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Department of Human Services Victorian Mental Health Service System Sue Brennan Acting Director Mental Health 9 July 2007.

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Presentation on theme: "Department of Human Services Victorian Mental Health Service System Sue Brennan Acting Director Mental Health 9 July 2007."— Presentation transcript:

1 Department of Human Services Victorian Mental Health Service System Sue Brennan Acting Director Mental Health 9 July 2007

2 Mental health – broad brush Growing community awareness and expectations re mental health,mental illness and services 19% of Victorians (1 in 5) experience some form of mental illness over lifetime (~ 3% severe;~4% moderate) 23% of those on C/y based orders & Combined C’y & Treat’t order with MH problems; 26%+ of prison population Mental illness is often combined with other factors which adds to complexity eg AOD, housing issues; child protection, ABI, offending/justice


4 Service system broad brush Commonwealth & State contribute (COAG) Promotion/prevention focus & activities – Vichealth; public health; local government; other universal services eg schools Primary mental health – GPs, community health; Maternal & Child Health ‘Tier’ 2/secondary level services – private psychologists, AOD, homelessness services Specialist MH services – state funded clinical and PDRS (NGO); private psychiatrists Commonwealth funded services across the spectrum – system increasingly complex with risk of further fragmentation

5 State funded specialist system Clinical (CAMHS, adult, aged) Inpatient beds PARC beds Secure Extended Care beds Community Care Units Forensic beds Community mental health teams (CAT, MST, CCT, PMHTs) PDRSS – psychiatric dis’y rehab & support services (non govt) Residential rehabilitation Supported accommodation Home Based Outreach at 2 levels IRRCS Day Programs Mutual Self Help & Support Koori program

6 Legislative framework 1986 Mental Health Act – increased transparency & accountability for patients predominantly in institutional settings Statutory ‘watchdogs’ – Mental Health Review Board, Public Advocate; Chief Psychiatrist, Community Visitors, Ombudsman, Health Services Commissioner Sentencing Act 1991 – restricted involuntary treatment orders & hospital security orders Crimes (Mental Impairment & Unfitness to be Tried) Act 1997 – custodial & non custodial supervision 2007 – Charter of Human Rights & Responsibilities – increasing community expectations on respect for rights; MHA + MHB policies & procedures being examined

7 Issues Access – 50% of nominal client group being seen (60,000 clients per year) High demand on beds – long waits in EDs (ALOS – 11 days) High levels of complexity – dual diagnosis; other co- morbidities; growing proportion of involuntary (71% of admitted group) Workforce shortages & maldistribution Beyond health – housing, employment, social connection Accommodating community safety as well as personal autonomy & rehabilitation/recovery

8 Recent service developments Build the core and develop new service models PARC Youth early psychosis CAMHS & Schools Early Action (conduct disorder) Families where parents have a mental illness (FaPMI) strategy Aged intensive community treatment (bed substitution)

9 New mental health strategy Whole of government approach – IDC with Vicpol, DoJ, Education, Office for Children, Housing, Primary Health etc Key areas under consideration – early intervention; access and responsiveness of system including for people in crisis, and system gaps for particular groups; family support; MH/AOD interface; justice interface; community participation

10 Justice system interfaces and issues Diversion– relevant programs include - court liaison services – (DHS 1994) court based, provided by Forensicare in 4 metro & 5 rural courts – assessment; links to services - court integrated services program (DoJ2006 assistance; case man’t; pathways to service; joint DoJ/MHB project examining program Neighbourhood Justice Centre – 2006; court; on site services; work with local community All aiming to divert; achieve access to right care; reduce re-offending

11 Other developments Community Corrections Protocol – under development; aims for a systematised approach for people in corrections system with MH problems or in need of crisis care Prisoner pathways and discharge plans MH/Juvenile Justice & Community Corrections/COATs protocols are in place

12 Areas for further development Diversion programs Attention to pre and post release – risk of relapse & reoffending at transition – how can services work better & achieve continuity of care? Core MH specialist service system resources and skills (clinical & PDRSS) Required focus on the forensic group

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