Informed, engaged communities for health

Filter by Categories
Aged care
Budgets
Federal Budget 2023-2024
Federal Budget October 2022
Federal Budget 2022-23
Federal Budget 2021-22
Budget2020Health
Federal Budget 2020-21
Federal Budget 2019-20
Climate and health
Climate emergency
Heatwaves
Healthcare sustainability
#CoveringClimateNow
#HealthyCOP27
#HealthyCOP26
COVID collection
Long COVID
COVID-19
COVIDwrap
COVID SNAPS
#JusticeCOVID
Caring for the Frontline
COVIDglobalMHseries
Croakey Conference News Service
Our Democracy Forum
#AskMSF
#ASMIRT2023
#NSPC23
#16nrhc
#GreenHealthForum22
#Heal2022
#ICEM22
#NAISA22
#NNF2022
#RANZCP2022
#RethinkAddiction
#RTP22
Choosing Wisely National Meeting 2022
Equally Well 2022 Symposium
GiantSteps22
Croakey Professional Services
NHLF series
#KidneyCareTogether
ACSQHC series
ACSQHC series 2022
ACSQHC series 2021
ACSQHC series 2020
ACSQHC series 2019
CATSINaM 25 Years
Croakey projects
The Health Wrap
ICYMI
@WePublicHealth
@WePublicHealth2023
#CroakeyVOICES
#SpeakingOurMinds
Croakey longreads
#CroakeyREAD
CroakeyEXPLORE
#PHAAThinkTank 2022
Summer reading 2022-2023
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
Determinants of health
Environmental determinants of health
Social determinants of health
Discrimination
Racism
Justice and policing
Poverty
Newstart/JobSeeker
Education
Housing
Internet access
Justice Reinvestment
Social policy
Commercial determinants of health
Alcohol
Digital platforms
Food and beverages
Sugar tax
Tobacco
Vaping
Plain packaging
Gambling
Pharmaceutical industry
Arms industry
Disasters and extreme weather events
Disasters
Extreme weather events
Bushfires
Bushfire-emergency 2019-2020
Floods 2023
Floods 2022
Floods 2021
Floods 2011
Donor-funded journalism
Donor-funded journalism – 2023
Donor-funded journalism – 2022
Donor-funded journalism – 2021
Donor-funded journalism – 2020
Elections
#NSWvotesHealth2023
Victorian election 2022
Federal Election 2022
The Election Wrap 2022
#QldVotesHealth
SA election 2022
WA election 2021
Tasmanian election 2021
First Nations
Indigenous health
Uluru Statement
The Voice
Community controlled sector
Cultural determinants of health
Cultural safety
Social and emotional wellbeing
Indigenous education
Lowitja Institute
NT Intervention
WA community closures
Acknowledgement
#CTG10
#NTRC
#RCIADIC30Years
General health matters
Consumer health matters
Cancer
Cardiovascular disease
Chronic conditions
Non communicable diseases
Diabetes
Oral health
Disabilities
Fetal Alcohol Spectrum Disorders (FASD)
Genetics
Medical marijuana
Mental health
Suicide
Trauma
LGBTQIA+
HIV/AIDS
Women's health
HRT
Abortion
Men's health
Youth health
Child health
Pregnancy and childbirth
Organ transplants
Pain
Sexual health
Infectious diseases
Influenza
Mpox
Swine flu
Death and dying
Euthanasia
Global health matters
Global health
WHO
Conflict and war
Asylum seeker and refugee health
#WorldInTurmoil
Ebola
NHS
Health policy and systems
Health reform
Workforce matters
Health financing and costs
Health regulation
Strengthening Medicare Taskforce 2022
Co-design
TGA
Royal Commissions
National Commission of Audit 2014
National Health Performance Authority
Pharmaceutical Benefits Scheme
Private health insurance
Healthcare
Primary healthcare
cohealth
Social prescribing
Rural and remote health
General practice
International medical graduates
Primary Health Networks
NDIS
Nursing and midwifery
Australian Medical Association
Allied healthcare
Pharmacy
Paramedics
Pathology
Naturopathy
Hospitals
Emergency departments and care
Palliative care
Safety and quality of healthcare
Adverse events
Choosing Wisely
Co-payments
Out of pocket costs
Complementary medicines
Conflicts of interest
Health ethics
Digital technology
Telehealth
E-health
Equally Well
Health Care Homes
Medicare Locals
MyHospitals website
Screening
Surgery
Tests
Media and health
Media-related issues
Public interest journalism
Misinformation and disinformation
Social media and healthcare
Health & medical marketing
The Conversation
Media Doctor Australia
News about Croakey
Public health and population health
Artificial intelligence
Public health
Prevention
Health inequalities
Human rights
Health in All Policies
Health impact assessment
Legal issues
Australian Centre for Disease Control
VicHealth
Health literacy
Health communications
Vaccination
Air pollution
Physical activity
Sport
Obesity
Road safety
Transport
Gun control
Illicit drugs
Injuries
Marriage equality
Occupational health
Violence
Weight loss products
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
Government 2.0
Web 2.0
Nanny state
National Preventive Health Agency
Research matters
Health and medical research
#MRFFtransparency
Evidence-based issues
Cochrane Collaboration
Health and medical education
NHMRC
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2021
2021 conferences
#21OPCC
#BackToTheFire
#FoodGovernance2021
#GiantSteps21
#GreenHealthForum21
#HealthClimateSolutions21
#HearMe21
#IndigenousClimateJustice21
#NNF2021
#RANZCP2021
#ShiftingGearsSummit
#ValueBasedCare
#WCepi2021
#YHFSummit
2020 conferences
#2020ResearchExcellence
#Govern4Health
#HealthReImagined
#SAHeapsUnfair
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
Croakey Professional Services archive
#CommunityControl
#CommunityControl Twitter Festival
#COVIDthinktank21
Lowitja Indigenous knowledge translation series
Croakey projects archive
#CommunityMatters
#CroakeyFundingDrive 2022
#CroakeyLIVE #Budget2021Health
#CroakeyLIVE #USvotesHealth
#CroakeyLIVE Federal election 2022
#CroakeyYOUTH
#HousingJusticeAus
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
#LookingLocal
#OutOfPocket
#OutOfTheBox
#RuralHealthJustice
#TalkingTeeth
@WePublicHealth2022
@WePublicHealth2021
@WePublicHealth2020
AroundTheTraps
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Gavin Mooney
Inside Story
Journal Watch
Naked Doctor
Poems of Public Health
Summer reading 2021-2022
Summer reading 2020-2021
Summer Reading 2019-2020
Summer Reading 2017-2018
Summer Reading 2016-2017
The Koori Woman
TOO MUCH of a Good Thing
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
Elections and Budgets 2013 – 2019
#AusVotesHealth Twitter Festival 2019
#Health4NSW
Federal Election 2019
NSW Election 2019
Federal Budget 2018-19
Federal Budget 2017/18
NZ Election 2017
Federal Budget 2016-17
Federal Election 2016
#HealthElection16
NT Election 2016
Federal Budget 2015-16
Qld Election 2015
NSW Election 2015
Federal Budget 2014-15
Victorian Election 2014
Federal Budget 2013-14
Federal Election 2013
Federal Budget 2012-2013
Federal Budget 2011
Federal Budget 2010
Federal Election 2010
Federal Budget 2009-2010
Support non-profit public interest journalism
Filter by Categories
Aged care
Budgets
Federal Budget 2023-2024
Federal Budget October 2022
Federal Budget 2022-23
Federal Budget 2021-22
Budget2020Health
Federal Budget 2020-21
Federal Budget 2019-20
Climate and health
Climate emergency
Heatwaves
Healthcare sustainability
#CoveringClimateNow
#HealthyCOP27
#HealthyCOP26
COVID collection
Long COVID
COVID-19
COVIDwrap
COVID SNAPS
#JusticeCOVID
Caring for the Frontline
COVIDglobalMHseries
Croakey Conference News Service
Our Democracy Forum
#AskMSF
#ASMIRT2023
#NSPC23
#16nrhc
#GreenHealthForum22
#Heal2022
#ICEM22
#NAISA22
#NNF2022
#RANZCP2022
#RethinkAddiction
#RTP22
Choosing Wisely National Meeting 2022
Equally Well 2022 Symposium
GiantSteps22
Croakey Professional Services
NHLF series
#KidneyCareTogether
ACSQHC series
ACSQHC series 2022
ACSQHC series 2021
ACSQHC series 2020
ACSQHC series 2019
CATSINaM 25 Years
Croakey projects
The Health Wrap
ICYMI
@WePublicHealth
@WePublicHealth2023
#CroakeyVOICES
#SpeakingOurMinds
Croakey longreads
#CroakeyREAD
CroakeyEXPLORE
#PHAAThinkTank 2022
Summer reading 2022-2023
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
Determinants of health
Environmental determinants of health
Social determinants of health
Discrimination
Racism
Justice and policing
Poverty
Newstart/JobSeeker
Education
Housing
Internet access
Justice Reinvestment
Social policy
Commercial determinants of health
Alcohol
Digital platforms
Food and beverages
Sugar tax
Tobacco
Vaping
Plain packaging
Gambling
Pharmaceutical industry
Arms industry
Disasters and extreme weather events
Disasters
Extreme weather events
Bushfires
Bushfire-emergency 2019-2020
Floods 2023
Floods 2022
Floods 2021
Floods 2011
Donor-funded journalism
Donor-funded journalism – 2023
Donor-funded journalism – 2022
Donor-funded journalism – 2021
Donor-funded journalism – 2020
Elections
#NSWvotesHealth2023
Victorian election 2022
Federal Election 2022
The Election Wrap 2022
#QldVotesHealth
SA election 2022
WA election 2021
Tasmanian election 2021
First Nations
Indigenous health
Uluru Statement
The Voice
Community controlled sector
Cultural determinants of health
Cultural safety
Social and emotional wellbeing
Indigenous education
Lowitja Institute
NT Intervention
WA community closures
Acknowledgement
#CTG10
#NTRC
#RCIADIC30Years
General health matters
Consumer health matters
Cancer
Cardiovascular disease
Chronic conditions
Non communicable diseases
Diabetes
Oral health
Disabilities
Fetal Alcohol Spectrum Disorders (FASD)
Genetics
Medical marijuana
Mental health
Suicide
Trauma
LGBTQIA+
HIV/AIDS
Women's health
HRT
Abortion
Men's health
Youth health
Child health
Pregnancy and childbirth
Organ transplants
Pain
Sexual health
Infectious diseases
Influenza
Mpox
Swine flu
Death and dying
Euthanasia
Global health matters
Global health
WHO
Conflict and war
Asylum seeker and refugee health
#WorldInTurmoil
Ebola
NHS
Health policy and systems
Health reform
Workforce matters
Health financing and costs
Health regulation
Strengthening Medicare Taskforce 2022
Co-design
TGA
Royal Commissions
National Commission of Audit 2014
National Health Performance Authority
Pharmaceutical Benefits Scheme
Private health insurance
Healthcare
Primary healthcare
cohealth
Social prescribing
Rural and remote health
General practice
International medical graduates
Primary Health Networks
NDIS
Nursing and midwifery
Australian Medical Association
Allied healthcare
Pharmacy
Paramedics
Pathology
Naturopathy
Hospitals
Emergency departments and care
Palliative care
Safety and quality of healthcare
Adverse events
Choosing Wisely
Co-payments
Out of pocket costs
Complementary medicines
Conflicts of interest
Health ethics
Digital technology
Telehealth
E-health
Equally Well
Health Care Homes
Medicare Locals
MyHospitals website
Screening
Surgery
Tests
Media and health
Media-related issues
Public interest journalism
Misinformation and disinformation
Social media and healthcare
Health & medical marketing
The Conversation
Media Doctor Australia
News about Croakey
Public health and population health
Artificial intelligence
Public health
Prevention
Health inequalities
Human rights
Health in All Policies
Health impact assessment
Legal issues
Australian Centre for Disease Control
VicHealth
Health literacy
Health communications
Vaccination
Air pollution
Physical activity
Sport
Obesity
Road safety
Transport
Gun control
Illicit drugs
Injuries
Marriage equality
Occupational health
Violence
Weight loss products
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
Government 2.0
Web 2.0
Nanny state
National Preventive Health Agency
Research matters
Health and medical research
#MRFFtransparency
Evidence-based issues
Cochrane Collaboration
Health and medical education
NHMRC
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2021
2021 conferences
#21OPCC
#BackToTheFire
#FoodGovernance2021
#GiantSteps21
#GreenHealthForum21
#HealthClimateSolutions21
#HearMe21
#IndigenousClimateJustice21
#NNF2021
#RANZCP2021
#ShiftingGearsSummit
#ValueBasedCare
#WCepi2021
#YHFSummit
2020 conferences
#2020ResearchExcellence
#Govern4Health
#HealthReImagined
#SAHeapsUnfair
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
Croakey Professional Services archive
#CommunityControl
#CommunityControl Twitter Festival
#COVIDthinktank21
Lowitja Indigenous knowledge translation series
Croakey projects archive
#CommunityMatters
#CroakeyFundingDrive 2022
#CroakeyLIVE #Budget2021Health
#CroakeyLIVE #USvotesHealth
#CroakeyLIVE Federal election 2022
#CroakeyYOUTH
#HousingJusticeAus
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
#LookingLocal
#OutOfPocket
#OutOfTheBox
#RuralHealthJustice
#TalkingTeeth
@WePublicHealth2022
@WePublicHealth2021
@WePublicHealth2020
AroundTheTraps
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Gavin Mooney
Inside Story
Journal Watch
Naked Doctor
Poems of Public Health
Summer reading 2021-2022
Summer reading 2020-2021
Summer Reading 2019-2020
Summer Reading 2017-2018
Summer Reading 2016-2017
The Koori Woman
TOO MUCH of a Good Thing
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
Elections and Budgets 2013 – 2019
#AusVotesHealth Twitter Festival 2019
#Health4NSW
Federal Election 2019
NSW Election 2019
Federal Budget 2018-19
Federal Budget 2017/18
NZ Election 2017
Federal Budget 2016-17
Federal Election 2016
#HealthElection16
NT Election 2016
Federal Budget 2015-16
Qld Election 2015
NSW Election 2015
Federal Budget 2014-15
Victorian Election 2014
Federal Budget 2013-14
Federal Election 2013
Federal Budget 2012-2013
Federal Budget 2011
Federal Budget 2010
Federal Election 2010
Federal Budget 2009-2010

Storm clouds over the future of mental health and disability services

Marie McInerney writes:

The mental health sector is in the midst of “a perfect storm” of change, as one speaker put it during the recent VICSERV #TowardsRecovery conference in Melbourne. This comes as the sector grapples with how to offer people with mental illness not just choices but control over their lives.

Mental Health Australia CEO Frank Quinlan told delegates that the system was in a period of “quite unprecedented change”, with the rollout of the National Disability Insurance Scheme (NDIS), the new role in mental health of Primary Health Networks (PHNs) and other reforms planned or underway in response to the National Mental Health Commission’s Review of Mental Health Programmes and Services.

While many of the major system changes underway, including the NDIS, are welcomed in the mental health sector, there is confusion over details and concern that many people with mental health issues could fall through new gaps in the system.

Some at the conference said the upheaval rivals the days of deinstitutionalisation, particularly in Victoria which has just emerged from much criticised recommissioning of mental health services and where there is also uncertainty about what of its mental health community support funds will be committed to the NDIS.

These concerns are only exacerbated by the uncertainty surrounding the policy outcomes likely to result from the July 2 federal election, and the marathon eight-week election campaign and caretaker period.

Despite all the planning for the NDIS, which on 1 July begins its full national rollout after three years of trials, the fate of some programs such as the Personal Helpers and Mentors (PHaMs) program is still not known.

(As a measure of ‘reform fatigue’, Victorian Alcohol and Drug Association CEO Sam Biondo told one session that when he started out in the 1970s, all he wanted was change; now all he wants is some stability).

“Some organisations don’t know what contracted services they’ll be offering on July 1,” Quinlan told Croakey in a follow-up interview yesterday. “That means uncertainty for their clients, people who rely on them, and also for their workforce who don’t know whether they will have employment in six weeks time.”

At the weekend Mental Health Australia released its election platform, saying the important reforms that are underway “cannot be forgotten during the current electoral cycle”. It is calling on political leaders for long-term commitment to:

  • reducing the national suicide rate
  • improving the physical health of people with a mental illness
  • increasing employment rates for people experiencing mental illness and their carers
  • increasing mental health consumer and carer participation and choice in national policy design and implementation
  • maintaining current overall levels of investment in mental health, with measures that support full reinvestment of cost efficiencies and savings.

Mental Health Australia will produce a ‘report card’ to be released prior to the election, outlining the major parties’ response on these issues.

Meanwhile, just a few days after the conference ended, one of its speakers, Professor Jane Burns, CEO of the Young and Well Cooperative Research Centre, joined other mental health leaders in releasing details on suicide across 28 Federal electorates, calling on party leaders and candidates to spell out what they intend to do to address the rising toll of suicide and self-harm across Australia.

NDIS concerns

The mental health sector has welcomed the NDIS, saying a well funded and well run scheme will meet many needs.

But the numbers provide the context for some of the concerns raised at the conference: it is estimated that each year in Australia, there are around 600,000 people who experience severe mental illness, and 300,000 who experience severe mental illness with “complex inter-agency needs”.

By comparison, there are around 60,000 places in the NDIS for people with mental health issues.

VICSERV CEO Kim Koop said the conference message was: “The NDIS is a welcome addition to a contemporary mental health system but is not sufficient replacement for the current offering.”

She said Victorian community managed mental health services were “desperate for more information” about the NDIS.

But the State Government has an equal role to play, she said, pointing out that the bilateral agreement makes clear that the introduction of the NDIS is a shared responsibility between the States and the Commonwealth. “Both need to step up and provide information,” she said.

VICSERV has played a lead role in documenting the Victorian trial of the NDIS in the Barwon area, but is waiting to hear back on how its concerns will be addressed.

Koop said:

The NDIS is not a bad thing (for mental health).

The trouble is that the funding for the existing services is being transferred to the NDIS and that it is still very uncertain if the NDIS will offer a similar range of services.

At the moment it’s just really unclear. We’re waiting to hear from the NDIA (National Disability Insurance Agency) around the review of supports for people with mental illness but until that comes out, we just don’t know what kind of supports, what price they will be at, what workforce (levels) there will be required.”

Delegates at one conference session peppered a panel that included senior managers in the National Disability Insurance Agency (NDIA) about many details of the NDIS’s likely operation.

A delegate told the panel it had been great to have different trials conducted across Australia over the past three years but their different reports on different experiences have created “confusion and misinterpretation…trying to compare apples with oranges”.

Others expressed continuing concern about how people with episodic mental health issues would be included in a Scheme designed around permanent disability.

On markets and mental health

The session followed a keynote by UK philosopher Dr Simon Duffy raising issues such as citizenship and the need to focus on community rather than institutional and organisational interests. By contrast, the language of the NDIS discussions was all around markets, market failures, entrants and competition.

In an aside to me, one delegate questioned whether there is a “market” in people with mental illness.

Asked at another session whether there really was a “fair dinkum market'” for organisations to start competing in, National Mental Health Commissioner Rob Knowles said there wasn’t yet.

But he warned that one would develop as it has in other countries, and he was not sure people in the sector understood the significance of the changes that will occur.

When the UK went down this road, about 80 per cent of existing services were provided by not for profit organisations, the remainder by private providers. That was soon reversed, he said.

A mistake many not-for-profits made was to think “people stick with us”. Knowles said: “People are much more fickle than that. I think there are significant challenges for those operating in this: how they make themselves be a service provider of choice”.

Concerns for Aboriginal health

A delegate from an Aboriginal community controlled health organisation (ACCHO) raised issues for her sector, where Aboriginal communities are estimated to have twice the incidence of disability as non-Aboriginal communities but much less access to services, and agencies that are not specialists for disability support.

“If you focus most of the effort on transitioning current supports (to the NDIS), that will continue to leave Aboriginal communities under-supported,” she told the NDIS panellists.

She was told the NDIA had identified it needed to do a lot more work around Aboriginal disability, and would step up that engagement and transition work. Other culturally and linguistically diverse (CALD) communities will also get a bigger focus.

Another ACCHO representative voiced fears that if Aboriginal people with disability transitioned to other services under the NDIS, only to find they were not culturally safe for them, that the ACCHO workforce might not still be there for them to return to.

What will PHNs offer mental health?

Another panel session focused on the news, announced last year, that funds will be reallocated from Canberra to primary health networks (PHNs) to commission — but not deliver — mental health services.

Again, the sector has welcomed the move, particularly as a bridge between States and Commonwealth, but with concerns about how it all might work in practice.

Quinlan gaps

The aim of the PHNs, to make sure they get local services on the ground where they are needed, was very welcome, Quinlan said. The concern is how to maintain national standards.

He said: “For example with eating disorders and suicide prevention, you can quickly see you wouldn’t want 31 PHNs across the country all inventing their own way of doing things. Addressing how we tackle some national issues while ensuring local suitability is a big challenge.”

The PHN session involved panelists Jason Trethowan – Chief Executive, Western Victoria PHN, Lyn Morgain – Chief Executive, cohealth, and Christopher Carter – Chief Executive, North Western Melbourne PHN. They outlined what PHNs would cover, and what they wouldn’t.

The questions they sought to answer in their session demonstrated the issues of concern for many of the delegates there:

  • How will planning be undertaken that ensures the range of demographic, clinical, aged related, cultural, socio-economic and comorbidity of people is properly planned for?
  • How will the flexible funding pool work – be prioritised – is it flexible for service models of care?
  • How will PHNs work with the State system, and with each other to ensure continuity – especially given the transient nature of some consumers?
  • What does this mean for existing youth primary mental health services? Youth with severe mental health?
  • How will we ensure that services for Aboriginal and Torres Strait Islander people recognise the social determinants of health and cultural safety?
  • What are the potential approaches to reduce fragmentation (suicide prevention)?
  • What are the commissioning challenges and opportunities for rural communities?
  • There will likely be a gap with the move of specialist recovery based community mental health support services to the NDIS. Will PHN’s be able to fund recovery based CMH or will as suggested PHNs be limited to commissioning only “clinical primary MH” as has been suggested in some of the guidance documents?

PHNs in scopePHNs not in scope

PHN perspectives

Croakey later asked panellist Chris Carter for his reflections on the session.

Q: What were the main messages you wanted to get across during the session on the role of PHNs within the context of national mental health reforms?

That the role of PHNs is developing – in the first phase this will be about development of a stepped care model that reflects regional needs, and is focussed around safe, quality mental health care.  There will be a number of stages and phases in the evolution of an integrated system given the high level of fragmentation in the healthcare system.

Q: What key concerns emerged from the session? What’s your response to them?

Not really concerns, but a genuine desire to participate in the conversation about reform – how PHNs will take into account the diversity of populations, families and individuals when considering future planning and investments in the mental health system.

Q: The Federal Opposition said recently: “The PHNs, as the critical commissioners under the new reform agenda, are stuck in an unenviable position, wedged between the enormous pressure to deliver the reforms with unreasonable demands and an information vacuum from the Department of Health and at the same time trying to manage an increasingly agitated mental health sector hungry for information and advice.” What’s your response to that?

Our role as PHNs is to help facilitate as much information sharing and participation in planning processes as is possible.  Some of the tension lies between acute and primary systems, as well as State and Commonwealth systems.  At a regional level, our job is to bring local intelligence / evidence and wisdom to try and meet the needs of consumers / citizens, whilst bringing along the sector – which we acknowledge is reform / change fatigued in Victoria.

Q: What do you want to see promised for mental health in the federal election? Has the campaign put major work on hold? What certainty is needed now?

I support Mental Health Australia’s call for a long-term strategy for mental health – and would add that we need to integrate State and Commonwealth responses at a regional level in order to target diverse populations and diverse needs.  The election campaign has not put our work on hold – we are on track to implement continuing and new arrangements ready for July 1 and beyond in partnership with stakeholders.

Some Twitter observations

PHNs twitterPHNs twitter2

Control, not choice

Another big theme at the conference was given a sharp focus by keynote speaker Simon Duffy – that the idea of ‘choice’ is not enough for people with disabilty.

Rather, he said, control is what’s vital. (See also Duffy’s views about the NDIS in this earlier Croakey story and in this interview on Radio National’s Life Matters).

In a similar vein, RMIT Associate Professor Paul Ramcharan told delegates about the It’s My Choice toolkit (DVD, discussion guide and booklets) developed with Inclusion Melbourne, a day service that supports people with intellectual disability. The project sought to inform people with disabilities, family, friends and others as well as service personnel about how to explore choices within complex lives and relationships. .

Ramcharan later told Croakey:

“Of the nine principles of choice (identified), one in particular challenges us to rethink the notion of choice. In this principle,  the important question is not whether people with disability have choice – given that no one really has a total choice in what happens in their lives and that choices are made within a complex of relationships, services and environments. The question should be whether the limitations placed on their choices are reasonable or not.

Organisations delivering services should be looking at discrimination and community norms and other barriers that get in the way of people expressing their choices not just about mundane matters like what to eat and wear (though important) but pervasive areas relating to health, education, work, family and intimacy.

Choice of services alone does not equate to personal choice. It’s the journey of life that counts, not formal academic indicators, but the rich fabric that enriches our lives day to day.”

(Note: this quote above was added to the original published story to give more context about the project).

 

See his slide below.

PRINCIPLE6
Conference perspectives

Quinlan view from front

Quinlan twitter

[divide style=”dots” width=”medium”]

• Marie McInerney is covering the #TowardsRecovery conference for the Croakey Conference News Service. Bookmark this link to track the coverage.

VICSERV-TowardsRecovery_logo

 

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Search by: Categories or tags

Filter by Categories
Aged care
Budgets
Federal Budget 2023-2024
Federal Budget October 2022
Federal Budget 2022-23
Federal Budget 2021-22