actcoss text final.indd - ACT Council of Social Service

etween supported accommodation programs
and vocational and other rehabilitation programs
to improve access.’ 84 While this is a constructive
proposal, the need for Government support to
enhance the capacity of community organisations to
engage in collaboration and network-building must
again be emphasised. A more detailed discussion of
the kinds of support required is developed in the final
part of this paper.
EMPLOYMENT SERVICES
Recent evidence suggests that some three quarters
of those of working age with a mental illness in
Australia are not in the labour force. 85 Despite
this, there are currently only two employment and
vocational rehabilitation services in the ACT: the
Mental Illness Fellowship and Workways. Both
services were consulted during this project and
indicated that they had effective referral partnerships
with each other (related to the employment readiness
of the service user), in addition to relationships
with other community services. However, there was
a perception expressed by one organisation that
relationships between employment or vocational
rehabilitation services and the rest of the social
service system are fairly poor, with sub-sectors very
segregated. Although both organisations outlined
the key services with which they were linked,
including mental health support and rehabilitation
organisations, primary health care services, crisis
accommodation services and alcohol and drug
services, most relationships were described as ‘ad
hoc’, rather than systemic or formal. Interestingly,
systemic and working relationships were considered
quite distinctly, with relationships classified as either
formal, at management level, with no day-to-day
shared client management or informal, involving
daily contact around clients. This suggested the need
to integrate these relationship models.
Some particular employment issues were identified
around dual-diagnosis clients. Difficult issues were
identified in relation to drug and alcohol use in an
employment context and an employer’s duty of
care. This suggested the need for closer links to
be developed between mental health employment
services and AOD services, to provide the necessary
alcohol and drug support to enable dual-diagnosis
clients to maintain or resume employment. Finally,
due to the narrowing of the role and function of
Commonwealth job capacity assessors, the need
for links with other community mental health
organisations becomes all the more critical. In the
new Commonwealth policy and funding climate,
this is the only way that employment services can be
provided holistically in a context of broader support
structures.
PRIMARY HEALTH CARE
Primary health care services consulted emphasised
the significant proportion of their clients primarily
seeking mental health, emotional and social
wellbeing assistance. This is consistent with the
Productivity Commission’s recent finding that 11.4
in every 100 encounters with a general practitioner
(GP) involves mental health problems. 86 Primary
health care services consulted included some generic
health services, in addition to population specific
services, for example, youth and Indigenous health
services. What was striking about a number of
these population-specific services was their holistic
and non-bureaucratic approach to health. Several
organisations provided a vast array of services,
applying a holistic health philosophy that treated
individuals in all of their particular circumstances
rather than as belonging to one illness or disorder
category. In this respect, some organisations were
models of integrated health care.
Despite this, some of the services consulted had
fairly low levels of awareness of relevant community
mental health services. This is partly explained by the
fact that they perform an array of services and may
have less need to refer on to other organisations,
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84 Action 6.5 at 23.
85 Council of Australian Governments, National Action Plan on Mental Health 2006-2011, 2006 at 4.
86 Productivity Commission. Review of Government Service Provision, 2007 at 11.46.
NO WRONG DOORS Towards an integrated mental health service system in the ACT•June 2007
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