By Adele Beasley
26 March 2021
“How can we help?”
That is the question the Royal Commission wants mental health support providers to ask when someone presents at a service. This shift in philosophy provides the expectation that a person will receive the type of support they want and need, as well as assistance to get it. People will access services that build on their strengths as well as address their needs.
Community-based model of care
The Royal Commission has proposed a system that is fundamentally restructured around a community-based model of care, where people access treatment, care and support close to their homes and communities.
The 65 recommendations, in addition to the nine recommendations from the interim report, propose a set of reforms that is transformational. Their goal is to rebalance the system so that more services will be delivered in community settings and will extend beyond a purely health-focused response to a more holistic support of good mental health and wellbeing across the community.
The ‘mental health and wellbeing system’
In a major structural and cultural change, the Commission is renaming the mental health system the ‘mental health and wellbeing system’. This recognises the range of supports that are required for people experiencing mental ill-health to live full and contributing lives.
They have redesigned the system so that people can have greater access to both clinical and wellbeing - what was previously named psychosocial - supports. Clinical and community partnerships will enable the joint delivery of these services.
The Commission has said that the intensity of the wellbeing supports that each consumer needs will be discussed and jointly agreed with the consumer as part of the standardised processes they are taken through. This is what Mind does with our My Better Life® plan – we ask people a range of questions to understand what they need to start and succeed in their recovery journey.
Social determinants of mental health
The Commission has understood that the social determinants of mental health are crucial to shaping a person’s life.
They have recommended that the 2000 places that the government had already announced as part of the Big Housing Build are delivered as ‘supported housing’ places – reflecting the findings of our Trajectories research, that while housing is the foundation for mental health, alone it is not enough. People need wrap-around support to stabilise and recover. The 500 medium-term places for young people will provide a safe and stable place for young people to pursue their own goals.
Consolidating a focus on the social determinants of mental health will be facilitated by the establishment of a Mental Health and Wellbeing Secretaries’ Board. This will be chaired by the Department of Premier and Cabinet, and be comprised of the Chief Officer for Mental Health and Wellbeing and the Secretaries of the Department of Health, the Department of Education and Training, the Department of Families, Fairness and Housing, the Department of Justice and Community Safety and the Department of Treasury and Finance.
Commissioning and funding
As Mind CEO Gill Callister said in her opinion piece in The Age, the challenge in realising Victoria’s new mental health and wellbeing system will be in the implementation. The roadmap has been set. The Royal Commission’s vision will only be achieved through a truly collaborative approach to implementation, led by people with lived experience. And we must also ensure the system has properly funded commissioning arrangements in place, so that providers have the means to work together to deliver the holistic range of supports that we know can make a real and lasting difference to consumers.
Adele Beasley is the Manager of Policy and Campaigns in Mind’s Research and Advocacy Division