Summary of progressed by priority area January to December 2010

Summary of progress by priority area January to December 2010

At the commencement of the National Action Plan in July 2006, Victoria committed funding of at least $472.2 million over five years. Victoria's commitment under the National Action Plan to 2010-11 totalled approximately $800.6 million, and Victoria now invests just over $1 billion per annum in specialist mental health services alone.

In March 2009 the Victorian Mental Health Reform Strategy for 2009-2019 came into being. The strategy put in place a wide-ranging agenda for development and change across mental health and related service systems, and represented a significant shift in the way in which Victoria responded to mental health issues. Built on the core concepts of prevention, early intervention, recovery and social inclusion, the strategy took a whole of government, whole of population approach to improving health, social and economic outcomes for people with a mental illness. The activities reported on here represent those actions within our reform agenda that tie into the 4NMHP. Top of page

Priority area 1: Social inclusion and recovery

Victoria recognised that the important contribution of education and employment outcomes and future action in this area will be informed by the work of the Ministerial Advisory Committee on Mental Health. Victoria has a strong commitment to improving coordination between the primary care sector and specialist mental health services with initiatives including; the Community Mental Health Planning and Service Coordination Initiative; Primary Care Partnerships; Mental Health Primary Early Intervention teams; Child and Youth Demonstration Projects; and six new early intervention Youth Mental Health Teams.

Promoting a recovery oriented culture and practice within all mental health services was a key element underpinning the reform agenda. Key activities included: the development of a Psychosocial Rehabilitation and Recovery Development and Reform Plan and a framework for recovery orientated practice for the specialist mental health service system. We engaged in a range of strategic planning activities and innovative programs developments that integrated housing and specialist mental health support services including; the development of a joint action plan between departments; the Victorian Homelessness 2020 Strategy; a new tier of intensive support into the PDRSS Home Based Outreach Support program; and a new supportive housing models. There were also a number of projects that supported and informed the development of a national stigma reduction strategy, including being a partner in the beyondblue: national depression initiative and involvement in the MMHA Stigma Reduction Project.

Victoria committed to developing and implementing integrated approaches between relevant sectors, with a four year pilot of a specialist 'Assessment and Referral List' in the Magistrates Court; implementation of the Justice Mental Health Strategy; establishment of a Justice Mental Health Partnership Group; and the roll out of Forensic Clinical Specialist positions to ten area mental health services being indicative of the work that was underway. Key activities and programs in the development and implementation of a renewed Aboriginal and Torres Straits Islander Social and Emotional Well Being Framework included; development of a culturally responsive metropolitan wide Aboriginal mental health service; building a skilled and sustainable Aboriginal mental health workforce; and development of a whole of government Indigenous Suicide Action Plan. Top of page

Priority area 2: Prevention and early intervention

Victoria engaged in a number of activities to improve mental health literacy and enhance resilience. Young people were prioritised as an area for early action. Key activities included; funding a professional development program for early childhood services and schools; development of a Mental Health Promoting Schools and Early Childhood Education and Care Settings Framework; development of a framework for mental health promotion in workplaces; roll-out of KidsMatter; a training program to improve mental health literacy and intervention skills; and the establishment of a state-wide mental health promotion network.

Victoria recognised the value of targeted early intervention service through the roll out of the Child and Adolescent Mental Health and Schools Early Action (CASEA) program. Further, in responding to the needs of young people with mental health problems Victoria developed a new community based crisis treatment and support response - targeted to teenagers and young people; implemented a new approach to reducing in suicide amongst young people; implemented a new Youth Justice Mental Health Initiative; established new dedicated coordinators in mental health services; implemented new models of housing and support that focus on preventing a transition to adult homelessness; and delivered an embedded Youth Dual Diagnosis response within the youth homelessness service system.

In addition, Victoria engaged in a number of cross government strategic planning and service development and delivery activities that supported frontline emergency services (police and ambulance) and welfare/social support services to better respond to people experiencing a psychiatric crises, including those at risk of suicide. Activity in this area included; targeting local communities of increased risk linked to recent incidence of suicide or associated risk factors; and consolidation and enhancement of the 24/7 triage service in selected services. Victoria also implemented an extension training program on mental health first aid for the Victorian Police Force and developed a whole of government Indigenous Suicide Action Plan. Top of page

Priority area 3: Service access, coordination and continuity of care

Victoria committed to supporting local communities in developing solutions to improve mental health outcomes. Activities included the implementation of the new Community Mental Health Planning and Service Coordination Initiative in all Department of Health Regions; the engagement of specialist mental health services in local service coordination platforms such as Primary Care Partnerships; and support for Area Mental Health Services (AMHS) and PDRSS Alliances to facilitate local service planning and coordination.

There were a number of strategic activities to improve the flow of information between primary care and specialist mental health service, including demonstration projects involving primary health (including community health) and specialist mental health services to improve physical health outcomes for people with severe mental illness.

Victoria also developed a new police and community triage model to provide short term case management and care coordination for people with behavioural problems who have repeated police interactions. This service model provided an integrated emergency management response to people experiencing a psychiatric crisis. We established Police and Ambulance protocols with Mental Health and established an interdepartmental liaison committee to oversee the protocols and joined up service delivery across mental health, disability and emergency sectors.

Victoria has an ongoing commitment to improving coordination and linkages between mental health services, alcohol and other drug services, and primary care services. A new approach to the coordination of care of adults with severe mental illness was trailed. Other key initiatives included: the ongoing development of education and training materials for staff in the mental health and alcohol and drug service systems; support to the ETU to involve consumers and carers in the development of the online course materials; provision of scholarships for alcohol and drug and mental health workers; and three month reciprocal rotations for clinicians in the other service sector.

Demonstration projects were funded to bring about broad change management reforms across the health service system to better respond to the needs of people with serious mental illness experiencing chronic physical disease and the establishment of Mental Health System Development Managers in each Department of Health regions facilitates cross sector collaboration to address local mental health issues. The Victorian Dual Disability Enhanced Regional Service Response (VDDS ERSR) project was also piloted.

Victoria established the Mental Health Advice Line, a dedicated 24 hour telephone line providing mental health information, advice and referral to the Victorian community. In addition we progressively consolidated and streamline access to specialist mental health triage services; and introduced a standardised triage classification scale for use by community based clinical mental health services. Top of page

Priority area 4: Quality improvement and innovation

The Mental Health Statement of Rights and Responsibilities were considered as part of the review of the Victorian Mental Health Act 1986 (the Act). The review examined whether the Act provides an effective legislative framework for the treatment and care of people with a serious mental illness in Victoria. A draft exposure Bill has now been prepared and has been put out for public comment. The reform of Victoria's mental health legislation continues to support cross border agreements and interstate transfers of people under civil and forensic orders. Victoria continues to work with neighbour states on cross border agreements that facilitate the movement of people under civil and forensic orders across the borders.

Victoria was represented on the Project Steering Committee for the National Mental Health Workforce Strategy and Plan. Participation at this level facilitated good connection between National and Victorian Mental Health workforce priorities and actions.

Victoria committed to reviewing existing consumer and carer workforce models through the specialist mental health workforce partnership group and through targeted sector discussions including consumer and peer workers and carers. Victoria developed a new Mental Health Quality Framework.

Victoria was an active participant in the MHISS which progressed the implementation of the national mental health performance framework and benchmarking framework. A new indicator suite for CAMHS, Aged, and Extended Care settings was endorsed which broadly aligns with the National framework. Victoria committed through the reform strategy to a common mental health outcomes framework that embraced key determinants of mental health including social, cultural, and behavioural, as well as service adequacy factors, and common service and client outcomes monitoring tools consistent with the national health performance framework.

Victoria supported a national mental health research agenda by its development of an applied mental health research and evaluation agenda to strengthen the evidence base informing policy and program development and service delivery by the promotion of the wider application of research, evidence and practice knowledge to achieve best practice across the specialist mental health service system. Top of page

Priority area 5: Accountability – measuring and reporting progress

The Victorian Mental Health Reform Strategy incorporated an outcomes framework, modelled on the national health performance frameworks, adapted to incorporate the broader social and economic factors impacting on mental health and the multi-system perspective required for a whole of government approach to mental health. The framework enabled Victoria to track progress and to be accountable for population health, client and system outcomes across government and various levels of Victoria's health and social support service systems over the life of the strategy. The framework provided the basis for a set of agreed mental health indicators and measures and took in account the measures identified in the Fourth National Mental Health Plan and COAG National Action Plan on Mental Health.

Victoria continued to work with funded services to improve data collections in order to monitor and improve system performance. Reports were produced on a quarterly basis on a range of key performance indicators broadly consistent with the national framework for children, adolescents, adult and older people mental health services. These reports form the basis of service performance management between the Department of Health and health service providers. A similar reporting system is under development for the non clinical Mental Health sector.