Delivering National Mental Health Reform

Australians with a mental illness will get the care they need, when they need it, under a $2.2 billion over 5 years reform package for mental health services.

These reforms are aimed at improving the lives of thousands of Australians with mental illness by:

• Providing more intensive support services, and better co-ordinating those services, for people with severe and persistent mental illness who have complex care needs;
• Targeting support to areas and communities that need it most, such as Indigenous communities and socioeconomically disadvantaged areas that are underserviced by the current system; and
• Helping to detect potential mental health problems in the early years, and supporting young people who struggle with mental illness.

Given the impact of mental illness on individuals, their families and the community, the Gillard Government believes mental health reform should be a priority. That belief is reflected in the funding that has been provided in what is a very responsible Budget.

Through the Government’s broader workforce participation reforms, we will also focus on strengthening social and economic participation opportunities for people with mental illness.

To ensure strong focus and delivery of these reforms, the Government will introduce greater transparency and accountability for mental health services, through the establishment of a Mental Health Commission which will report to the Prime Minister and produce an annual Mental Health Report Card.

This Budget includes $1.5 billion over 5 years in initiatives including:

(1) A $571.3 million investment over 5 years in more and better coordinated services for the severely mentally ill

The Gillard Government will invest $343.8 million over 5 years in better coordination and more services for the severely mentally ill – so that 24,000 Australians trying to manage a severe and persistent mental illness will, at last, have assistance to access properly co-ordinated, more comprehensive care and support.

Patients and families of people with severe mental illness will have one point of contact for all of their care needs, meaning less frustration and anxiety for families who live in constant fear of a call from the emergency department when things go wrong, or despair when they can’t navigate the maze of government and non-government services on their own.

Medicare Locals or large Non-Government Organisations (NGOs) will be responsible for providing the care coordination in Medicare Local regions. These organisations will receive funding to provide coordination services, and flexible funding to purchase or broker additional clinical and non-clinical services for people with severe mental illness in their areas where there are service gaps and unmet need.

The Government will also provide $227.6 million over 5 years to expand successful community mental health programs: Support for Day to Day Living in the Community and the Personal Helpers and Mentors providing support for the mentally ill and mental health respite.

This expansion will assist an additional 18,000 people over five years through the Support for Day to Day Living in the Community program, and employ 425 new community mental health workers, called ‘personal helpers and mentors’, to work one-on-one with people with mental illness across Australia.

New personal helpers and mentors will assist around 3,400 people with severe mental illness reconnect to health care, the workforce and the community. Personal helpers and mentors provide practical, intensive support to help participants set and achieve personal goals, such as finding suitable housing, using public transport or improving relationships with family and friends.

As part of this expansion, $50.0 million will be allocated to provide personal helpers and mentors to specifically help people with mental illness on, or claiming, income support of the Disability Support Pension who are also working with employment services.

The new mental health respite services will help around 1,100 families and other carers across the country who need support to take a break from caring.

People with severe mental illness and their families have been crying out for better coordination and integration, and more comprehensive services – so that they can properly manage their health, participate in the community and stay out of hospital. These investments will help to deliver this.

(2) $220.3 million over 5 years to strengthening primary care and better targeting services through to those most in need

To better ensure mental health services are targeted to those who need them most, the Government will invest $205.9 million over 5 years in funding more psychological services through an expansion of the Access to Allied Psychological Services (ATAPS) program. This investment will more than double existing funding provided through this program.

This investment will be used to target hard to reach areas and groups that are currently underserviced, such as children, Indigenous communities and socioeconomically disadvantaged communities – providing treatment for an additional approximately 185,000 people over five years.

The Government will also invest a further $14.4 million over 5 years in e-mental health, to establish a single mental health online portal. This will provide easy, ‘one stop’ access to evidence-based online psychological therapy to approximately 45,000 people over five years. Online mental health therapy provides an alternative means of accessing services for people who can’t, or don’t want to, access a service provider face-to-face.

(3) A $491.7 million over 5 years boost to services for children and young people

The Government will invest $419.7 million over 5 years to expand mental health services for teenagers and young adults through providing more funding to the successful headspace and Early Psychosis Prevention and Intervention Centres (EPPIC) programs pioneered by former Australian of the Year Professor Patrick McGorry.

Funding will be provided for an additional 30 headspace centres, bringing the total number of headspace centres around Australia to 90. The Budget will also provide additional funding for existing headspace centres – helping them to better service existing demand. At full operation, the 90 centres will have the capacity to assist approximately 72,000 young people around the country.

The Government will provide funding, and seek matching contributions from the States and Territories, to provide 12 EPPIC centres. In addition to the four additional centres committed to in the 2010 Budget, this will deliver 16 new EPPIC centres around the country.

The Government will also invest $11.0 million over 5 years in building strong and healthy kids, to help build resilience and identify emerging mental health problems early. This will include the development of a health check for children at three years old (replacing the existing four year old check) which will include markers of social and emotional development.

The number of Family Mental Health Support Services will also double from 40 to 80, with an additional investment of $61.0 million over five years. These services operate alongside family relationship services and provide a way for families to get help for their children who are showing early signs of problems, or at risk of mental illness, outside of the clinical mental health system.

These new support services will provide more than 32,000 children and young people with support such as counselling, and support in their own home to help them attend school and build better relationships with family and friends.

Strengthening social and economic participation

People with mental illness have very low workforce participation rates – 42 per cent compared to almost 83 per cent of people without disability.

The Government will improve social and economic participation for people with mental illness through providing $2.4 million over 5 years to employment services to better equip them to help people with mental illness into jobs.

The Building Australia’s Future Workforce package involves investment, including measures to support the very long-term unemployed, and disability support pensioners, many of whom have a mental illness.

As part of our broader Building Australia’s Future Workforce reforms, the Government is also expanding funding for training and flexible supports for job seekers, new and expanded wage subsidy programs for job seekers with disability, and measures to encourage Disability Support Pension (DSP) recipients, back into work, where they have some work capacity.

Working with the States and Territories

The Australian Government cannot deliver mental health reform alone.

The Gillard Government will provide an incentive for the States and Territories to increase investment in their areas of responsibility by making $201.3 million over five years available in a competitive funding pool for the states. The Government will seek co-investments from States and Territories for priority projects in these areas.

The funding will be flexible to meet particular service gaps in each state and territory, including supported accommodation and admission and discharge from hospital as priority areas for investment.

More investment in these areas can help prevent the cycle of crisis hospitalisation and homelessness that too many people with severe mental illness face.

Through our investments in the regional priority round of the Health and Hospitals Fund, the Government is also providing $78.5 million for four mental health infrastructure projects.

The Government is already providing for about 300 sub-acute beds or bed-equivalents for mental health patients around the country through existing COAG investments.

Through the upcoming COAG meeting, the Government will continue to work with the States and Territories to strengthen services in these important areas.

Strengthening transparency and accountability – now and for the long-term

The Gillard Government is strongly committed to planning more effectively for the future mental health needs of the community, creating greater accountability and transparency in the mental health system and giving mental health prominence at a national level – with the establishment of Australia’s first National Mental Health Commission.

The National Mental Health Commission will be established within the Prime Minister’s portfolio, and through her will report back to the Parliament – bringing a truly whole-of-government focus to the task of mental health reform.

Mental health reform will not be achieved overnight. Accordingly, the Government is also developing a ten year Roadmap for Reform of Mental Health. The Roadmap, to be further developed in consultation with stakeholders and the States and Territories, will create a vision for long-term reform of the mental health system.

A fiscally responsible approach

The Government is providing $1.5 billion over five years in initiatives through this package. When combined with our 2010 Budget and election commitments, which deliver $624.0 million in funding for services over the same five year period, this represents a total commitment of $2.2 billion over five years for mental health services.

In line with the Government’s fiscal rules and strategy, all of these new investments are offset by genuine savings.

These include a redirection of $580.5 million from the Better Access program to the measures outlined above, achieved through:

• Reducing the Medicare rebate for GP mental health care plans, to better match the time usually taken for the completion of a plan, while maintaining an incentive for GPs to complete Mental Health Skills Training; and
• Capping the total number of allied psychological consultations available each year under the program at 10 rather than 12, reflecting the fact that the vast majority of patients receiving allied health treatment through the Better Access program receive between one and ten allied health services each year.

A recent evaluation of this program showed that while the Better Access program has improved treatment rates for people with mental health disorders such as anxiety and depression, many of the most disadvantaged Australians are still not accessing the services they need. In the current fiscal environment, it is appropriate to redirect a proportion of the more than $4 billion which is otherwise projected to be spent on this program over the next five years, to services which are targeted to those people most in need.

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These investments and program reforms will give Australians who suffer from poor mental health quick access to appropriate support and the best chance to recover, stabilise and stay well in the community.

The Government’s comprehensive strategy is founded on the evidence of what works, and follows extensive consultations with the mental health sector and the community.

These investments in more services, better targeted services, and better coordinated services, will make a real, practical difference to the lives of Australians with mental illness.