1. Leading Mental Health Reform in the Australian Context Eddie Bartnik Commissioner for Mental Health, Western Australia International Initiative for Mental Health Leadership Auckland, New Zealand 8th March 2013

2. Outline Functions and scope of the West Australian Mental Health Commission Context for reform at national and state levels “Mental health 2020 : Making it personal and everybody’s business” Some key examples of personalisation, collaboration and co- production to strengthen a community level response Reflection on progress with key reforms Key challenges ahead

3. Functions and Scope First MHC in Australia and established in March 2010 A “Commissioning Commission” : Policy, planning and purchasing functions, leads mental health reform across government and tackles stigma and discrimination in the community Budget approx $600m for mental health and contracts with public mental health, private and non government agencies Administrative umbrella for Mental Health Review Board, Council of Official Visitors and Drug and Alcohol Authority, Ministerial Council for Suicide Prevention and Mental Health Advisory Council Approx 46,000 people receive public mental health services and 8,000 through funded NGOs Commonwealth funds primary care and a range of NGOs as well WA population 2.4m people over 2.5m km2; approx 10% of nation

4. Image sourced from: http://www.businessmigration.wa.gov.au

5. Reform Context National level National health reform (NHRA, local health networks, Medicare locals, Independent Hospitals Pricing Authority and Activity Based Funding/ Nationally Efficient Price National mental health reform (New National Mental Health Commission 2011 – National Report Card; COAG process and 10 year Roadmap for Mental Health and new Mental Health Working Group; 4 th National Mental Health Plan; national LIFE framework Federal budget initiatives $2.2bn over 5 years package in 2011/12 - primary care, youth headspaces and early intervention for psychosis centres, suicide prevention strategy, NPA with states/territories for some and direct tenders for other services National Disability Insurance Scheme

6. Reform Context State level Economic Audit report 2010 – citizen focus, collaboration, outcomes and partnership themes: Premiers Partnership Forum Delivering Community Services in Partnership Policy – components 1 and 2 sustainability funding, procurement reforms Budget corrections and efficiency dividends for government services Review of the Mental Health Act 1996 First Minister for Mental Health and Mental Health Commission Rapidly growing population and hospitals infrastructure Need for a clear and strong state mental health strategy to engage the community and drive reform

7. Get to know people Person Centred Planning e.g.“The Big Plan” Stokes Review discharge planning Drug and alcohol People with Exceptionally Complex Needs Housing Individual ised Community Living Support Personal budgets Anti Stigma Research Youth – Music Feedback Act Belong Commit Campaign Schools – Aussie Optimism Child and Parent Centres New MH Bill Improved Governance (MHAC; Consumer Peak) Planning and Infrastructure – closer to home Clinical Services Plan Sector Development Scholarships and training DCSP policy and wages Individual service design Peer workforce MCSP and One Life strategy Community action plans and agency pledges Research Edith Cowan University Court Diversion – new Childrens and Adults Police – co-response and transport Assertive Community Response - Children Self harm in schools New youth stream – Youth Axis and Early Psychosis State wide specialist Aboriginal MHS Looking Forward project

8. Reflections Synergies between the national MHC “Contributing Life” and WA “A good life in the community” frameworks that are building stronger engagement beyond the health systems Problems built up over a long period and time needed to change things Effective use of community engagement (eg MH2020 and MH Bill) and independent reviews (eg Stokes, Henderson) Many building blocks in place Governance and advocacy (eg Minister for Mental Health, MHC, Suicide Prevention Strategy, Mental Health Bill, new Statewide Specialist Aboriginal Mental Health Service, new Consumer Peak Association and Mental Health Advisory Council, strengthened consumer and family leadership)

9. Reflections Joint purchasing framework and Clinical Services Plan with Department of Health; engagement of a Consultant Psychiatrist at MHC Increased range of new services and choice (eg more robust NGO sector, first court diversion services in childrens and adult courts, first subacute services, new youth early intervention for psychosis program, new inpatient services closer to home, ICLS and over 100 homes and personal recovery plans/ support packages (demonstration of possibility) and new self directed care initiatives in the non government sector Stronger community engagement and co production e.g. Ministerial Council for Suicide Prevention and Suicide Prevention Community Action Plans in more than 200 communities and 180 employers Strategic investments in workforce and peer support

10. Challenges Safeguarding mental health funding in the context of health reform including data and measurement Ensuring a fair share of new NDIS and that the sector is ready Managing the transition from ED/inpatient focus to a community focus in a climate of rapid population growth and new hospitals development Keeping momentum / demonstration effect of self directed support and whole of government and community engagement Delivering new services while major new service developments and some projects funding running out Better integrated services require better joint commissioning with the Commonwealth government and Drug and Alcohol Services as well as service provider collaboration and individual coordination

11. Challenges Commissioning and decommissioning, sector development and workforce Momentum and doing enough of the right things fast enough to make the transition Strong values based leadership for reform Contact details: www.mentalhealth.wa.gov.auwww.mentalhealth.wa.gov.au