A Healthier Future - Supporting people living with mental illness

05.10.2009

Improved care for people with serious mental illness

Our second priority for improving access and equity is better care for people with serious mental illness. We set out ways to ensure there is a range of treatment and support services for people with a mental illness, connected across the spectrum of care. We recommend an expansion of sub-acute services in the community and propose that all acute mental health services have a ‘rapid response outreach team’, available 24 hours a day, which can provide intensive community treatment and support, as an alternative to hospital-based treatment.

Redesigning our health system to meet emerging challenges

Our second goal for reforming the health system aims at fundamental redesign that will allow us to better respond to emerging challenges. It is based on three design elements.

Embed prevention and early intervention

The first design element is to embed prevention and early intervention into every aspect of our health system and our lives.

Key to this is the establishment of an independent National Health Promotion and Prevention Agency. The Agency should have a broad role to drive a fundamental paradigm shift in how Australians, and our health system, think and act about health and keeping well, including through better education, evidence and research.

Our recommendations related to prevention and early intervention focus on children and young people. The evidence is overwhelming. If we act early, we can prevent or reduce the magnitude of many disabilities, developmental delays, behavioural problems and physical and mental health conditions.

Our recommendations for a healthy start to life involve ensuring that children and parents – and potential parents – get access to the right mix of universal and targeted services to keep healthy and to address individual health and social needs.

We also have a particular focus on encouraging good mental health in young people. Most new cases of what become chronic mental illnesses – including psychotic disorders such as schizophrenia – emerge in late adolescence and the early adult years. We are recommending the national implementation of youth-friendly, community-based services providing information and screening for mental disorders and sexual health, and specialist clinical services for prevention of, and intervention for, early psychosis.

Recommendations

71. We recommend that a youth friendly community-based service, which provides information and screening for mental disorders and sexual health, be rolled out nationally for all young Australians. The chosen model should draw on evaluations of current initiatives in this area – both service and internet/telephonic-based models. Those young people requiring more intensive support can be referred to the appropriate primary health care service or to a mental or other specialist health service.
72. We recommend that the Early Psychosis Prevention and Intervention Centre model be implemented nationally so that early intervention in psychosis becomes the norm.
73. We recommend that every acute mental health service have a rapid-response outreach team for those individuals experiencing psychosis, and subsequently have the acute service capacity to provide appropriate treatment.
74. We recommend that every hospital-based mental health service should be linked with a multi-disciplinary community-based sub-acute service that supports ‘stepped’ prevention and recovery care.
75. We strongly support greater investment in mental health competency training for the primary health care workforce, both undergraduate and postgraduate, and that this training be formally assessed as part of curricula accreditation processes.
76. We recommend that each state and territory government provide those suffering from severe mental illness with stable housing that is linked to support services.
77. We want governments to increase investment in social support services for people with chronic mental illness, particularly vocational rehabilitation and post-placement employment support.
78. As a matter of some urgency, governments must collaborate to develop a strategy for ensuring that older Australians, including those residing in aged care facilities, have adequate access to specialty mental health and dementia care services.
79. We recommend that state and territory governments recognise the compulsory treatment orders of other Australian jurisdictions.
80. We recommend that health professionals should take all reasonable steps in the interests of patient recovery and public safety to ensure that when a person is discharged from a mental health service that:

  • there is clarity as to where the person will be discharged; and
  • someone appropriate at that location is informed.

81. We recommend a sustained national community awareness campaign to increase mental health literacy and reduce the stigma attached to mental illness.
82. We acknowledge the important role of carers in supporting people living with mental disorders.
We recommend that there must be more effective mechanisms for consumer and carer participation and feedback to shape programs and service delivery.