4.10.1 RationaleEvaluation and accountability are key themes of the National Mental Health Strategy and were the drivers of much of the information development that occurred in the early years. The agreement by all governments to a national approach to mental health recognised that an important aspect of the reform process was to ensure the process would be monitored and reported publicly on a regular basis. This has been achieved through regular reporting of progress in the National Mental Health Report, supplemented by independent evaluations of each five year National Plan.
The National Mental Health Report series has reported on all years of the Strategy since 1993 as a specific requirement of the Australian Health Care Agreements 1998-2003 and the former Medicare Agreements. When the current series concludes, the reports will have provided detailed snapshots of mental health services in Australia across the 1993-2003 decade, charting the changes in spending, service mix and workforce that have resulted from the national reforms. The report has no counterpart in Australia's health system or in the international mental health field.
Additional benefits have accrued through the national monitoring process, particularly the provision of comparative data for use by States and Territories in planning and resourcing their services. It has also given insights into Australia's mental health reforms for consumers, carers and the community that would otherwise not be accessible. For these reasons, it is not surprising that feedback from the national consultation forum held in February 2004 argued strongly for continued access to this type of information.
While acknowledging these achievements, a new approach to national monitoring of mental health services is needed that responds to the emerging issues and priorities outlined in the National Mental Health Plan 2003-2008. The National Mental Health Report has been based on indicators developed in 1992 that emphasised structural changes in service mix and overall resourcing levels. These were appropriate to the original reform goals of the Strategy, but do not address the actual performance of the mental health system in meeting the needs of the community. Additionally, the focus of reporting to date has been confined primarily to public sector specialised mental health services, giving only limited attention to the role of primary mental health care and the private sector.
The objectives under the National Mental Health Strategy have broadened substantially over the past decade, from efforts to transform an outmoded and institution-centred system of care to wider concerns that reflect a new appreciation of the central place of mental health in the overall health and wellbeing of the community. Monitoring progress across all key Strategy areas requires an approach that continues the role of previous National Mental Health Reports in putting national data into the public domain, while also having the flexibility to report on the new and emerging issues.Top of page