18 November 2022
Mind Australia is encouraged by the Queensland Government’s Better Care Together plan for mental health and alcohol and other drug (AOD) services.
As Mind delegates attend the Queensland Mental Health Commission’s Leading Reform Summit 2022 this week, it is an opportunity to reflect on the great opportunities for making positive change in Queensland’s mental health system.
As a community-managed mental health provider, we understand the need for reform of Queensland’s mental health system. We want to see Queenslanders facing fewer barriers to accessing services, especially where their needs may stretch across multiple systems.
This need for reform has been recognised by the Queensland Parliament’s Mental Health Select Committee in their Inquiry into the opportunities to improve mental health outcomes for Queenslanders, whose final report made 57 recommendations for change.
Following this, the Queensland Government released its plan for Queensland’s mental health and AOD services – Better Care Together – as part of its commitment to delivering on many of the recommendations made by the Parliamentary Inquiry.
The Inquiry Report, the Government’s response and Better Care Together recognise the strength of working in partnership, embedding lived experience, and moving towards a community-based system that includes psychosocial supports, and which addresses the social determinants of mental health such as housing.
Better Care Together acknowledges the importance of psychosocial support services in assisting individuals to meet their treatment and recovery goals. Psychosocial support services – like the kind provided by Mind – help people with mental health and wellbeing issues to manage daily activities, to rebuild and maintain connections, to engage with education and employment, and to participate fully in the community.
Despite the recognition – and evidence – of the role community-based psychosocial services can play in reducing acute admissions, and providing an alternative to the Emergency Department, the NGO sector continues to be undervalued and underutilised.
Whilst we are pleased to see the Government’s increased investment in mental health in response to the Inquiry, ahead of the Queensland Mental Health Commission’s Leading Reform Summit we want to highlight a number of areas which need to be addressed in order for reforms to be implemented effectively.
This includes an interim solution for the delivery of psychosocial supports, whilst work is underway with the Commonwealth Government on a new program of psychosocial supports under the National Mental Health and Suicide Prevention Agreement.
Sustainable investment in community mental health services and stronger partnerships
We want to see a governance and operational structure which is co-designed and which equally values the contributions of the government organisations (NGO) and the clinical health service. We also want to see a funding structure that enables equal and collaborative relationships between NGOs and health services.
There should be a shared commitment to learning and development of staff from all services, and a commitment to working towards shared goals – including collecting outcome measures for evaluation and continuous improvement. Recognition of the expertise in the NGO sector will be necessary to strengthen partnerships and build a truly community-centric system. For that to happen, we need to have a seat at the table.
We know the Queensland Government will be providing additional funding to assist enhanced provision of psychosocial supports delivered by NGOs. However, we are concerned this will be delayed due to negotiations under the National Mental Health and Suicide Prevention Agreement. In the interim, we encourage the Queensland Government to work with the NGO sector to roll out a suite of psychosocial supports that meet community need.
Investment in workforce recruitment and retention
In commissioning psychosocial supports and community-based mental health services, we also need a consistent approach to commissioning, one that recognises the cost of delivering high-quality services and recruiting and retaining staff. We want to see joint commissioning with an agreed minimum corporate cost. We need longer contracts and funding envelopes that allow for ongoing training and capacity building.
We are already experiencing staffing shortages and, without intervention, these are likely to get worse.
Investment in lived experience
We’re pleased the government’s response to the Parliamentary Inquiry committed to establishing new Mental Health Lived Experience Peak Body, and committed to expanding Queensland’s Lived Experience (Peer) Workforce. We want to see a nationally consistent approach to credentialing peer workforces, including accreditation and practice standards, and we encourage the Queensland Government to work with the Commonwealth to advance this.
Mind has significant experience providing peer-led services and supporting designated lived experience roles within our organisational structure, at all levels. Last year, we released our Lived Experience Strategy, highlighting the important role people with lived experience will play in shifting the culture in the mental health sector.
We also know the value of alternative entry points to the Emergency Department and the power of a compassionate, recovery-oriented and peer-led response to distress. In Queensland, people presenting to EDs with mental health or behavioural problems have increased from 154 per day in 2016-17 to 179 per day in 2021-21 - accounting for three per cent of all ED presentations (Source: Australasian College for Emergency Medicine).
Our Connect program in South Australia and LGBTQIA+ Aftercare in Victoria each provide clear evidence that peer workers walking alongside people in crisis is effective. These services address a gap in the mental health system by providing more suitable alternatives to the ED, by delivering holistic and tailored support in the community that addresses the life areas that intersect with mental health.
There is a significant opportunity under Better Care Together to utilise the lived experience (peer) workforce to provide services in the community that help people achieve and sustain recovery.
Investment in housing for recovery
We are supportive of the Government’s commitment to improving access to secure and affordable housing and relevant mental health psychosocial support for people at risk of, or experiencing, homelessness. This includes Better Care Together’s prioritisation of integrated health and housing responses. We know that housing is essential to recovery, and we have clear evidence from our Haven Foundation residential model that access to housing with support has positive outcomes for participants in their mental health recovery, and their capacity to live independently.
This is a great opportunity for Queensland to achieve real, meaningful mental health reform that will change lives. The pathway to achieving a better mental health system has been laid out – we just need a few more bricks in the path for it to be delivered.