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Mental Health Inquiry 2019

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Mental Health Inquiry 2019 Submission Productivity Commission Mental Health Inquiry 2019 April 2019 ConNetica Team ConNetica Consulting Pty Ltd Directors: Adjunct Professor John Mendoza & Marion Wands We also wish to acknowledge the contributions made (in previous work) and incorporated into this submission by Professor Luis Salvador Carulla (Centre Director, Centre for Mental Health Research, ANU); Asso Professor Lisa Woods (Centre for Social Impact, UWA; and Dr Martin Harris (Strategic Transitions and UTas). ConNetica is a member of the Behavioural Health in ED Community of Practice with the Institute for Healthcare Improvement (Massachusetts), and a partner with ANU’s Centre for Mental Health Research in Psicost Scientific Association Australasia. PO Box 1311 Coolum Beach Qld 4573 P: 07 5491 5456 W: www.connetica.com.au ABN: 76 124 523 815 Table of Contents ABBREVIATIONS....................................................................................................................... IV THIS SUBMISSION ..................................................................................................................... 6 ABOUT CONNETICA .................................................................................................................. 8 1 ASSESSING THE CURRENT AND POTENTIAL INTERVENTIONS TO IMPROVE MENTAL HEALTH OUTCOMES............................................................................................... 11 1.1 NATIONAL CONTEXT............................................................................................................ 12 1.1.1 SUICIDE PREVENTION STRATEGY IN AUSTRALIA ....................................................................... 12 1.1.2 FIFTH NATIONAL MENTAL HEALTH AND SUICIDE PREVENTION PLAN ...................................... 12 1.1.3 NATIONAL EXAMPLES OF SUICIDE PREVENTION & MENTAL HEALTH PROMOTION ................ 13 1.2 INTERNATIONAL EXAMPLES & INNOVATIONS IN SUICIDE PREVENTION ................................. 17 1.2.1 WORLD HEALTH ORGANISATION (WHO) .................................................................................. 17 1.2.2 USA ............................................................................................................................................. 18 1.2.3 DO ‘NATIONAL SUICIDE PREVENTION FRAMEWORKS’ MAKE A DIFFERENCE? ........................ 18 1.3 STRUCTURAL ISSUES IDENTIFIED FROM INTEGRATED ATLAS STUDIES ................................. 18 1.3.1 OTHER STRUCTURAL AND SYSTEMS APPROACHES ................................................................. 20 1.4 ISSUES ARISING FROM THIS SUMMARY ................................................................................ 25 2 CONTRIBUTING COMPONENTS TO IMPROVING MENTAL HEALTH AND WELLBEING .............................................................................................................................. 27 2.1 SUICIDE AND SELF HARM .................................................................................................... 28 2.1.1 WHAT IS SUICIDE AND SELF-HARM ............................................................................................ 28 2.1.2 RISK FACTORS ............................................................................................................................ 28 2.1.3 CAUTION ON RISK FACTORS ...................................................................................................... 37 2.1.4 AN ANALYSIS OF PROTECTIVE FACTORS .................................................................................. 37 2.1.5 INTENTIONAL SELF-HARM .......................................................................................................... 44 2.1.6 IDEATION-TO-ACTION FRAMEWORK ........................................................................................... 45 2.1.7 IMPLICATIONS FOR SUICIDE PREVENTION STRATEGIES ........................................................... 46 3 SKILLS ACQUISITION, EMPLOYMENT AND HEALTHY WORKPLACES ..................... 47 4 CHALLENGES FOR SMALL AND MEDIUM BUSINESSES ............................................. 48 APPENDIX A - A SUMMARY OF SELECTED INNOVATIONS FROM ACROSS AUSTRALIA AND OVERSEAS....................................................................................................................... 49 BIBLIOGRAPHY/REFERENCES .............................................................................................. 56 ConNetica April 2019 i List of Tables TABLE 1 A Summary of Selected Suicide Prevention Training Programs .............................................. 16 TABLE 2 Summary of Key Features of CBCAR Framework (Gelderen et al, 2018 .................................. 22 TABLE 3 CBCAR Framework Description ................................................................................................ 22 TABLE 4 The List of Foundational Community Factors .......................................................................... 43 TABLE 5 Functions of deliberate self-harm (Klonsky 2007) ................................................................... 44 List of Figures FIGURE 2 The AAD Model ...................................................................................................................... 14 FIGURE 3 Integrated Atlases of Mental Health & Chronic Care in Australia ......................................... 19 FIGURE 4 Conceptual model derived from participatory mapping of suicide pathways ..................... 24 FIGURE 5 The Dahlgren-Whitehead model of Social Determinants of Health ...................................... 30 FIGURE 6 ACEs influence over the life course (Source: Centers for Disease Control, Atlanta 2016) .... 34 FIGURE 7 The adult resilience framework (The Resiliency Initiative 2012) ........................................... 41 ConNetica April 2019 ii “If you always do what you’ve always done, you always get what you’ve always gotten.” Jessie Potter, opening speaker, 7th Annual Woman to Woman Conference, 1933. “In treating a suicidal risk, scrupulously maintain continuous contact with the patient and enlist the help of all possible interested persons” Soloman & Patch, Handbook of Psychiatry, 1974 “It is abundantly clear that the chronic stress of struggling with material disadvantage is intensified to a very considerable degree by doing so in more unequal societies. An extensive body of research confirms the relationship between inequality and poorer outcomes, a relationship which is evident at every position on the social hierarchy ….. “It is the distribution of economic and social resources that explains health and other outcomes in the vast majority of studies.” WHO Europe, 2009 ConNetica April 2019 iii Abbreviations Abbreviation Definition AAD Alliance Against Depression ABC Act-Belong-Commit (Campaign) ABS Australian Bureau of Statistics ACE Adverse Childhood Experiences ACSQHC Australian Commission for Safety and Quality in Healthcare AIHW Australian Institute for Health and Welfare AOD Alcohol and Other Drugs APMC Agile Psychological medicine Clinic ASDR Age Standardised Death Rate ASIST Applied Suicide Intervention Skills Training (Program) BDI Black Dog Institute CALD Culturally and Linguistically Diverse CAMS Collaborative Assessment and Management of Suicidality program CASE Chronological Assessment of Suicide Events CDC Centers for Disease Control and Prevention (USA) DALYs Disability-Adjusted Life Year DHHS Department of Health and Human Services (Victoria) DoH Department of Health (Australia) DSH Deliberate Self Harm DSM Diagnostic and Statistical Manual of Mental Disorders EAAD European Alliance Against Depression ED emergency department EMPHN Eastern Melbourne PHN GFC Global Financial Crisis HOPE Hospital Outreach Post-Suicidal Engagement ICP Integrated Care Pathway ISH Intentional Self-Harm IHI Institute for Healthcare Improvement IRSD Index of Relative Socio-economic Disadvantage LGA Local Government Area K10 Kessler 10 LiFE Living is for Everyone Framework ConNetica April 2019 iv LGBTI Lesbian, Gay, Bisexual, Transgender and Intersex MAS mood, anxiety and somatoform (disorders) MHA Mental Health Australia MHFA Mental Health First Aid MHR mental health related MHS Mental Health Services NDIA National Disability Insurance Agency NDIS National Disability Insurance Scheme NMHC National Mental Health Commission NSSI Non-suicidal self injury NT Northern Territory NYC New York City NZ New Zealand PHIDU Public Health Information Development Unit PTSD Post-Traumatic Stress Disorder RTC Randomised Controlled Trial SAMHSA Substance Abuse and Mental Health Services Administration (USA) SEAL Social and Emotional Learning SEMPHN South Eastern Melbourne PHN SEYLE Saving and Empowering Young Lives SPRC Suicide Prevention Resource Centre (USA) SPRS suicide prevention regional strategy SUB Substance Use Disorder STB Suicidal thinking and behaviour TRAIC Tackling Regional Adversity through Integrated Care UK United Kingdom UN United Nations USA United States of America WAPHA Western Australian Primary Health Alliance WBSS Way Back Support Service WHO World Health Organisation WIS/WIC Walk in Service or Walk in Clinic ConNetica April 2019 v This Submission The Productivity Commission (the Commission) has been tasked by the Australian Government to “consider the role of mental health in supporting economic participation, enhancing productivity and economic growth” and make “make recommendations, as necessary, to improve population mental health, so as to realise economic and social participation and productivity benefits over
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