Background
Australia’s health system and mental health sector
Mental health policy in Australia 1992–2012
Conceptual framework
Policy levers—the “control knobs” of the health system
Lever | Definition | Example |
---|---|---|
Organisation | Macro-level changes in location, magnitude, co-ordination and diversity of human and physical capital | Establishment of local hospital networks |
Regulation | Enforced changes in behaviour | Service standards for healthcare professionals |
Community Education | Spreading of information to influence changes in behaviour | Mass media health education campaigns |
Finance | Revenue generation and allocation/distribution of funds | Subsidies for private health insurance |
Payment | System of incentives for health providers | Activity-based hospital funding |
Methods
Organisation
Regulation
Community education
Finance
Payment
Results
Organisation | Regulation | Community education | Finance | Payment | |
---|---|---|---|---|---|
First Plan (1993-98) |
SS
|
HR&CA
|
HR&CA
|
SQ&E
| |
Mainstream mental health service management | Review consumer rights and responsibilities | National Community Awareness Program | Separate budget for mental health | ||
SS
|
HR&CA
|
R&SA
| |||
Shift acute beds to general hospitals | Review mental health and anti-discrimination legislation |
Increase recurrent mental health spending
| |||
RCN
|
SS
|
R&SA
| |||
Formalise consumer/carer consultation | Remove cross-border transfer anomalies |
Increase community-based and general hospital funding
| |||
SS
|
SQ&E
|
R&SA
| |||
Case Management system | National Mental Health Information strategy and National Minimum Dataset | Review Medicare Agreements | |||
SS
|
SQ&E
| ||||
Increase ambulatory workforce
| Independent evaluation steering committee and National Mental Health Commission | ||||
SQ&E
| |||||
Annual National Mental Health Reports | |||||
SS
| |||||
Review interagency protocols to support continuity of care | |||||
Second Plan (1998-2003) |
SS
|
SQ&E
|
HR&CA
|
SS
|
SS
|
Shift acute beds to general hospitals | National Standards for Mental Health Services | Review media portrayal of mental illness | Redirect funds released from deinstitutionalisation towards community-based services | New funding models to improve referral links between primary and secondary providers | |
RCN
|
SS
|
HR&CA
|
SS
| ||
Formalise consumer/carer consultation | Review interagency protocols to support continuity of care | Mental health education in schools | Review Medicare Benefits Scheme (MBS) items and introduce new MBS items to support referral between health practitioners | ||
SS
|
SQ&E
|
HR&CA
|
R&SA
|
R&SA
| |
Grow 24-h staffed community based residential services
| New outcome measures | Mental health training for health professionals, in particular frontline workers | Review allocations under the general health budget for Federal and State/Territory Governments | Specialised funding models for rural and regional populations | |
R&SA
| |||||
Increase treatment rates for mild and moderate mental illness
| |||||
R&SA
| |||||
Improve mental health curricula for Indigenous health workforce
| |||||
R&SA
| |||||
Specialist youth early intervention centres (e.g. Headspace, Early Psychosis Prevention and Intervention Centres (EPPIC) | |||||
R&SA
| |||||
Specialised service models for special needs populations | |||||
Council of Australian Governments (COAG) Action Plan (2006) |
R&SA
|
SQ&E
| R&SA |
R&SA
| |
24-h 7 day mental health telephone service | COAG Mental Health Groups in each jurisdiction | Review mental health content in tertiary health degrees | Mental Health Nurse Incentive Program | ||
R&SA
|
SQ&E
|
HR&CA
|
R&SA
| ||
Increase web-based mental health resources
| Publish official Progress reports annually | Mental health training for health professionals, in particular frontline workers | Flexible employment schemes and funding models for rural and regional areas | ||
SS
|
SS
| ||||
Consolidate youth mentoring and early intervention programs into a single program | Review existing MBS items and introduce new MBS items to support referral between health practitioners | ||||
R&SA
| |||||
New youth early intervention projects | |||||
RCN
| |||||
Family Mental Health Support Service | |||||
RCN
| |||||
Increase mental health respite services for carers
| |||||
R&SA
| |||||
Step-up and step-down community facilities | |||||
ISS
| |||||
Community Coordinators | |||||
SS
| |||||
Increase day-to-day living support programs and Personal Support program
| |||||
RCN
| |||||
Increase Personal Helpers and Mentors service
| |||||
SS | |||||
Disability Employment Services group | |||||
R&SA
| |||||
Increase supported places in University mental health degrees, particularly to Indigenous students
| |||||
R&SA
| |||||
Increase Indigenous health workforce
| |||||
R&SA
| |||||
Additional funding to drug and alcohol service providers
| |||||
2011-12 Budget |
SS
|
SQ&E
|
R&SA
|
R&SA
| |
Care Facilitator scheme | National Mental Health Commission | National Funding Pool for States/Territories | Reduce Medicare rebate for General Practitioner mental health plans and introduce tiered rebate system | ||
RCN
|
SQ&E
|
R&SA
| |||
Additional Personal Helpers and Mentors and places in Family Mental Health Support Services
| Fund research into improving data sets and performance accountability | Reduce annual number of rebated consultations with allied psychological services | |||
R&SA
|
SQ&E
|
R&SA
| |||
E-health portal for mental health | Annual Report Card on mental health reform |
Expand Access to Allied Psychological Services scheme
| |||
R&SA
|
SQ&E
|
SS
| |||
Additional Headspace and EPPIC sites
| Australian Early Development Index tool and an expert group in child mental health | Review wage-subsidy schemes and Disability Support Pension | |||
R&SA
|
SS
| ||||
Routine Health and Wellbeing checks for 3 year olds | National Partnership Agreements and new Service Planning Framework | ||||
RCN
| |||||
National Mental Health Consumer Body |