actcoss text final.indd - ACT Council of Social Service

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seeking help with other services. Ultimately, a culture should be created in which individual wellbeing is a service system responsibility, borne by each service individually and collectively. 11. Community organisations review internal structures to ensure that they are supportive of collaboration Research indicates that effective cooperation requires organisations to have compatible internal structures that are conducive to collaboration. This might be characterised by ‘effective internal communication, effective internal teamwork, understanding of and capacity to provide quality services, and an organisational culture that values learning.’ 101 We recommend that community sector services review their organisational structures by reference to these criteria as a pre-requisite to entering collaborative relationships. 12. Develop and facilitate an integrated dual diagnosis strategy All organisations consulted during this project indicated that dual diagnosis, or co-morbid clients comprised a significant area of unmet need in the existing service system. Suggested responses to this need varied, from the need for a designated dual diagnosis facility 102 , to a dual diagnosis step-up/ step-down facility accompanied by an outreach team to a systemic reform and integration of the mental health and AOD service systems. Given the significance of the dual-diagnosis client group as proportion of mental health and AOD service users, anything short of service integration seems like a bandaid solution, failing to address systemic and causal factors by maintaining service system segregation. An integrated dual-diagnosis system might be developed in a number of ways. Firstly, through the creation and improvement of referral and information-sharing protocols between the two sub-sectors. Secondly, through the crossdisciplinary training of staff in both sectors. Thirdly, detailed protocols should be developed outlining the care and treatment process for different kinds of dual-diagnosis clients to take into account the varying levels of severity of each condition. 103 There are a number of case studies from other service systems of both designated dual-diagnosis facilities and service integration which should be considered in the development of an integrated dual-diagnosis strategy. 104 Consultation participants raised concerns about the capacity of staff in non-mental health services to deal with clients experiencing mental health and dual-diagnosis issues. In response to this concern, we recommend the development of clear mental health and dualdiagnosis policies by each service provider from across the service system (for example, alcohol and drug services, accommodation services, community legal services, primary health care services, recreational facilities etc). This would better prepare staff in such services to respond appropriately to mental health consumers and dual-diagnosis clients and improve consistency in treatment and service delivery. This should also include referral guidelines and therefore contribute to the development and strengthening of community sector service networks. ___________________________________________________________________________________________________________________________ 101 Dr Rae Walker, Collaboration and Alliances: A Review for Vichealth, September 2000, published by Victorian Health Promotion Foundation at 19. 102 This view was expressed during the Mental Health Service Review, in the ACT Mental Health Plan, Draft Summary Report of working groups, 16 October, 2006, but was also suggested in a number of ACTCOSS consultations with community sector organisations. 103 This might adopt a four quadrant model for categorising co-occurring disorders, such as that developed by the U.S. National Association of State Alcohol and Drug Abuse Directors (NASMHPD) and the National Association of State Alcohol and Drug Abuse Directors (NASADAD) Joint Task Force. 104 See, for example, Odyssey House Auckland – Dual Diagnosis Program and Family Program, discussed in Lynne Major-Blatch & Kim Fleming, Alcohol and Drug Foundation ACT, Report to Alcohol Education & Rehabilitation Foundation: Attendance and presentation of papers at: World Federation of Therapeutic Communities Conference, New York, USA; Australian Psychological Society Conference, Auckland, New Zealand and Professional training and development: United Kingdom, United States and New Zealand August-September 2006 at 38. For more information, see the Odyssey House website, at http://www.odyssey.org.nz/. 37 Towards an integrated mental health service system in the ACT•June 2007 NO WRONG DOORS
13. Support the community mental health sector to adequately train workers, including cross-sectoral training and staff exchanges Many consultation participants expressed the need for increased training for community mental health and AOD workers. We recommend the development of minimum training standards for community mental health workers complemented by adequate financial and logistical support for organisations to meet these standards. In addition, we recommend the development of a program of cross-sectoral training, particularly for mental health and AOD workers around dual-diagnosis clients. Other priorities include training for consumers (where involved in advocacy, peer support and selfhelp work), Indigenous workers and Culturally and Linguistically Diverse (CALD) workers. Staff placements and exchanges should comprise part of any training program, with a focus on exchanges between mental health and drug and alcohol services as between clinical and non-clinical services. 14. Investigate options to improve consumer information services, for example, by establishing a central information and referral shopfront and/or a central telephone information line able to provide information about government and community mental health services. Consumers consulted during the project highlighted the lack of awareness about services as a key impediment to effective system-wide service delivery. They called for a central information service which could assist clients to navigate the service system, with up-to-date information on eligibility criteria, waiting lists, current services and contact details. The idea of a ‘shopfront’, operated by the community sector and partly staffed by consumers was widely supported among the consumer group, who highlighted the problems of access to information and service indexes quickly becoming out-of-date. This could be complemented by an information telephone line, to improve client access to information and comprise a key part of the ‘no wrong door’ approach. 105 These various options should be investigated and explored by government. 15. Develop specific mental health policies targeting vulnerable population groups, including youth aged 18-25 years and members of Indigenous and CALD communities. Some of the problems faced by 18-25 year olds, Indigenous and CALD persons in the mental health system have been identified in the above discussion. In responding to these issues, some specific mental health policies should be developed in relation to these population groups. Firstly, effective and age appropriate services need to be developed for 18-25 year olds. Secondly, the need to improve services to the Indigenous population was recognised in The ACT Mental Health Strategy and Action Plan 2003-2008. A number of strategies were also specified in relation to the Indigenous community, with commitments to establish an Aboriginal and Torres Strait Islander Mental Health Reference Group, place specialist mental health staff within Indigenous organisations and provide culturally focussed training to specialist mental health staff. In addition, the ACT Action Plan for Mental Health Promotion, Prevention and Early Intervention 2006-2008 identified Aboriginal and Torres Strait Islander people as a priority population group. The strategy outlined a number of actions to be undertaken by government and community groups to support PPEI for Indigenous peoples. This included exploring ‘opportunities to improve the collaborative working arrangements between Aboriginal specific and mainstream mental ___________________________________________________________________________________________________________________________ 105 This reflects a recommendation arising from the ACT Mental Health Plan, Draft Summary Report of working groups, 16 October, 2006 at 2. NO WRONG DOORS Towards an integrated mental health service system in the ACT•June 2007 38
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 32 and 33: and by the reluctance of some parti
Page 34 and 35: payments, they may live in public h
Page 36 and 37: work most effectively when working
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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