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and by the reluctance of some particular population groups to access mainstream services. However, it also reflects the need for inter-sectoral links to be improved and networks to be developed. This is necessary as community health services will, in certain cases, need to refer clients to specialist mental health services. In addition, as referral is a two-way path, linkages are essential to ensure that clients who do access mainstream services but who could benefit from non-mainstream services (for example, youth or Indigenous) are connected with those services. Finally, the benefits of linkages between organisations extend beyond referral pathways, opening opportunities for information exchange and collaboration. There have been a number of recent initiatives through which primary health care providers have sought to establish and improve linkages with community services. These have predominantly involved general practitioners (GPs) and include the ACT Division of General Practice’s Mental Health Team; Hospital GP liaison officers; the Can-Do Dual Diagnosis Partnership and the TOP Team, opiate co-morbidity program. The first of these, the Mental Health Team, within the ACT Division of General Practice, provides education and training to GP’s and practice nurses, implements relevant programs in response to new government policy and supports GP’s in inquiries about mental health. Secondly, GP liaison officers have been located at hospitals in the ACT to play a role in patient dischargeplanning. Thirdly, the ‘Can Do’ program is a dualdiagnosis partnership project between GP’s and community sector organisations. Its objective is to develop deeper links between community sector organisations and particular medical practices. It builds on, develops and extends some already established links to improve service coordination for dual-diagnosis clients. Finally, the TOP Team, within the Division of GP’s, runs an opiate co-morbidity program, including an Indigenous stream. The program coordinates primary health care with alcohol and drug services, networking with relevant services. Significantly, this includes a number of relevant community services, for example, carers groups and the Belconnen community program. Part of the role of the TOP team is to promote relevant community sector services to GP’s, in recognition that lack of awareness is a significant obstacle to GP’s referring clients to relevant services. Although a constructive and significant initiative, consultation feedback suggested that much work is still to be done to raise awareness about community services, and develop closer referral links with GP’s. Consultation participants expressed the view that GP’s’ level of knowledge of community services varied significantly, that there was confusion arising around which services were most relevant and appropriate for particular client groups and locations. The value of personal relationships and contacts between GP’s and services was emphasised, so that GP’s are able to link clients with services rather than merely providing information and contact numbers. From the perspective of GP’s, community services seem fractured and the system very confusing. The Division offers potential to be a vehicle for information exchange between primary health care and community services. It is able to distribute information to community sector organisations in newsletters, mail-outs, education forums and seminars. This is a cross-sectoral initiative with great potential for further development. YOUTH SERVICES A youth health service consulted estimated that more than half of its service-users seek advice and support for emotional and mental health related issues. Indeed, the youth sector generally identified mental health as one of its current strategic priorities. 87 Youth services are often left to support those youth clients with serious mental health problems who pose great challenges to services, but are ineligible for acute care. Being inadequately trained and equipped to provide such support, this takes its toll on staff and organisational resources. Youth service advocates expressed frustration at generally being overlooked ___________________________________________________________________________________________________________________________ 87 This is reflected in the current strategic plans of various youth organisations. 31 Towards an integrated mental health service system in the ACT•June 2007 NO WRONG DOORS
y the mental health sector, despite providing essential support services. The role that youth services play in promotion, prevention and early intervention at a critical time in an individual’s development was perceived to go largely unrecognised by other parts of the sector. This results in youth services feeling excluded from consultations on mental health issues and not being adequately integrated with the rest of the service system. In addition, youth services and advocates expressed concern about the service gap for those between 18 and 25 years of age. While the youth sector provides services to individuals up to 25 years of age, mental health sector services generally draw the line between childhood and adulthood at 18 years. This means that young adults can be inappropriately placed in facilities with much older adults. Youth services, community mental health services and government services should examine issues facing this age group in the mental health system with a view to developing some initiatives which ensure that individuals receive support, care and treatment in an age appropriate setting. INDIGENOUS SOCIAL SERVICES Consultation participants consistently expressed the view that Indigenous people are under-represented in mainstream service client groups, with many exclusively accessing Indigenous services, like the Winnunga Nimmityjah Aboriginal Health Service. This was explained in terms of cultural difference, the fear of judgment and social alienation. One consultation participant suggested that without workers from an Indigenous service undertaking to continue involvement and oversight, clients would not agree to access government services, like Child and Adolescent Mental Health Services (CAMHS). The ACT Mental Health Strategy and Action Plan 2003-2008 committed the ACT Government to supporting the development of links with Indigenous communities, to improve the cultural appropriateness of mainstream services and support the development of an Indigenous mental health workforce. 88 Consultation feedback suggests that this process needs to be advanced as a priority, with some clear and effective strategies to make mainstream services more accessible to Indigenous communities and to improve links between Indigenous services and mainstream community mental health services. COMMUNITY LEGAL CENTRES AND LEGAL AID A significant number of those who access community legal centres (CLCs) have a mental health condition. This is consistent with what we know of the complex causal links between mental illness, poverty, homelessness and crime. There is currently no mental health specific community legal advice service in the ACT. 89 The Welfare Rights and Legal Centre reported that mental health consumers most commonly seek their advice on a range of welfare related legal matters, particularly housing and Centrelink entitlements. They also access disability discrimination legal advice. Legal Aid represents clients involved in Mental Health Tribunal matters in addition to individuals with a mental health condition involved in criminal matters. Mental health consumers indicated that CLCs, like the Welfare Rights and Legal Centre, also functioned as critical aids in navigating the welfare system and advising on entitlements. The CLCs in the ACT have referral links to each other and to Legal Aid. They provide information to clients about an array of other community services, but generally have greater contact with particular non-legal services with which there is an established relationship. Links between community legal services and the broader social service system are mostly ad hoc rather than systemic. In its submission to the Senate Select Committee on Mental Health, the Public Interest Advocacy Centre (PIAC) commented on the interface between CLCs, mental health services and other services, stating: People with a mental illness receive services from a range of entities. They may receive pension ___________________________________________________________________________________________________________________________ 88 See, for example, Action 18. 89 This is unlike Victoria, which has a community mental health legal centre. Such a model was considered positively by those consulted, and a need for such a service is suggested by consumer feedback that mental health advocacy services in the ACT are inadequate. NO WRONG DOORS Towards an integrated mental health service system in the ACT•June 2007 32
Page 2 and 3: no wrong doors Towards an integrate
Page 4 and 5: Table of contents ABOUT ACTCOSS....
Page 6 and 7: executive summary The purpose of th
Page 8 and 9: 9. Youth aged between 18 and 25 yea
Page 10 and 11: part 1: introduction BACKGROUND AND
Page 12 and 13: care’ initiatives as a key fundin
Page 14 and 15: A belief in the value of coordinati
Page 16 and 17: to effective collaboration include:
Page 18 and 19: THE ACT SOCIAL COMPACT Relations Go
Page 20 and 21: health sector has long been ‘unde
Page 22 and 23: Consultations conducted in the deve
Page 24 and 25: 5. Commit to the development, with
Page 26 and 27: Failures of service coordination an
Page 28 and 29: esults for the individual concerned
Page 30 and 31: development of clear guidelines of
Page 34 and 35: payments, they may live in public h
Page 36 and 37: work most effectively when working
Page 38 and 39: seeking help with other services. U
Page 40 and 41: health and social and emotional wel
Page 42 and 43: eferences Government policy documen
Page 44 and 45: appendix B CONSULTATION QUESTIONS T

actcoss text final.indd - ACT Council of Social Service

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