actcoss text final.indd - ACT Council of Social Service

part 1: introduction
BACKGROUND AND METHODOLOGY
This paper was developed following discussions with
the Mental Health Community Coalition (MHCC)
on strengthening the community mental health
sector and improving outcomes for those affected
by mental illness. It was agreed that separate papers,
each with a different focus, would be the most
effective and appropriate way of exploring key
issues. As a result, the MHCC has developed a paper
with a ‘sector development’ or intra-sectoral focus,
examining organisational and sectoral challenges
and service delivery model options within the
community mental health sector. The ACT Council
of Social Service (ACTCOSS) separately embarked
on a paper with a focus on the community mental
health sector in context. This has developed into an
analysis of current relationships between different
parts of the Australian Capital Territory (ACT)
social service system, community and government,
examining referral links, coordination, cooperation
and collaboration.
This paper begins by outlining the core policy
principles which inform ACTCOSS’ analysis of
mental health service delivery systems and policies.
It explores the concept of collaboration, its various
forms, and ways in which governments can facilitate
inter-agency collaboration. The relationship between
community mental health services and government is
then considered. Funding, referral and inter-agency
relationships with government departments and
services are analysed. In Part Three, relationships
between the community mental health sector and
other parts of the community service sector (for
example, housing, alcohol and drug and Indigenous
services) are explored. In each part of the paper,
recommendations are proposed to respond to
identified challenges under each heading.
This policy paper is informed by an extensive survey
of relevant academic literature in addition to a
review of international, national, state and territory
policy documents and consideration of stakeholder
consultative input. Two consultative forums, jointly
facilitated with the MHCC, were held with mental
health community service providers, the first in
November 2006 and the second in February 2007.
ACTCOSS also facilitated a consumer forum, hosted
by the Mental Health Consumer Network (MHCN),
on 27 February, 2007. In addition, we conducted
individual consultations with some 13 community
sector organisations from across the service sector.
These organisations are all involved in providing
services to mental health consumers, though do not
all provide mental health specific services. A list of
these services is provided at Appendix A. During the
consultations, participants were asked a series of
generic questions, included in Appendix B. It should
be noted that consultations engaged with a limited
number of organisations from across the service
system. As a result, consultation feedback should not
be taken to represent uniform or agreed positions
across the sector, but rather, trends emerging from
the sample of organisations consulted. Similarly,
examples provided of partnerships and collaboration
should not be understood to exclude other examples
not highlighted during the consultation process.
THE COMMUNITY MENTAL HEALTH SECTOR
IN CONTEXT: TOWARDS AN INTEGRATED
SERVICE SYSTEM
ACTCOSS has long argued that the best outcomes
for service-users can only be secured through an
integrated service system, characterised by mutual
respect, effective referral and information pathways
and a commitment to coordination, cooperation,
and collaboration. In this paper, we have used the
expression ‘no wrong doors’ to describe an approach
to service delivery in which each organisation in the
service system is supported to assist all those who
seek help, either by providing services directly or
referring the individual on to another organisation
able to assist. This paper is premised on an awareness
of the social determinants of health and reflects an
understanding that both the causes and effects of
mental illness cross sectoral boundaries. Any reform
of mental health services in the ACT must therefore
take a systemic and cross-sectoral approach to
be most effective. The community mental health
sector must be seen as part of a broader network
of community sector services, and a necessary
9 Towards an integrated mental health service system in the ACT•June 2007 NO WRONG DOORS