Mental Health Reforms In Australia: Strategies And Challenges

Strategies for Mental Health Reforms in Australia

Question:

Discuss about the Complex Adaptive Systems Perspective.

The report analyses the various aspects of mental health reforms in Australia. The last five years has witnessed a lot of changes and reforms in Australia’s mental health sector in order to improve the services and performance of the existing health system of Australia. The reforms include Federal Government’s health reforms of 2010 and 2012, introduction of National Partnership Agreements and activity based financing. The national health and hospitals reform commission of the country supported all these. It has issued various packages to reform care for the mentally disordered patients, the increased mental diseases of ageing population and curtail health cost (Coleman, 2014). In order to cope up with the consumer demand, Australian government has utilized the benefits of technology and introduced a number of digitized health agencies.

The report discusses the reforms in the mental health sector in Australia. The Australian government has announced much expected response to the review of national mental health commission on mental health services and programs. Following the advocacy activities and policies of Mental Health Australia over more than three years, its members, consumers and career have welcomed this change. To them, it is the initialization of needed systematic change in sector of mental health in the country.

The report discusses the strategies of mental health reforms, its plans, policies and rights of the patients, scopes for improvement and the major challenges and issues that an executive faces at the time of implementation.

The national mental health strategy of Australia aims to assist the mental health of the communities of Australia, prevention of mental disorder development, reduction of effect of mental disorders on family, community and individuals and finally assuring the rights of the mentally ill people. These strategies include various plans, policies and statement of responsibilities. These strategies outline the directions that the government followed in health reforms over the decade between 2010 and 2022.

The Advisory Council of Australian Health Ministers (AHMAC) and Mental Health Drug and Alcohol Principal Committee (MHDAPC) have developed the Fifth National Mental Health Plan. To work together for improving the lives of the individuals suffering from mental illness and its effect on their families and communities, the Australian government has formed a working group with government of every states and territories. This working group is responsible for improving access to data of mental health and tracking the progress of the reform (www.health.gov.au, 2017).

National Mental Health Strategy of Australia

Australian government has announced the package of $194.5 million package to support and assistance to the individuals and families suffering from mental health issues. This will provide a great support to prevent the increasing threat of suicide attempt among the youth and enhance investment in using technologies in mental health centers. According to the reports of ABS (Australian Bureau of Statistics), which is nearly 80 per cent of suicide cases in Australia? The data collected from the employee assistance programs shows that 33 per cent of suicide resulted from anxiety followed by 23 per cent for depression. The government has established trial sites for preventing suicides across the country. The targets are the high-risk groups of aged people, youth, veterans, people under economic pressure and those who have already attempted suicide previously (McGorry, Bates & Birchwood, 2013). The government has identified the priority areas and allocated fund of $34 million accordingly. To prevent the tendency of suicide, new technologies have been introduced in the areas of research and treatment.

The government has found many headspace services for the people living in remote areas cannot access the mental health services, may be benefitted with this service. For implementation, the government has restored the fund to Early Psychosis Youth Services of $115.6 million. Project Synergy has been engaged as online solution for care and funded with $ 32.4 million. This project provides IT-based solutions and develops mental health services and apps for young people. Lifeline Australia provides text service for supporting in crisis and prevention of suicide.

The government has also funded the nurses’ college of mental health to provide direct benefit to the patients suffering from mental health. These nurses are appropriately trained to take primary and acute care (Kelaher et al., 2014). The reform has strengthened the role of National Mental Health Commission, which enables them to work independently which is to monitor proper implementation of the reforms and advise the government.

The government has formed the digital gateway to maximize the utilization of digital technologies in curing mental health. It aims to provide service through multi-channel platforms like social media, telephone and web, so that the people can access the information regarding the disease, get proper advice and quality services (Nicholson, Marley & Wells, 2012). This digital gateway has been an important approach by government for providing care for mental health. The consumers can be benefitted from the newly introduced digitalized payment system. This system aims to assist the government to deliver schemes like pharmaceutical benefit and Medicare in future.

Fifth National Mental Health Plan

The government has formed an expert reference group for mental health services to advice and response to the reviews of mental health services and programs. The government has brought changes in private health insurances. The government has renovated the Prostheses Benefit List so that the benefits must be worthy of expenses and the savings are transferred to the consumers through less increment of annual premium (Britt et al., 2013). The government assists the eligible adults suffering from mental illness with a package. This package includes the services of mental health treatment, housing support and accommodation.

The government has directed the Primary Care Networks to deliver services according to the needs of the individuals. Some challenges do not fit one-size-fits-all model therefore the care providers need to provide specific and appropriate mental health care to the local communities. In this project, the government has announced $350 million per annum. The funding is distributed through various Headspaces, Psychosis Prevention & Intervention Centres, Mental Health Services in Remote and Rural Areas and various fragmented Suicide Prevention programs.

The government has also taken initiatives to provide mental health education in schools (Paquette-Warren et al., 2014). This education aims to compile diverse existing services into a single service for the young people and children. This enables better promotion of mental health, early intervention and prevention of mental illness. The reforms also provides the staffs and the teachers needed trainings as well as resources so that they can create sympathetic and caring environment, reduce the impact of disorder before or when they emerge (Donato & Segal, 2013).

The centre and state and territory governments have launched programs to provide required opportunities to the people with mental disabilities to develop themselves and utilize their abilities in order to enjoy the full potential of social independence. This includes learning life skills development and recreation as well as holiday programs.

The concept of managing health care is seen as a useful approach to improve the effectiveness and in health care issue around the globe. In order to define managed care, it can be said that it is broadly an attempt to affect the cost, a mode of delivering care and maintain the quality of health care.

The Australian mental health lacks a clear system design. The system is also fragmented and therefore has insufficient coordination. These problems are compounded by the problems of payment system of support and social services. The working group of central and state governments, health insurers, the consumers and corporate sector are responsible for funding as well as expenditure (Collins, Rasmussen & Beutel, 2015). 90 percent of this funding system is provided by the governments and balanced by the insurers, consumers, NGOs and other payers. The funding split for drug services and health and non-health payments cannot be determined. This diverse funding system and expenditure arrangement is increased due to absence of coordination within the healthcare system. The system is totally based on goodwill and care of the care providers therefore, the reform must assure recovery of coordination, and consistency of service (Rickwood et al., 2014). This fragmentation of the service system may lead to confusion and frustration among the service users, care providers and the patients. Despite the government has been investing in betterment of the situation, too many patients with severe mental illness are not being benefitted due to the cracks of the services. In this fragmented health care system, when the new reforms are introduced, without understandable pathways, the complexity has been increased for the mentally ill people (McLachlan, 2013). The new initiatives have diverted attention from the challenge of providing health services in cost-effective way. Another issue is that without any understandable system design, it has become impossible to assess the actual amount the government has been spending to meet required services on mental health.

Mental Health Education in Schools

The private sector buys a range of health related services and goods for improvement of their workers and their families but the expenditure on mental health services except Employee Assistance Programs are not available.

The government does not bear the cost of behavioral health related accidents and emergency services. The patient has to go for treatment on his own expenditure (Sturmberg, O’halloran & Martin, 2012).

For a manger of a mental health care organization, the recent health care reform of Australia has brought about some unavoidable challenges like-

• Challenges of patient care: The biggest organizational challenge is to collaboration and working with the external resources such as patient care and billing. As the organization works under multi-faceted system, the joint action and cooperation among care providers, billing services, insurance companies and clearinghouses has become painful experiences (Best et al., 2012).
• Challenges to keep up with the regulations: One of the hardest organizational challenges is to keep up with the regulation that the reform provides announced by the government of Australia (Mason, 2013). The behavioral and mental health care sector always been under pressure. The reason behind this is that both the federal and state governments have subjected it of regular intervention. This compels the organization to change its workflow to stay acquiescent.
• Administrative tasks: the recent reforms have increased difficulties in performing the administrative tasks and decision-making procedures. The functional duties of an executive include patient registration, filing claims and documentation. The scenario has now changed where these task have been performed by the care providers.
• The reform does not take care of the cultural related challenges that the organization faces. Cultural related frustrations vary from working with difficult people present both inner and outer structure of the organization (Bateman, Henderson & Kezelman, 2013). Interpersonal conflicts creates problem in workplaces, which need to be governed.
• The government has also need to give more stress on creating awareness about the mental health, which is almost a common issue in all over the world. Public indifference in mental health care and importance of qualitative care has become challenge for a manger (Hall, 2015).

Conclusion:

Therefore, from the above discussion, it may be concluded that the Australian central government and federal or state governments have brought some changes in the existing regulations. Utmost importance is given to the digitization or services provided with the help of internet. Some opportunities are there to improve the health services. This involves improvement of the ways so that all the elements of the service system must work together and be collaborative and coordinative. The elements must interact with each other. In order to be successful, health interest teams or working groups including all the people of Australia need to take initiatives and mobilize together. Most important stakeholders are the consumers, who are the users enjoying the benefits if the system, must take responsibilities and care of themselves. The commissions set up and funded by the government must indulge in honest research and acquire feedbacks so that the opportunities or the scope for development that the recent reform has kept can be easily filled up.  The people must share responsibilities to bridge the gap between supply and demand of the health care services in future.

References:

Bateman, J., Henderson, C., & Kezelman, C. (2013). Trauma-informed care and practice: towards a cultural shift in policy reform across mental health and human services in Australia, a national strategic direction. Position paper, Mental Health Coordinating Council.

Best, A., Greenhalgh, T., Lewis, S., Saul, J. E., Carroll, S., & Bitz, J. (2012). Large?system transformation in health care: a realist review. The Milbank Quarterly, 90(3), 421-456.

Britt, H., Miller, G. C., Henderson, J., Bayram, C., Valenti, L., Harrison, C., … & O’Halloran, J. (2013). General Practice Activity in Australia 2012-13: BEACH: Bettering the Evaluation and Care of Health (No. 33). Sydney University Press.

Coleman, M. P. (2014). Cancer survival: global surveillance will stimulate health policy and improve equity. The Lancet, 383(9916), 564-573.

Collins, S. R., Rasmussen, P. W., & Beutel, S. (2015). The rise in health care coverage and affordability since health reform took effect. Commonwealth Fund: Washington, DC.

Donato, R., & Segal, L. (2013). Does Australia have the appropriate health reform agenda to close the gap in Indigenous health?. Australian Health Review, 37(2), 232-238.

Hall, J. (2015). Australian health care—The challenge of reform in a fragmented system. New England Journal of Medicine, 373(6), 493-497.

Kelaher, M., Sabanovic, H., La Brooy, C., Lock, M., Lusher, D., & Brown, L. (2014). Does more equitable governance lead to more equitable health care? A case study based on the implementation of health reform in Aboriginal health Australia. Social Science & Medicine, 123, 278-286.

Mason, J. (2013). Review of Australian government health workforce programs.

McGorry, P., Bates, T., & Birchwood, M. (2013). Designing youth mental health services for the 21st century: examples from Australia, Ireland and the UK. The British Journal of Psychiatry, 202(s54), s30-s35.

McLachlan, R. (2013). Deep and Persistent Disadvantage in Australia-Productivity Commission Staff Working Paper.

Nicholson, C., Marley, J. E., & Wells, R. (2012). The Australian experiment: how primary health care organizations supported the evolution of a primary health care system. The Journal of the American Board of Family Medicine, 25(Suppl 1), S18-S26.

Paquette-Warren, J., Roberts, S. E., Fournie, M., Tyler, M., Brown, J., & Harris, S. (2014). Improving chronic care through continuing education of inter-professional primary healthcare teams: a process evaluation. Journal of interprofessional care, 28(3), 232-238.

Rickwood, D. J., Telford, N. R., Parker, A. G., Tanti, C. J., & McGorry, P. D. (2014). headspace—Australia’s innovation in youth mental health: who are the clients and why are they presenting?. The Medical Journal of Australia, 200(2), 108-111.

Sturmberg, J. P., O’halloran, D. M., & Martin, C. M. (2012). Understanding health system reform–a complex adaptive systems perspective. Journal of Evaluation in Clinical Practice, 18(1), 202-208.

www.health.gov.au. (2017). Department of Health – 2016-2017 MYEFO Drives Health Reform. Health.gov.au. Retrieved 20 October 2017, from https://www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2016-leySL109.htm