Critically Evaluating The Fifth National Mental Health Plan In Australia

Overview of Issue

Health system of Australia is the combination of funding giving by Federal and State government, and it is also the responsibility of both the governments. This combination creates difficulties for the patients to navigate. Instead of its complexity, universal health system of Australia achieves good outcomes in effective manner. It must be noted that, expenditures related to the health in Australia is almost same as the OECD average, at 8.8% of GDP. In Australia, life expectancy at birth is the 6^th highest in the OECD, at 82.2 years. In context of meeting the challenge of rising mental diseases, Australia needs to reduce their health system fragmentation in terms of improving the co-ordination while taking care of the patients (OECD, 2015).

The Fifth National Mental Health Plan (Fifth Plan) is developed by the Australian Health Ministers’ Advisory Council (AHMAC) Mental Health Drug and Alcohol Principal Committee (MHDAPC). The policy of the health department reflects the nationality agreed priority areas and actions for the next five years in terms of achieving the integrated system of mental health. This policy mainly builds on the foundation which is set by almost four previous National Mental Health Plans, and also by previous state and territory mental health and suicide prevention plans, and national health and mental health reform efforts. A national consultation process in terms of developing the Fifth Plan will initiate in November 2016 (Department of Health, 2012a).

The main aim of this assignment is to critically evaluate the Fifth National Mental Health Plan of the Australia government. Structure of this assignment includes the comprehensive overview of issues, policy formulation process, evaluation of implementation planning process, impact line of the policy in context of any other similar policy, and strengths and weakness of the policy. At the end, brief conclusion is stated to conclude the paper.

The actual issue in context of this policy is the preferment of the mental health and well-being of the community of Australia, and provide these health services to all the community members in equitable manner in context of preventing the development of the issues related to health and mental illness. This policy mainly aims to decrease the effect of mental health issue and mental illness, which further includes the stigma effect on the individuals, families, and whole community. This policy also focuses on the promotion of the recovery from mental health issues and mental illness. It also deal with one more issue that is assurance of the rights of people related to the mental health problems, and also enable them in participating in the society in meaningful manner (Department of Health, 2015).

Various stakeholders are there which relate to this process that are patients, government organizations, non-government organizations, community groups, etc (WHO, no date). Generally, these stakeholders are categorized into four groups and the interest and influence of these groups are stated below-

• First and most important group is the group of patients and community member, because these are the one who get directly affected by the policy framed by the health ministry. Influence of this group and related interest of this group related to the policy is high. As policy makers hold the fiduciary duty towards this group to ensure their advantages from the policy, because they are the one for whom policy is framed.
• Providers are another group of stakeholders who also directly affects the policy, because they are the one who are responsible to give the services to the patients and other members of community. In other words, they are responsible to give health care services in terms of patients and preserve the information related to them.
• Third group of stakeholders operationalize the financial elements of the framework related to the policy and this group known as the payors. In this policy they are responsible to enrol the patients as the beneficiaries. They do not have that much influence on the policy framed by the policymakers.
• Policy makers are another group which is responsible to establish the framework through which health care is given to the citizens of the country. This is the jurisdictional entity, as in this policy it is the ministry of health (pressbooks, no date).

It must be noted that, the actual purpose of this policy developed at both national and state level. While formulating this policy, makers recognize the range between the mental health, issues related to mental health, and mental illness. There are number of people which experience the matters related to the mental illness that mainly require the treatment related to clinical and also the services given to the community. There are number of other people which mainly face the emotional and mental health issues which directly affect their ability in fulfilling their social obligations and also require particular services to helping them in overcoming with this issue. Those people who are at risk because of the developing mental health issue and mental illness can get the advantage of prevention and early intervention activities. On the other hand, community awareness in context of the efforts related to mental health promotion mainly reduces the stigma and discrimination (Department of Health, 2012b).

Evaluation of Formulation process and resultant policy

The commission mainly focus on giving the robust reason to reshape, readdress, rebalance, and repackage the method related to mental health, and further reflect the risk related to the status quo. Formulation process of this strategy mainly addresses the fundamental change in the manner in which all these mental health programs and services are distributed. This shift mainly involves following aspects-

• Shifting from program and services are prevented by the program limits and also ancient representations related to the supple and joined-up systems which mainly focus on the requirements and opinions of the customers and also maximize their potential.
• Shifting related to disintegration, repetition, and provision gaps on the ground which is related to the current national and state level programs distribution of this at that system which is already deliberate and synchronized at the regional level.
• It mainly focuses on the early prevention, which means, instead of waiting for the illness to develop or symptoms to elevate before giving the services. In other words, there is shift towards the effective early intervention in the manner in which services and programs formulated by ministry are delivered.
• It further shifts from the one size fits all approach, which means, all the programs mainly focus on giving the mental health care service under the new care management program that will targeted those services which match the needs of consumer and also make the effective use of the staff and know-how.
• Shift from the dependence on ancient replicas of face to face service delivery in context of use of the technology in innovate way and also the new digital ways to take care of patients (Department of Health, 2015).

Locally planned and coordinated services related to mental health with the help of main health networks and also the founding of the supple main health care backing pool. This appraisal mainly recognized the disparity occurred between the national program objects, and the main issue in the implementation is the services delivered on the ground. The review in this context linked with the issue related to the badly intentional and integrated programs which were mainly descended in from various works to the absence of local leadership and unbending funding. This evaluation further concludes that, ministry hold an opportunity to create the PHN infrastructure for getting the better targets and mental health efforts in terms of meeting the local needs. In other words, there is no effective planning in context of this policy and this ineffectiveness in planning further creates hurdle in the implementation of the policy.

Formulation of this policy also considers the easy way to access digital mental health gateway. In this context, ministry believes that mental health is clinically operative in nature and offers number of new and reliable opportunities for both government and community. It highlights the robust proof in terms of self-guided and clinical moderated digital mental health interventions. This is especially happens in case of depression and anxiety which is accompanied with the digital mental health options shows similar clinical results in lieu of those face to face therapies which are more conventional in nature.

It refocuses on the primary health care programmes and services in context of supporting the stepped care model. Additionally, opting the stepped care approach in the system of mental health develop opportunities for improving the primary mental health of the patient, and it also gives support to the health professionals in terms of working with the stepped and integrated approach. It further highlights the need to support the role of GPs in better way with the help of guidelines which mainly supports the stepped care approach. This command further suggests that the individuals with the lower level needs, get direct access to the face-to-face psychological services as this must be limited for those who fails to respond to the first line response such as the digital mental health services (Department of Health, 2016).

Change is the most important approach of the Australian government, which means, real and meaningful change in the delivery of the mental health services play important role. It also promotes the early prevention and improvement of the system for the benefits of all the Australians. Government is pleased in informing this reform policy, but also realise that the changes in this policy are required and need to be implemented in such way as it avoids the disruption to service continuity for consumers and providers alike. At the end all the departments worked with the stakeholders for ensuring the successful implementation of this policy.

Impact Line of the Policy

Ministry further established the mental health expert reference group to give advice on the substantial system issues which is identified by the review. It further targeted the consultations groups which include the experts related to the Indigenous issues and suicide prevention, and this is accompanied with the other government agencies which mainly resolve the challenges related to the implementation and identification of the opportunities. This consultation process is central to informing this response (Department of Health, 2012a).

Those programs which are funded by the commonwealth in terms of this policy also need proper implementation of the planning process stated in terms of these programs. No real evidence in terms of the policy implementation is found which clearly states that particular services and programs were not adding the value or they should be defunded because of the lack of impact. Instead of this, it is found that effectiveness of the services and programs are negatively impacted because of the poor design of the policy planning, and ultimately this result in the poor implementation and results. It must be noted that policy design is not guided by the consistent and consolidated frameworks, and the decisions taken by the policy makers fails to support the decisions of the government. Regional integration helps in bringing together the mental health policy and services in terms of meeting the needs of the individuals at local level in effective way, and this must be done by using the resources in best manner and also in coordinated way. Those people who are suffering with the severe and complex mental health issues, new approach of the assessment will be developed and innovative models through which funding follows the needs of consumers will be implemented (Department of the Premier and Cabinet, 2015.  The new approach includes two types of elements that are ground up and top down. At the national level, federal government will seek the support from different states and terrorise in terms of implementing the arrangements with the help of regional planning and integration. For effective implementation of this policy, ministry builds the capacity of PHNs to lead these efforts in the partnerships with the Local Hospital Networks (LHNs) and other important stakeholders including non-government organisations, Aboriginal and Torres Strait Islander organisations and consumers. Following are some figures related to this policy, and all these figures clearly demonstrate the importance of effective implementation of this policy.

• Each and every year almost 16.8 % population in Australia experience the symptoms of mental illness which is sufficient to warrant the diagnosis.
• Almost 23.1% have symptoms which fall short of the formal diagnosis but they have other indicators of need for mental health assistance (Department of Health, 2015).  

This government already show their intentions that they does not give their support to the proposal of the commission to reallocate the minimum funding of $ 1 billion in the commonwealth funding to the public hospital services in the forward estimates into the services which are alternative in nature. As disclosures made by the consultation groups, no disadvantage or harm is caused to the consumers because of the absence of the simple contrast between services and reducing funding for public hospital services. There is significant proportion of the commonwealth funding to the public hospital services and also used to support the community-based clinical mental health services (Department of Health, 2012b).

Strengths and Weakness of the Policy

Above stated evaluation clearly state that this policy affects the consumers in number of ways, as response of government in this context ultimately improves the complete mental health system. It further provides the specific benefits to the consumers who bear the risk of mental illness. Some of these advantages and findings of the above evaluation are stated below-

• Across the Australia, consumers get the benefit from the local service system of this policy, as this system is designed and planned as per the needs of the consumers. This local system will directly support the communication among the providers, and also with the help of consumers ensures the best use of workforce and available resources.
• Policy focus on giving the better targeted clinical services in the primary care setting, and this will be available for matching the need of the consumers. As intense nature of the service enhance with the higher the need of the consumer.
• New digital getaways are used in terms of services for matching the needs of the individuals. In other words, those services are given to the individuals which best meet their needs and gives easy access to the information about the mental health services. Those services which are low cost or anonymous in nature will be easy to access through the phones or web based services, and this is also supported by the online system.
• Children under this policy get the advantage from gaining the resilience skills, and this further supported by the better equipment’s and informed parents, teachers, and service providers (Department of Health, 2016).
• Number of young people in Australia also gets the advantage from the services which recognize the connection between their mental health issues and also their ability to participate in the mental health issues.
• This policy also gives advantage to the aboriginal and Torres Islanders by enhancing the number of services given to them in terms of mental health (Department of Health, 2013).
• Those people who are at the risk of suicide also get support from the local communities through the new evidence which is based on the approach of suicide prevention. Those people who self-harmed themselves or attempt suicide get the critical support in form of follow up from the service providers.
• Those people who are suffered from the critical and high level mental health illness will get the advantage from new assessment process and also from the packaging of the available services. It further coordinates the health and support disability services in better manner (Department of Health, 2014).

This policy addresses the need to move towards the more agile and consumer focused approach in terms of delivering the services related to mental health. Currently, this policy structure in the health department cover almost 20 separate areas of funding the activity and all these activities developed in sedimentary layers over number of years. It must be noted that, this policy is not well sufficient in terms of joining up the approaches for improving the benefits to the consumers. These separate programs activities will be mixed up in five core programs, and following are the key areas on which this policy focus in the commonwealth health department

• National leadership;
• Promotion, prevention and early intervention;
• Primary mental health care;
• Suicide prevention; and
• Supporting the psychosocial needs of people with severe mental illness.

As all these areas ultimately enhances the strength of this policy as compared to previous policies developed by the ministry of health.

However, there is some weakness of this policy also such as effectiveness of the services and programs are negatively impacted because of the poor design of the policy planning, and ultimately this result in the poor implementation and results. Design of the policy is not guided by the consistent and consolidated frameworks, and the decisions taken by the policy makers fails to support the decisions of the government (Department of Health, 2015).

Conclusion

After considering the facts of this paper, it is clear that this policy related to mental health system is effective in nature and focus on fulfilling the basic requirements of the individuals required these services. This policy also focuses on the promotion of the recovery from mental health issues and mental illness. It also deal with one more issue that is assurance of the rights of people related to the mental health problems, and also enable them in participating in the society in meaningful manner. There are number of other people which mainly face the emotional and mental health issues which directly affect their ability in fulfilling their social obligations and also require particular services to helping them in overcoming with this issue.

Formulation process of this policy is effective in nature as number of expert groups and authorities are involved in the formulation process of this policy. Locally planned and coordinated services related to mental health with the help of primary health networks and also the establishment of the flexible primary health care funding pool. Formulation of this policy also considers the easy way to access digital mental health gateway. It refocuses on the primary health care programmes and services in context of supporting the stepped care model. Additionally, opting the stepped care approach in the system of mental health develop opportunities for improving the primary mental health of the patient.

Real and meaningful change in the delivery of the mental health services play important role in the implementation of this policy. It also promotes the early prevention and improvement of the system for the benefits of all the Australians. Ministry further established the mental health expert reference group to give advice on the substantial system issues which is identified by the review. No real evidence in terms of the policy implementation is found which clearly states that particular services and programs were not adding the value or they should be defunded because of the lack of impact. Instead of this, it is found that effectiveness of the services and programs are negatively impacted because of the poor design of the policy planning.

Therefore, it can be said that there are some loopholes in the process of implementation of this policy and it is necessary for the government to address these loopholes for effective implementation.

References

Department of Health, (2012a). E?Mental Health Strategy for Australia. Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/Content/7C7B0BFEB985D0EBCA257BF0001BB0A6/$File/emstrat.pdf.

Department of Health, (2012b). National mental health policy 2008. Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/Content/B4A903FB48158BAECA257BF0001D3AEA/$File/finpol08.pdf.

Department of Health, (2013). National Aboriginal and Torres Strait Islander suicide prevention strategy. Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/Content/mental-pub-atsi-suicide-prevention-strategy.

Department of Health, (2014). Fourth national mental health plan: an agenda for collaborative government action in mental health 2009-2014. Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/Content/mental-pubs-f-plan09.

Department of Health, (2015. Australian Government Response to Contributing Lives, Thriving Communities – Review of Mental Health Programmes and Services. Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/Content/0DBEF2D78F7CB9E7CA257F07001ACC6D/$File/response.pdf.

Department of Health, (2016). Mental health policy. Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/Content/mental-policy#aus.

Department of the Premier and Cabinet, (2015). Developing policy. Retrieved from https://www.dpc.sa.gov.au/__data/assets/pdf_file/0005/16880/Policy-Development-Guide-2.pdf.

OECD, (2015. Health policy in Australia. Retrieved from https://www.oecd.org/australia/Health-Policy-in-Australia-December-2015.pdf.

Press books. 3. Introducing the Key Stakeholders: Patients, Providers, Payors, and Policymakers (the Four P’s). Retrieved from https://jln1.pressbooks.com/chapter/3-introducing-the-key-stakeholders-patients-providers-payors-and-policymakers-the-four-ps/.

WHO. Engaging stakeholders. Retrieved from https://www.who.int/nationalpolicies/processes/stakeholders/en/.