Introduction by Croakey: The Victorian mental health system is highly fragmented, with an inefficient patchwork of programs and services resulting from siloed funding arrangements between Commonwealth, State and private services.
That is the diagnosis of the Victorian and Tasmanian PHN Alliance’s submission to the Royal Commission into Victoria’s Mental Health System, which is holding public hearings until 26 July.
The submission calls for system reform to simplify access and navigation, to better integrate mental health services with primary healthcare and other health services, to ensure comprehensive, appropriate and consistent support to individuals, families and carers, and to build a sustainable workforce.
The submission (with recommendations summarised here) says that promoting mental health and addressing mental‐ill health requires a holistic view of health that considers the physical, social, cultural and economic determinants of health.
It notes that PHNs have a dual role in relation to mental health reform and system transformation, as commissioners of primary healthcare services and as improvement partners, supporting the clinical and non‐clinical workforce to build skills and expertise.
Meanwhile, the North Western Melbourne Primary Health Network and Croakey have issued an open invitation for consumers, carers, health professionals, community members, service providers and policy makers to participate in a #CroakeyGO – a collaborative act of walking journalism – on 1 August, with the aim of sharing experiences and knowledge about how to improve mental health service delivery.
In the article below, Adjunct Associate Professor Christopher Carter, CEO of the North Western Melbourne Primary Health Network, which is sponsoring the event, says he and his colleagues will be listening closely for ideas about how to create “a more coordinated, integrated and responsive mental system for the future”.
Christopher Carter writes:
Finding your way through the mental health system in Victoria can be like entering a maze.
While Primary Health Networks like ours and others are working hard to improve coordination across the many services and programs that make up the mental health system, for too many people and their loved ones, navigating that maze to find appropriate and effective care can be daunting.
To improve the care and experience of people accessing the mental health system, we need to better understand their journey. And we can do this by better connecting with the mental health consumers, carers and providers who walk this path every day.
One of the ways we are putting this into practice is by sponsoring a walking journalism project known as a #CroakeyGO, on Thursday 1 August from 10am. This will involve a walk around local mental health facilities, general practices and community health services in Fitzroy and Carlton.
Everyone in NWMPHN’s region is invited to attend, either in person or by following on the day through social media; on Twitter, follow #NavigatingHealth.
We plan to walk in the footsteps of a person accessing the mental health system in our community, looking at the care available at different entry points and investigating how it shapes their experience of the system and ultimately, their health outcomes.
At each location we will stop and hear the stories of consumers and providers about their experience and role in the system.
One of the stops will be at St Vincent’s Hospital Emergency Department. While not originally designed for providing mental health care, emergency departments (EDs) around the country have become key points of access for people with mental illness.
Hospital EDs are equipped to deal with medical emergencies and injuries, but aren’t necessarily set up or designed to deal with mental health crises.
Many EDs are strengthening their connection with local mental health crisis teams to better provide emergency mental health care and links to ongoing services, but challenges remain.
General practice perspectives
At the other end of the spectrum people are increasingly turning to their GP first with concerns about their mental health. The 2018 Health of the Nation report showed that psychological ailments are now the most common reason for a patient visit to a GP.
We will stop at Carlton Family Medical to talk with local GP Associate Professor Ralph Audehm about the challenges this brings, and how general practitioners are working through the system to provide the best mental health support.
The GP mental health treatment plans support referral and access to a range of services (including subsidised access to private providers); however, the complex maze of services can make it difficult to link someone to the right care for them.
Between general practice and emergency departments lie many other mental health services and programs for various types of conditions and levels of need, available through community organisations and private practitioners. There are also mental health services designed for people from diverse communities.
But while a wide range of services is available, consistently being able to connect an individual to the right service when they need it remains difficult.
Stops at Queerspace at Drummond St Services and the Victorian Aboriginal Health Service will highlight the importance of culturally appropriate and relevant mental health services, and also the challenges diverse communities often face in connecting to such services.
Navigating the mental health system can be difficult for anyone. For groups facing added layers of stigma, discrimination or ignorance of specific health issues, it can be nearly impossible.
But while we should never look away from the gaps and obstacles many people face in order to get help, we also need to know about things that are working.
At each scheduled stop and every step in between, we’ll be talking with consumers, carers, providers and others about what is working, what isn’t, and where are the opportunities for us to work with our community to make mental health better for everyone.
All of the discussions and everything that comes out of the day will directly inform our Regional Plan for Mental Health for our catchment of around 1.7 million people in north, west and central Melbourne.
This will guide the way we create a more coordinated, integrated and responsive mental system for the future. We look forward to seeing you on the walk and sharing your thoughts and experiences on how we can make it happen.
• NWMPHN’s first #CroakeyGO will be held on 1 August from 10am. Come along and help us improve mental health services in north western Melbourne. To find out more, visit our website at www.nwmphn.org.au/croakeygo or register at info@Croakey.org
The map and itinerary for the walk will be published at Croakey closer to the time.
Croakey journalists will attend and report on the discussions.
Meanwhile, the conversations have already begun…