actcoss text final.indd - ACT Council of Social Service

Consultations conducted in the development of
that Strategy expressed similar concerns about
staff turnover and awareness of MOUs as those
expressed in the current consultation process. This
suggests that further action must be taken to raise
awareness. Finally, it would be useful for an analysis
of the impact, benefits and limitations of such MOUs
to be undertaken, to inform future approaches to
government and community sector relationships and
improve the MOU process and framework.
Joint case management
Joint case management involves collaboration
between individual workers or staff teams from
different services in order to coordinate support
services for a common client. Consultation
participants indicated that some joint case
management occurs with government mental
health services, but that this is not the norm. This
is consistent with general comments that there are
insufficient case managers in MHACT. Some AOD
services indicated that they were engaged in joint
case management with MHACT, but there was
no routine case management for dual-diagnosis
service-users. Participants made general comments
about the varying quality and intensity of MHACT
case management, suggesting that although there
were some very effective case managers, others
were thought to either under-manage or overcontrol
service provision. The variable quality of
case management impacts upon relations between
community sector services and government as
it effects liaison around particular clients and
relationships of trust.
those clients deemed eligible and who have been
referred to MHACT through the triage system. A
significant amount of feedback was received about
the current operation of these community teams, the
general impression being that they were not widely
available and that case management varied in quality
and intensity. It was suggested that better protocols
should be established such that, after an acute
episode, clinical case managers transfer responsibility
for care coordination to community health care
professionals, maintaining links with MHACT, rather
than withdrawing all case management and support.
Models in service coordination
Models in coordinated mental health service
systems, involving government and community
services, exist in other states and territories. One
particularly effective model of coordination is the
Victorian ‘Primary Care Partnerships’ strategy, which
links community health, local government and
specialist providers. 63 The strategy was designed to
‘create a genuine primary care service system’. 64 It
requires that each ‘Partnership locality’ prepare a
Community Health Plan, which, among other things,
outlines service coordination and identifies service
partnerships. Partnerships involve voluntary alliances
of primary care service providers within a defined
area and aim to strengthen inter-agency coordination
around ‘needs identification, planning and service
delivery.’ 65 The Strategy adopts a social model of
health, and aims to improve promotion, prevention
and early intervention. 66 The organisations involved
in the Partnerships include a range of services from
‘community health and general practice, relevant
parts of local government, Home and Community
Care coordination
Care (HACC) and aged care services, services for
Care coordination generally involves a key health
women, indigenous and ethnic people, community
worker within one service or agency coordinating
mental health, sexual health and dental services.’ 67
primary health, mental health and other services
This model provides an excellent example of
for a particular client. MHACT has established
systemic coordination and integration and should be
community mental health teams, which include
considered in the development of a strategic response
team leaders and clinical case managers (generally
to the issues identified in this paper.
a mental health nurse). This service is available to
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63 Vicserv, The development of Psychiatric Disability Rehabilitation and Support Services in Victoria (2003), Part 9.
64 Department of Human Services (2000), Going Forward: Primary care partnerships, Department of Human Services, Melbourne at 1.
65 Dr Rae Walker, Collaboration and Alliances: A Review for Vichealth, September 2000, published by Victorian Health Promotion Foundation at 3.
66 Dr Rae Walker, Collaboration and Alliances: A Review for Vichealth, September 2000, published by Victorian Health Promotion Foundation at 4.
67 Dr Rae Walker, Collaboration and Alliances: A Review for Vichealth, September 2000, published by Victorian Health Promotion Foundation at 4.
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Towards an integrated mental health service system in the ACT•June 2007 NO WRONG DOORS