MEDICUS MARCH 2016

C O V E R S T O R Y

to mental health. The review highlighted the existing complexity, inefficiency and fragmentation of the mental health system, and made 25 recommendations for improvement across nine focus areas. The Commonwealth Government’s Response to Contributing Lives, Thriving Communities – Review of Mental Health Programmes and Services (The Response) was released quietly less than a year later on 26 November 2015, heralding a significant shake-up for mental health nationally. With an emphasis on primary mental healthcare services, consumer-centred reforms and framed on the basis of making changes within existing budget resources, The Response outlined nine key areas with a focus on the following concrete actions to be addressed between 2016 and 2019: • Contestable mental health services will be commissioned, not delivered, through the recently established Primary Health Networks (PHNs); • Coordinated packages of care will be created for people with severe and complex needs and flexible support for mild and moderate needs; • A new Digital Mental Health Gateway will optimise the use of digital mental health services; The release of this national reform was conducted with little fanfare, but is timely for WA in the wake of a number of sentinel events for our mental health system and in the context of a growing feeling of disconnect in WA mental health: • Almost simultaneous to the release of The Response, the WA Mental Health Commission released its long-awaited WA Mental Health, Alcohol & Other Drug Services Plan 2015- 2025 (The Plan); an initiative based on a core recommendation from the compelling Stokes Review from 2012. The Plan emphasises a consumer-focused model of care, and proposes big changes for mental health in WA if it is successfully implemented (including an increase in hospital beds and specialist care and a shift towards the provision of more community-based • A new approach to suicide prevention, co-ordinated by PHNs.

outcomes. These initiatives have been met with a mixed response, especially in relation to state- initiated plans. WA’s mental health system has long been pilloried for its inertia in acting on the issues – both immediate and long-term – that daily affect vulnerable patients and medical practitioners at the frontline. Acute mental healthcare in the State is in crisis (read Associate Professor David Mountain’s comment on page 31 for more on this). The Mental Health Act 2014 (WA), which was proclaimed in State Parliament in November last year, has been criticised for inadequate clinician engagement, a deficient training program and the bureaucracy that weighs it down. The Western Australian Mental Health, Alcohol and Other Drug Services Plan 2015-2025 (The Plan 2015- 2025) was sold as a first of its kind for the State, setting a bold agenda to create a more connected, high quality and person-centred system focused on the provision of holistic care and support. The Plan remains funder and provider neutral and dare we say it, indeterminate on action too (In his article on page 27, WA Mental Health Commissioner Tim Marney has commented on his department’s collaboration with organisations such as WAPHA. However, unfortunately Mr Marney did not take the opportunity to provide Medicus with an update on the current status of The Plan or proposed activities to advance The Plan over the next 12 months). Nevertheless, despite the general bleakness that enshrouds the mental health sector, there is now slowly emerging a feeling of hope; the potential for positive change and improvements in mental health delivery in WA, provided that Commonwealth and State Governments collaborate to ensure the appropriate provision and coordination of services across the board. In 2014, the Commonwealth tasked the National Mental Health Commission (NMHC) with conducting a national review of mental health programs and services. The final report Contributing Lives, Thriving Communities was released on 1 December 2014 and fulfilled a Coalition election commitment

Continued on page 20

M A R C H 2 0 1 6 M E D I C U S 19