actcoss text final.indd - ACT Council of Social Service

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executive summary The purpose of this paper is to explore the extent to which the community mental health system in the ACT is linked and integrated into a broader social service system. In doing so, this paper examines the relationship between community mental health services in the ACT, government agencies and the broader community social service system. The paper’s starting premise is that mental illness is a social issue that transcends sectoral boundaries. Research demonstrates that mental health consumers are more likely to be affected by a number of other issues, for example, alcohol and drug problems, homelessness, poverty and unemployment. As a result, mental health consumers commonly need to access a broad range of social services, including alcohol and drug services, crisis accommodation services, employment or vocational rehabilitation services, primary health care services and community legal services. The coordination of these services is critical to ensure that consumers receive appropriate and timely assistance, are referred on to relevant services and are not left to fall through service or sectoral ‘gaps’. Part One of this paper outlines the background and research methodology of this project. The need for an integrated service system is established and the governmental policy shift towards inter-sectoral linkage is highlighted. The core policy principles which inform the paper are then defined, concluding with a definition and discussion of ‘collaboration’, a central concept throughout the paper. In Part Two, the relationship between the ACT community sector and the ACT Government is explored. This analysis is situated within the context of the ACT Mental Health Strategy and Action Plan 2003-2008 and the ACT Social Compact. Three key aspects of the relationship are examined: the funding relationship, formal inter-agency agreements (e.g. memoranda of understanding or ‘MOUs’) and less formal service delivery practices of informationsharing, referral and client case management. A number of recommendations are proposed, designed to improve the relationship between the community sector and government around mental health service delivery. Finally, in Part Three, the relationship between the community mental health sector in the ACT and other parts of the community social service system is considered. The relationship between the community mental health sector and specific sub-sectors is considered individually. Sub-sectors discussed include: • Alcohol and drug services; • Housing providers and accommodation services; • Employment services; • Primary health care services; • Youth services; • Indigenous social services; • Community legal centres and Legal Aid; and • Disability services. A series of recommendations are proposed, designed to improve intersectoral relationships and service system integration. It is hoped that by closely analysing the state of relationships between community mental health services and other parts of the social service system (government and community) priority issues can be identified and addressed. In particular, it is hoped that the recommendations proposed in this report provide a framework for action to support community organisations to coordinate, cooperate and collaborate. SUMMARY OF KEY FINDINGS The relationship between the community sector and government 1. The ACT Government has made a policy commitment to develop further links and partnerships with the community mental health sector and to enhance coordination between inpatient and community based mental health service services. 5 Towards an integrated mental health service system in the ACT•June 2007 NO WRONG DOORS
2. A lack of awareness by government and community sector staff in relation to the existence and content of the Social Compact is impeding its effectiveness as a framework for relations of recognition and partnership. 3. Little research or evaluation of MOUs between government departments and community organisations has been conducted, such that it is difficult to gauge their effectiveness or highlight areas for improvement. The major impediment to their effectiveness identified by participants was ignorance of the existence and terms of agreements by government staff. 4. The need for improved system level integration between government departments and sub-sectors was identified, as well as the need for a clear statement on the interaction between Mental Health ACT (MHACT) and the rest of the sector. 5. Consultation participants perceived that interdepartmental ‘siloing’ was still a significant issue despite government commitments to improve inter-departmental cooperation. 6. There is a general perception that community mental health services are under-funded and overlooked in the allocation of mental health funding. 7. Accountability reporting was consistently identified as a challenge by community organisations from across the sector, particularly affecting small organisations. 8. Service delivery relationships between community organisations and Mental Health ACT were variable, with a need for improved referral relationships and joint case management, particularly for dual-diagnosis service-users. 9. Philosophical, language and diagnosis differences were said to pose challenges to cooperation between government and community services and to generate service delivery gaps. The relationship between the community mental health sector and other parts of the social service system 1. Few community mental health organisations have entered formal agreements with other community organisations or been involved in joint projects. 2. There is currently a low level of mental health community case management. 3. Many referral relationships currently depend on individual contacts rather than entrenched service relationships. Many of these relationships are perceived as ‘chaotic’ by consumers. 4. Relationships between the mental health and alcohol and drug (AOD) sectors remain variable, with dual-diagnosis service users in some cases unable to get simultaneous support for co-occurring disorders. 5. Cross-sectoral training was identified as a priority training area, particularly around dual-diagnosis. 6. Linkages between employment services and other services are mostly ad hoc rather than systemic or formal inter-agency relationships. 7. There is a need to increase awareness about community mental health services within primary health care services to improve referral relationships. 8. The need to improve linkages between youth services and mental health networks and to include youth services in mental health policy consultations was identified. NO WRONG DOORS Towards an integrated mental health service system in the ACT•June 2007 6
Page 2 and 3: no wrong doors Towards an integrate
Page 4 and 5: Table of contents ABOUT ACTCOSS....
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 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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