actcoss text final.indd - ACT Council of Social Service

complement to government services. Consistent with
this view, the ACT Mental Health Strategy and Action
Plan 2003-8 recognises the need for a systemic
approach, expressing a commitment to ‘refining
service delivery systems to improve outcomes’. 4
This Part analyses the extent to which a systemic
approach has been developed, highlights existing
examples of cooperation and explores possible
strategies to improve system integration.
Mental health interventions are positioned
on a continuum from ‘prevention’ through to
‘maintenance and support’. 5 Community mental
health services play an important role in early
intervention, prevention and promotion, as well as
recovery from a mental health episode. Feedback
from service provider and consumer consultations
indicated that individuals in regular contact with
community services were less likely to experience
an acute mental health episode, with warning signs
likely to be detected by community workers and
necessary support provided or acquired through
referral. 6 At the prevention end of the spectrum,
while mental health services play an important role,
broader social support structures are also critical.
These include families, schools, employment, primary
health care services, drug and alcohol services,
housing and accommodation services and other
social service providers. 7 The roles of clinical mental
health services, community mental health services
and this broader range of social services are interdependent
and complementary. The coordination
and integration of these services is critical to ensure
that service-users do not fall through structural
gaps but receive timely, appropriate and effective
treatment and support.
The importance of inter-sectoral collaboration around
mental health service delivery has been recognised
at an international, national and territory policy level.
This is consistent with a general social service policy
trend towards integrated service systems and the
trans-sectoral implications of mental health. Indeed,
the World Health Organisation (WHO) has recognised
that, ‘(t)he needs of people with mental disorders
transcend traditional sectoral boundaries’. 8 Following
this, the World Health Report recommended
inter-sectoral linkage as a way to improve health
service delivery. The WHO has also developed some
general principles for mental health inter-sectoral
collaboration.
At the national level, the Council of Australian
Governments (COAG) National Action Plan on
Mental Health 2006-11 emphasises coordination
and collaboration between government, private
and community providers. In addition, the National
Mental Health Policy and Strategy, the National
Homelessness Strategy, and the National Drug
Strategy all express a commitment to inter-sectoral
collaboration and partnership. 9 The evaluation
of the Second National Mental Health Plan found
that continuity of care remained elusive, while
inter-sectoral collaboration needed to be pursued
10
systematically, rather than in an ad hoc
fashion.
Pilot ‘linkages’ programs around Australia have
shown consistently positive results, with patient care
improving and provider collaboration continuing
post-trial. 11 In addition, community sector mental
health policy papers have stressed the importance of
such collaboration. This has been a constant theme
in a series of Mental Health Council of Australia
reports, which call for community coordination
and whole-of-government approaches. 12 The Time
for Service Report identified ‘collaborative primary
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4
At 41.
5
Australian Council of Social Service, Submission to Senate Select Committee on Mental Health, ACOSS Info 376 – July 2005, at 14.
6
This is despite the fact that ‘indicated prevention’ is often conceived as a clinical rather than community rehabilitation and support function.
7
Australian Council of Social Service, Submission to Senate Select Committee on Mental Health, ACOSS Info 376 – July 2005, at 14
8
World Health Organisation, The Mental Health Context (Mental Health Policy and Service Guidance Package), 2003 at 29.
9
For example, The National Mental Policy states that it ‘aims to encourage co-operation between mental health services and the various programs and services
needed to enable people with severe mental health problems and mental disorders to participate more fully in community life.
10 As described in the ACT Mental Health Strategy and Action Plan 2003-8 at 34.
11 Gavin Andrews, ‘The crisis in mental health: the chariot needs one horseman’, (2005) 182(8) MJA 372.
12 See, for example, The Mental Health Council of Australia, Not for Service: Experiences of injustice and despair in mental health care in Australia (2005) at vii-viii.
NO WRONG DOORS Towards an integrated mental health service system in the ACT•June 2007
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