Mental Health’s Direction

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People risk falling between mental health services as patients transfer between services.

If it’s not front page news, it can appear that mental health is going through a quiet patch. This is pure perception. The inherent challenges in the mental health sector are constant, regardless of the media visibility – just ask the clinicians, patients and their families.

I am charged with monitoring standards across WA’s mental health services. The Chief Psychiatrist’s Standards were rolled-out with the Mental Health Act 2014. These are statutory standards mental health practitioners must familiarise themselves with.

Here is a brief look at some important future issues.

I will leave aside the Fifth National Mental Health Plan consultation and major mental health standards development from the Australian Commission for Safety and Quality, but will mention the National Disability Insurance Scheme. The concept is timely, but it appears unlikely to be broad enough to appropriately fund the community-managed organisations to capture the real psychosocial support need for those with severe and enduring mental illness. Strong community psychosocial support is needed to back-up clinical services.

Unsurprisingly, points of transition between services remain a risk for serious negative outcomes for patients – the sentinel event data I receive confirms this. There is a statutory standard for transfer of mental health care between services, including transfer to primary care. With the new Health Services Act 2016, we now have several Boards overseeing the new Health Service Providers (HSPs; previously Area Health Services). The HSPs have a governance responsibility to ensure that individuals needing care across services have clear and timely co-ordination.

With the tepid findings in the recent release of the Headspace report card nationally, it is worthwhile noting that the WA Department of Health and Mental Health Commission have taken active steps to expand local clinical youth mental health services. I note the challenge for primary care in this space. I would strongly encourage Health to advertise widely the pathways and resources for youth mental health as they emerge.

On a pleasing note, I’m impressed so far with the mental health component of the new WA online Health Pathways program that will provide, for GPs, summarised information, timely decision trees, pathways and direct instruction on local referrals, all on the desktop. Modelled on established eastern states and NZ programs, it’s still building local mental health content, but the quality of information being developed is robust. Well done WAPHA.

Issues don’t disappear with the media cycle. While the mainstream news attention is often narrowly focused on methamphetamine, we must also keep a spotlight turned to the needs of the ubiquitous broader mental health sphere.

Reference: Chief Psychiatrist’s Standards of Care are at www.chiefpsychiatrist.wa.gov.au

ED. Mental health organisations recently highlighted shortcomings in the Fifth National Mental Health Plan. Their joint letter (https://mhaustralia.org) said there were alarming gaps between previous commitments by the Council of Australian Governments (COAG) on mental health and the consultation draft for the Plan released last October. Wide feedback was that the draft Plan reflected old modes of thinking. The group asked for the roles and responsibilities of governments be clarified, targets and indicators be included, more focus on early intervention and prevention, and expanded community services to be imbedded where the need was. Signatories to the joint letter include the National Mental Health Consumer & Carer Forum, Suicide Prevention Australia, Orygen, Sane Australia, ReachOut, R U OK?, the Black Dog Institute and a further 50 organisations.