1 July 2011

Community Sector gets a mental health framework

| johnboy
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Katy Gallager has announced the release of an “Action Framework” for the 27 mental health agencies and community service organisations involved in mental health services in Canberra.

“The ACT is one of the leading jurisdictions in Australia in regards to community mental health – providing recovery services and rehabilitation, supported accommodation, sub-acute residential and outreach services, and mental health promotion and prevention to schools and the community.”

“The feedback from this review means we now know more about our community mental health sector than ever before. An Action Framework will now be implemented to ensure the ACT community mental health sector serves the needs of consumers and carers, and leads Australia.”

The Framework includes recommendations for;

— More integrated service planning between government and community agencies;
— Better outcome measurement;
— Quality benchmarking;
— Leadership development in the sector;
— Measures which will give agencies capacity to consolidate into more sustainable organisations; and
— Implementing and monitoring the ACT Mental Health Services Plan 2009 – 2014.

We’ve requested the framework and will post when we get it.

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The ACT is one of the leading jurisdictions in Australia in regards to community mental health

Wow, really? Scary thought.

At the risk of having a dialogue with myself, I will post a couple of snippets from the document.

“Opportunities for improved partnerships elicited an enthusiastic response from the agencies. Multiple respondents suggested improved partnerships between the mental health sector and the alcohol and drug sector, and also between mental health and care and protection services”

“Other gaps in services identified included the following areas:
•?Comorbidity services, particularly in relation to rehabilitation;
•?Youth services;
•?Establish a complex needs solution such as a supportive village model.
•?Drop in centre for the South side of Canberra (similar to Rainbow model);
•?Commitment to longer term care – relevant to both clinical and support staff;
•?Anger management services;
•?Collaborative recreational projects such as the former film/music festival;
•?Brain injury services particularly relating to psychosocial rehabilitation;
•?Dual disability services;
•?Family Therapy;
•?Perinatal MH services – Gap relates specific to hands on support and clinical management;
•?Psycho-education groups – Fundamental topics (how to deal with…);
•?Individual support for families – i.e. not group sessions. Need identified for individual assessment of the impact of mental illness on family members and individual (1-1) support; and
•?COPMI services in the form of direct service provision, not kits of information.
Respondents felt there were opportunities for joint service provision, particularly in relation to encouraging cooperation between complementary services such as mental health and alcohol and drug support. Shared training across service types was also highlighted as an opportunity for better understanding of need”.

Service providers already insist they work closely together. Hopefully something will be done to stop them all just working on their little “bit” of a whole person. Failure to see someone as a whole just lets them down. They are more than their illness, more than their disorders, they need homes where they are accepted (not complained about), flexible employment opportunities (where symptoms are understood and allowed for). When people become unwell, their whole life can unravel in a matter of months. They are systematically interviewed and assessed by “experts” who don’t even know them, their history or what they are like generally. We stopped locking people up in Asylums years ago. However, all that’s replaced them is a system of chaos with massive gaps and, jails.

As for a supportive village, Canberra has some beautiful spaces where perhaps a Residential Service could be set up something like this one (although I’m sure there would be resistance to it being located near suburban residences)

If I ever win Lotto, I’ll build one.

Yes it’s me on my soapbox again. I think it’s wonderful that govt is actually talking mental health promotion, prevention and early intervention.

I am interested to see how this framework will relate to the previous 2007 framework regarding carer and consumer participation. Also keen to see what the plans are around “an ACT wide intergrated Comorbidity Strategy”. I’d say there are a quite a few families who would love to see a cross sectoral approach between mental health and the alcohol and drug sector including entry and discharge options. Mental health will often say the substance use is the primary issue and expect a mentally ill person to go away, organise their own detox/rehab (which involves ringing around on daily basis to get in) and actually make the committment. Sometimes it makes more sense to keep a person in a safe place, balance them out with medication, good food and sleep until they are actually able to think straight again before they can make those kind of choices and committments. Some rehabs won’t even take people who are on psychiatric medication. Flicking a person between the two sectors just means more appointments, different philosophies, more confusion and stress. In the meantime, the person at the centre of it all remains in limbo, receiving only partial treatment while trying to get through each day.

I also welcome better outcome measurement so agencies can get a clear picture about what is and isn’t working in the long term. Maybe having to follow up what happens after people are discharged while still unwell or turned away from treatment services will prevent these practices occurring in the future.

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