actcoss text final.indd - ACT Council of Social Service

payments, they may live in public housing, they
may use employment agencies, and they may
access public or private medical services. They
may also have legal problems and seek legal
services. PIAC and HPLS [Homeless Persons’ Legal
Service] lawyers see many people with mental
illness seeking such services. It is our observation
that the interface between these services is often
uneven and leads to a ragged transfer of people
with mental illness from one service to the next.
As a result, continuity of care breaks down
and the individual is then reliant on their own
resources, which are usually meagre. 90
This description is consistent with the situation in
the ACT. The need for broader links between CLCs
and mental health services is evidenced by the
high proportion of mental health consumers who
access community legal services, the high number
of cases in which no legal remedy is available and
the importance of connecting often anxious and
frustrated clients with other services who may be
able to assist and address the broader social and
welfare implications of their grievance (for example,
homelessness due to eviction, poverty due to loss of
entitlements etc). Individuals with a mental illness
in such positions of stress are particularly vulnerable
to an acute mental health episode or ‘falling off
the edge’ in some other way. The Welfare Rights
and Legal Centre (WRLC) noted that most clients
with a mental health condition do not identify
as such in their contact with an advice service. In
some cases, it was observed that mental illness
impaired an individual’s capacity to approach a
legal process in a focussed and logical way, with
affected individuals likely to disengage from the
process out of frustration or lack of motivation.
CLCs can play an important linking role in the chain
of services. This potential role is complicated by
confidentiality obligations which would prevent CLCs
from contacting other services without the consent
of a client. However, in situations where a client
needs and wishes to receive assistance from another
service, CLCs are able to make contact and refer
clients on. For these reasons, energy and resources
should be directed to improving linkages between
CLCs and other community services, and to including
CLCs and Legal Aid in relevant cross-sectoral
networks.
DISABILITY SERVICES
There are two key aspects of the relationship
between mental health and disability services. One is
the conceptualising of mental health as a psychiatric
disability, and the second is coordinating dualdisability
services for clients with a physical disability
and mental illness (psychiatric disability).
The conceptual segregation of mental health
and disability is evident in the ‘siloing’ between
government disability and mental health
departments. Participants remarked on the
segregated bureaucracies and parallel policy
processes around issues like complex need. Some
highlighted the intersections between disability,
mental health and poverty which needed to be
addressed for housing, disability and Home and
Community Care (HACC) services. This ‘siloing’ is,
in many respects, mirrored in the community sector,
with both the disability and mental health sectors
regarding themselves as separate ‘sub-sectors’ and
little service coordination. However, there is some
movement to reconceptualise mental health as a
disability for the purposes of policy development,
advocacy and representation and some alliances
developing between mental health consumer
advocacy services and disability advocacy services.
The shift in thinking around mental health and
disability is best reflected in the role that ADACAS
plays in providing individual advocacy services for
people with physical and/or psychiatric disabilities
and the aged.
On the second issue, consultation participants
highlighted problems around dual-disability clients.
The Dual Disability Service, a joint initiative between
Mental Health ACT and Disability ACT, provides
information and advice to community workers
working with people with a physical disability and
mental illness. This is a valuable and welcome
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90 Public Interest Advocacy Centre, Submission to the Senate Select Committee on Mental Health, 20 May 2005 at 8.
33 Towards an integrated mental health service system in the ACT•June 2007 NO WRONG DOORS