019
Parliament House, Canberra
As a member association of Mental Health Australia (MHA), OTA has the opportunity to contribute to both national and regional mental health reform agendas. Increasingly, these agendas aim to address the shortcomings of traditional mental health systems. The MHA Policy Forum in November highlighted a potential shift in mental health services towards greater investment in wellbeing and value outcomes, and the development of a more culturally capable and clinically diverse workforce.
Thanks to OTA, I had the opportunity to represent our profession in a multi-disciplinary roundtable which considered community mental health workforce development strategies. Our recommendations will be forwarded to the Productivity Commission which, as I am sure you know, is currently conducting a sweeping review of mental health and its socio-economic impact on the Australian community.
Forum Guest Speakers
The 2019 MHA Policy Forum began with a genuine and empathetic Grace Groom Memorial Oration delivered by Productivity Commissioner, Dr Stephen King. Dr King said the Commission’s Draft Report on Mental Health highlighted the need for a more person-centred and culturally capable mental health system. It was reassuring to hear one of our nation’s most influential economists conclude that the most important measure of value of a mental health system is the value that consumers and carers perceive in the services they have received. When asked what the core ingredient for mental health reform will need to be, Dr King said that reducing the stigma and discrimination experienced by mental health consumers was crucial. To watch a highlights video of the night, click here
Shadow Minister for Health, the Hon. Chris Bowen MP also highlighted the importance of the Productivity Commission’s report as a juncture in the “revolution” to fix the mental health system. He reminded us of the opportunity to learn from New Zealand’s investment in a wellbeing approach to reform.
Greens Senator Rachel Siewert noted the growth of the intentional peer support workforce, particularly in regional areas and Indigenous communities. She advocated for funding system reform to correct vulnerabilities created by models such as the NDIS, and called for future development of e-health and telehealth to be an adjunct to face-to-face services, rather than a replacement. Senator Siewert also echoed the Productivity Commissioner, with a call to action to expedite mental health strategic plans for people from Aboriginal and Torres Strait Islander backgrounds.
MHA then presented the Embrace Project, a multicultural mental health resource designed to support organisations to better meet the needs of people from diverse cultural backgrounds and to enhance contemporary help seeking behaviours within communities. As an example of unmet need, people from Arabic backgrounds in Sydney are using Skype to access mental health services from their country of origin. Difficulties in accessing local mental health services stem in part from the insufficient use of interpreters by mental health clinicians.
National Mental Health Commission Priorities
Ms Christine Morgan, CEO of the National Mental Health Commission presented the Draft Vision 2030. This is designed to articulate a “right” system, rather than small incremental changes to an existing system which is fractured and has no overarching funding or delivery framework, and which lacks coordination between federal and state and territory governments. National consultations highlighted 3 major barriers to improved mental health care, including:
- Poor access to fragmented and inconsistent services
- Stigma, including attitudinal stigma characterised by mental illness discrimination and racism
- Lack of trust in the mental health system
Necessary improvements identified include:
Improvements to community-based mental health care
1. At the individual level, reduce stigma, shame and discrimination, empower the voice of the person, and enhance face-to-face care
2. Community hubs that coordinate culturally appropriate and local services
3. Integrated systems without geographical and financial barriers (clinical and psychosocial services working together)
Wellbeing and a quality of life focus
1. Social determinants and social and emotional wellbeing as outcomes
2. Reduced suicide
3. Care coordination across integrated services as a whole
4. Housing stability and employment
5. Decreased engagement with corrections
6. Decreased use of involuntary and emergency services
How to make change happen
1. Focus on education and workplace environments
2. Digital and telehealth that strengthens person-to-person services
3. Community mental health hubs
4. Co-location models
5. Revised Stepped Care Models (e.g. primary health is fundamental across all areas)
The need for all professions to share and support each other, particularly co-production and joint training with the peer lived experience workforce, will be strategically and ethically paramount. The Policy Forum guest speakers agreed that mental health reform needs to address social determinants, such as housing, employment and other factors that are underlying causes of mental ill health.
By Geoff Lau, OTA Delegate
About the Author
Geoff Lau has worked extensively in adult mental health as an occupational therapist, clinical supervisor and manager since 1992; across acute to tertiary, inpatient and community-based services in Queensland and overseas. His core training in occupational therapy at The University of Queensland, combined with post graduate training in social science at the Queensland University of Technology, guided his clinical practice towards evidence-informed assessment and intervention. Learn more about Geoff.