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Report: Inquiry Into Mental Health Services in Australia The Senate Standing Committee on Community Affairs Towards recovery: mental health services in Australia September 2008 © Commonwealth of Australia 2008 ISBN 978-0-642-71987-4 Senate Community Affairs Committee Secretariat: Mr Elton Humphery (Secretary) Ms Christine McDonald (Principal Research Officer) Ms Lisa Fenn (Principal Research Officer) Mr Owen Griffiths (Senior Research Officer) Ms Leonie Peake (Research Officer) Ms Ingrid Zappe (Executive Assistant) The Senate Parliament House Canberra ACT 2600 Phone: 02 6277 3515 Fax: 02 6277 5829 E-mail: [email protected] Internet: http://www.aph.gov.au/senate_ca This document was produced by the Senate Community Affairs Committee Secretariat and printed by the Senate Printing Unit, Parliament House, Canberra. iii MEMBERSHIP OF THE COMMITTEE 42nd Parliament Members Senator Claire Moore, Chair ALP, Queensland Senator Rachel Siewert [from 1.7.08 and Deputy Chair AG, Western Australia from 27.8.08] Senator Gary Humphries [Deputy Chair until 27.8.08] LP, Australian Capital Territory Senator Judith Adams LP, Western Australia Senator Lyn Allison [until 30.6.08] AD, Victoria Senator Catryna Bilyk [from 1.7.08] ALP, Tasmania Senator Carol Brown ALP, Tasmania Senator Sue Boyce LP, Queensland Senator Mark Furner [from 28.8.08] ALP, Queensland Senator Kate Lundy [until 28.8.08] ALP, Australian Capital Territory Senator Helen Polley [unitl 30.6.08] ALP, Tasmania Participating Members Senator Andrew Bartlett [until 30.6.08] AD, Queensland Senator the Hon Richard Colbeck [from 1.7.08] LP, Tasmania Senator Michael Forshaw ALP, New South Wales Senator Ruth Webber [until 30.6.08] ALP, Western Australia 41st Parliament Members Senator Gary Humphries, Chair LP, Australian Capital Territory Senator Claire Moore, Deputy Chair ALP, Queensland Senator Judith Adams LP, Western Australia Senator Lyn Allison AD, Victoria Senator Carol Brown ALP, Tasmania Senator Sue Boyce [from 9.5.07] LP, Queensland Senator Concetta Fierravanti-Wells [until 9.5.07] LP, New South Wales Senator the Hon Kay Patterson LP, Victoria Senator Helen Polley ALP, Tasmania Participating Members Senator Andrew Bartlett AD, Queensland Senator Michael Forshaw ALP, New South Wales Senator Ruth Webber ALP, Western Australia iv v TABLE OF CONTENTS MEMBERSHIP OF THE COMMITTEE ................................................................iii ACRONYMS AND ABBREVIATIONS ...................................................................ix EXECUTIVE SUMMARY.........................................................................................xi RECOMMENDATIONS ..........................................................................................xiii CHAPTER 1 INTRODUCTION .....................................................................................................................1 Terms of reference..................................................................................................1 Interim report..........................................................................................................1 Conduct of the inquiry............................................................................................2 Australia/New Zealand Parliamentary Committee Exchange.............................3 Structure of the report.............................................................................................3 Acknowledgments ..................................................................................................3 CHAPTER 2 POLICY CONTEXT .................................................................................................................5 The COAG National Action Plan on Mental Health..............................................5 Other developments.............................................................................................7 The COAG Plan and the National Mental Health Strategy....................................8 State and Territory variation..............................................................................10 Future policy direction .........................................................................................11 The New Zealand experience ............................................................................13 Mental health commissions...............................................................................14 A recovery focus in mental health policy..........................................................17 Concluding comment............................................................................................19 CHAPTER 3 COORDINATION...................................................................................................................21 Government forums for coordination...................................................................21 COAG Mental Health Groups...........................................................................21 National Advisory Council on Mental Health...................................................24 Other government forums coordinating mental health policy ..........................26 Coordination across areas of responsibility..........................................................27 The COAG Plan and existing initiatives ...........................................................30 Legislative coordination and compulsory treatment orders ..............................32 Recognising different service structures ..............................................................33 Care coordination .................................................................................................35 Funding..............................................................................................................36 Implementation across the jurisdictions............................................................38 vi Concluding comment.........................................................................................39 CHAPTER 4 COMMUNITY SECTOR INVESTMENT..............................................................................41 Community sector funding...................................................................................41 Effect of the new funding..................................................................................42 Competitive tendering ..........................................................................................44 Valuing local knowledge...................................................................................45 Collaborative tendering .....................................................................................47 Onerous application process..............................................................................49 Meeting the needs of specific groups................................................................50 Sustainability of services...................................................................................50 Concluding comments..........................................................................................51 CHAPTER 5 PERSONAL HELPERS AND MENTORS.............................................................................53 The Personal Helpers and Mentors program........................................................53 Support for the program ....................................................................................53 Concerns about the program..............................................................................56 Who is the program for and is it reaching them? .................................................57 People who are excluded...................................................................................59 Geographic coverage............................................................................................59 PHaMs providers..................................................................................................61 PHaMs staff.......................................................................................................61 Peer support workers .........................................................................................61 Qualifications and training ................................................................................62 Capacity................................................................................................................64 Evaluation.............................................................................................................66 CHAPTER 6 BETTER ACCESS INITIATIVE............................................................................................69 The initiative.........................................................................................................69 Support for the initiative.......................................................................................71 Use of Better Access services...............................................................................72 Diagnosis and treatments...................................................................................73 Group therapies .................................................................................................74 Is Better Access providing 'new' services?...........................................................75 Barriers to access..................................................................................................77 Costs ..................................................................................................................77
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