The integration of mental health into general health care is not a simple undertaking and raises challenges for information collections. Mental health care differs in its nature and organisation from the conventional image of acute hospital specialities around which much of Australia's information development has been centred. Many of these differences are also characteristic of other specialities, such as the health care of older people or those with chronic illnesses, for example:
- Care may be long term or may occur in shorter but recurring episodes.
- Care is usually provided by multiple treatment teams working across hospital and community settings, including the consumer's home. This poses practical difficulties for clinical staff recording details of their work, and thus has implications for what information can become 'national information'.
- Coordination of the overall care effort can be difficult, and is dependent on modern communication technologies, most of which are not currently available to the typical mental health service provider.
- Outcomes are relatively difficult to study as many facets of consumers' and carers' lives may be affected over long periods of time.
- Because mental illness may affect all aspects of living, including work, family, and social life, mental health care has significant overlap with the work of the welfare sector, particularly in the areas of housing and disability support services. Capturing information about the mental health-welfare interface within national information collections is especially difficult.
- Services may need to work with consumers who, as a result of their illness, are affected by disorganisation or disinclined to accept treatments that professionals consider important for them to have.
- Special confidentiality and data protection issues arise from working with police and criminal justice agencies.
- The need to record, and report on, the use of the different Mental Health Acts operating within each State and Territory requires specific data collection and reporting.
- Concerns about public safety are high, with a relatively small number of service failures given substantial publicity. As a result, there is considerable public interest in information about the performance of mental health services.
At the national level, the factors outlined above emphasise the need for a specific focus on the mental health sector that takes account of the whole and not just parts of the service system, that looks at care provided over the longer term, and gives proper consideration to the specific requirements of the National Mental Health Strategy.
These factors support the development of a national mental health information plan that is progressed concurrently with the higher level system approaches to health information development that are taking place in Australia.