Mental health Policy & Funding Guidelines <<

Mental Health Services Annual Outlook 2004-05

The public mental health service system is a comprehensive specialist age-based treatment system. It comprises area based clinical mental health services, mainstreamed with general hospitals, and offers inpatient, community residential and ambulatory services as well as psychiatric disability and rehabilitation support services provided by non-government organisations. Victoria’s public mental health service system is operating in an environment of increasing demand, with all services experiencing sustained pressure.

New funding of $15 million in the 2004-2005 State Budget (comprising $6 million from the Hospital Demand Strategy and $9 million from Mental Health) will be used to implement a range of interrelated strategies selected on the basis of their capacity to assist public mental health services to more effectively manage demand. The strategies include:

Freeing Up Existing Capacity

This will be achieved through the implementation of a range of initiatives which will:

• Improve service efficiency and effectiveness within existing resources (refer to ’Initiatives to achieve long term planning and structural change’ for a summary of these projects).
• Prevent relapse and improve treatment outcomes.
• Divert demand from high cost impatient services, address critical service gaps and alleviate system blockages.
• Reduce demand through early intervention and prevention prior to, or at the onset of, mental illness.

Expansion of Existing Capacity (Growth)

The continued expansion of core services will enable the system to meet its statutory obligations to high-risk clients and assist in the management of demand.

Building System Infrastructure

Long-term strategies will continue to be implemented to build the sustainability of the service system. Key areas include workforce and capital infrastructure development linked to demand management priorities.

1. Freeing Up Capacity

1.1 Workforce development ($1.2 million)

A package of initiatives will be implemented including:

• A statewide in-service training program for all mental health staff, targeting aggression responses.
• The establishment of training clusters made up of a number of mental health area services with an ongoing role in providing workforce training.
• The provision of placements and support to facilitate workforce training at undergraduate and post graduate level, development and recruitment.

1.2 Relapse prevention ($1.4 million)

Psychiatric disability rehabilitation and support services

Funding is provided for additional psychiatric disability and rehabilitation services to assist clients with a serious mental illness and disability to live in their own home and facilitate recovery. These clients would otherwise be at high risk of requiring more intensive clinical or residential services.

1.3 Diverting demand ($6.8 million)

Funding is provided to:

Expansion of sub-acute services

Funding will be provided to develop a new sub-acute service for clients who would otherwise require inpatient care. This metropolitan based service will also provide post acute treatment and support to facilitate discharge from inpatient services.

Aged intensive treatment in the home

Establishment of clinical positions, which will provide continuing care services to older people with serious mental illness who are suitable for acute care in the home.

New acute inpatient positions

Development of new positions to be located in a number of adult acute inpatient units with high occupancy levels. These positions will support existing discharge functions and assist in improving links with follow up services to reduce unplanned readmissions.

New community positions

Establishment of community positions in adult services including positions to support existing discharge functions from case management services and help improve shared care arrangements with general practitioners and other health providers.

Provision of additional non-clinical support to residents with serious mental illness living in supported residential services who would otherwise require more intensive residential care.

Improved mental health triage

Development of training, guidelines and pilots projects for mental health triage. This project will be linked to workforce training initiatives and initially focus on improving access to services and reducing emergency department presentations.

1.4 Early intervention and prevention ($ 0.5 million)

Rural early psychosis

Funding will be provided to additional staff in a rural area to enable links with an existing metropolitan based early psychosis program. This initiative will enable young people with an emerging disorder, particularly those who also have co-existing substance abuse problems, to receive appropriate specialist treatment and improved continuity of care over the initial course of their illness.

2 Expansion of existing capacity

2.1 Growth in acute beds and services ($4.1 million)

Many of the greatest demand pressures on mental health services continue to be experienced in acute inpatient services, with the majority of adult beds operating at capacity. This is evidenced by high occupancy rates, reducing lengths of stay and overflow to general hospital beds. As a result at times of peak demand there can be problems with access to beds. This is compounded by lower bed numbers in some areas leading to long waiting times in emergency departments.

Funding in 2004–05 has been provided for opening 25 adult acute inpatient beds at the newly developed Casey Hospital in Berwick.

Examination of inpatient bed distribution and ways to improve access and management of inpatient services will be a priority in 2004–05.

2.2 Growth in community mental health ($1.0 million)

New funding has been provided for the targeted expansion of:

Child and adolescent services

Additional funding is provided to expand child and adolescent mental health services in the outer east of Melbourne. This funding will allow a more intensive service to be provided to young people with mental illness.

Psychiatric services for people who are homeless

Further funding is provided to homeless persons psychiatric outreach services to support a greater number of people with mental illness and problematic substance use living in crisis accommodation services in inner urban areas.

Consultation and liaison services

Funding is provided to expand consultation and liaison services to five rural hospitals to improve treatment outcomes for people with a serious mental health problems and physical illness.

3. Initiatives to Achieve Long-Term Planning and Structural Change

Major developments in this area include:

• Enhancement of service catchments and area collaboration to improve consumer access and cost effectiveness of current service delivery arrangements.
• New key performance indicators to monitor the efficacy of demand management strategies and improve overall service performance.
• New service planning benchmarks to identify a desirable level and mix of services and address distributional inequities that exacerbate demand pressures in certain areas.
• Proposals to strengthen coordination and partnerships across mental health services, including clinical and psychiatric disability rehabilitation and support services, and with mainstream health and other key community services,
• Implementation of cost effective service substitution strategies to reduce demand on high cost care, particularly in aged care
• Strengthening clinical leadership and workforce education to improve treatment effectiveness and enable practice to keep pace with the changing needs of the consumers.
• Implementation of a research and evaluation strategy to strengthen the evidence base for service improvements and demand management.