Mental health reform 2016
This page provides AASW members with latest social work-related developments of the Australian Government's current mental health reforms.
April 2016: Mental health reform influences
There are three major influences in the current reform of the mental health sector.
- The introduction of Primary Health Networks (PHNs), reflecting the government’s decision to channel funding for mental health services via local regional processes.
- The Fifth Mental Health Plan currently in development, which will lay out the directions for coming years. The Fifth Plan is being developed by the Commonwealth Government with all the States and Territories and will go out for stakeholder consultation in coming weeks.
- The roll out of the National Disability Insurance Scheme (NDIS) which changes the way in which services are provided to those eligible (approximately 65,000) for psychosocial disability support using an insurance model.
Other key government initiatives which will influence the Mental Health Sector and the treatment and recovery of people with mental illness include, but are not limited to:
- The development of a digital gateway for people with low intensity illness
- The review of the Primary Health Care system being undertaken by the Commonwealth Government; an initial initiative is the trial of the Medical Home model in some Networks.
- The current review of the Medical Benefits Scheme
- The review of the Social Welfare System. Contributions to this review include both the McClure and Forrest report.
- The ‘Federation Review’
- The implementation of changes in the delivery of Aged Care services via ‘My Aged Care’.
1. Primary Health Networks
Primary Health Networks (PHNs; there are 31 nationwide) are currently preparing for the first full year of operation in 2016-17. Key mental health programs to come under PHN management include:
- Access to Allied Professionals Scheme (ATAPS).
- Mental Health in Rural and Remote Areas
- Suicide Prevention
- Early Psychosis
- Mental Health Nurse Incentive Scheme (MHNIP)
PHNs are called on to develop:
- a regional approach to suicide prevention
- services for people with a severe mental illness and
- to target services to people at risk of mild mental illnesses also known as low intensity services.
PHNs have undertaken a needs assessment of their populations. It is expected that all programs will be influenced by this assessment.
PHNs are expected to supplement the role of the digital gateway in providing initial service to people experiencing symptoms of mental illness.
The key model of service development is ‘Stepped Care’ which the government sees as central to the reform of mental health services. The goal of this model is to ensure a range of service types, making the best use of available workforce and technology, available within local regions to better match with individual and population need.
Members can keep informed about government implementation in the PHN space by visiting the Department of Health's PHN page and by the PHN web pages relevant to your area.
2. Fifth National Mental Health Plan
The six main areas to be addressed in the plan are:
- Regional integration
- Suicide Prevention (with one emphasis being post discharge)
- Physical health of people suffering mental illness
- The mental health of Aboriginal & Torres Strait Islander peoples
- Stigma reduction
- Interface with the NDIS
At the Mental Health Reform Stakeholder Consultation group where the AASW has a representative, many other important areas were identified to be included in the new plan.
The first draft of this plan will be released within the next 6 weeks and be open for consultation; the timelines for responses are likely to be very tight. We will lodge a response to the first draft and are calling on members who are knowledgeable and experienced in this field to contact the AASW via email. Your help will help us make us ready to coordinate a response to the draft.
3. National Disability Insurance Scheme (NDIS)
The National Disability Insurance Agency (NDIA) has established a Mental Health Sector Reference Group with broad and experienced representation, including experienced consumer and carer representatives. The reference group issues an informative quarterly communiqué on their website.
In addition, the NDIA has developed a Coordination of Supports document about pricing and services definition around three levels of support coordination which applies to the mental health sector where psychosocial disability can be variable and episodic. The document may also be applicable to other sectors. The high level support coordination is strongly congruent to the AASW Scope of Practice for social workers in Disability.
February 2016: Department of Health about Mental Health Reform and PHNs communiqué
Since the Government’s Response to the Review of Mental Health Programmes and Services was announced on 26 November 2015, implementation arrangements have progressed across key elements of the reform package.
- Funded organisations were provided with advice in December 2015 about funding arrangements to apply to their projects from 1 July 2016. This includes Mental Health Nurse Incentive Programme, Partners in Recovery (refer below), Day to Day Living, Mental Health in Rural and Remote Areas, Access to Allied Psychological Services (ATAPS), Suicide Prevention, headspace and the Early Psychosis Programme.
- There will be a period of transition as existing funding arrangements between the Department and organisations are replaced by commissioning arrangements through Primary Health Networks (PHNs). The Department is talking directly with affected organisations and PHNs to support effective transition arrangements.
- Effort is focusing on the priorities for 2016-17 implementations, including the expanded role for PHNs, programme transition arrangements, development of new suicide prevention arrangements and child and youth arrangements.
- The level of funding flexibility from 1 July 2016 will vary across programme areas and in general this move will occur gradually, with many arrangements for delivery of services remaining effectively unchanged in 2016-17. A phased implementation approach over the next three years is being used to implement the more complex aspects of the reform package, including clinical care coordination packages for severe and complex mental illness.
- A package of detailed guidance material is being developed to assist PHNs in the successful delivery of system change reforms. The guidance material is intended to support the delivery of key mental health objectives while allowing for flexibility and innovation. It is anticipated the detailed guidance package will be provided to PHNs in late March 2016.
To further support implementation of the reform package, a Mental Health Reform Stakeholder Group has been established to support sector engagement, inform implementation issues and enable feedback to the Department and PHNs. The Group has discussed the importance not only of providing detailed guidance to PHNs, but also of ensuring information flows over time to the broader non government sector about reforms, and to support mental health professionals as partners in implementation of the reform process.
PHN lead sites are also being established to trial more complex aspects of the stepped care approach and to inform broader roll out in later years. An Expression of Interest process has been undertaken to select the lead sites and applications are currently being assessed. Selection of sites will aim to provide coverage across multiple jurisdictions and across metropolitan and rural areas, and enable development of: packages of care for people with serious illness (including for youth); low intensity service models; and innovative models of stepped care.
Extension of the Partners in Recovery (PIR) programme
The PIR programme has been extended for up to three years to support the transition of programme funding to the National Disability Insurance Scheme (NDIS). National rollout of the NDIS commences from 1 July 2016, with full rollout to be achieved by 2019-20.
The extension will ensure service continuity for programme clients until NDIS rollout is completed in each jurisdiction. Funding arrangements will take into account the timeframes for transition of eligible clients to the NDIS and implementation of continuity of support arrangements for clients found not eligible for the NDIS.
The Department will work closely with organisations to support ongoing service delivery and the transition of programme clients to the new arrangements.
- PIR funded organisations will continue to be block funded by the department through the transition. Programme contributions to the NDIS will be ‘in-kind’ during this time.
- Each PIR funded organisation will support the transition of eligible programme clients to the NDIS in line with the transition schedule for their jurisdiction.
- PIR Organisations will continue cross-sector collaboration to improve the service system for people with severe and persistent mental illness with complex, multi-agency needs.
- System reform and capacity building activities will take into account the Australian Government response to the national review of mental health programmes and services and NDIS rollout.
- Existing PIR boundaries will be maintained during NDIS transition.
Further information on the funding extension process will be provided to PIR Organisations, together with programme guidelines for the transition period, in March 2016.