Recommendation 35

What the Royal Commission said

The Royal Commission recommended that all mental health and wellbeing services across all age-based systems, including crisis services, community-based services and bed-based services:

• provide integrated treatment, care and support to people living with mental illness and substance use or addiction
• do not exclude consumers living with substance use or addiction from accessing treatment, care and support.

What are the opportunities

Implementing Recommendation 35 will mean that people with co-occurring mental illness and substance use or addiction and their families and supporters have access to integrated treatment, care and support in a variety of settings consistent with their needs, strengths and preferences.

To achieve this, the mental health and wellbeing and the Alcohol and Other Drugs (AOD) systems will remain distinct but will work more closely together, based on a shared understanding of best practice for integrated treatment, care and support.

What we've achieved

Integrated care

• An integrated AOD program has been introduced to increase access to specialist support within community mental health teams. This includes providing in‑reach support to inpatient units, helping services work together more effectively. The integrated AOD program delivered both primary and secondary consultations, improving how mental health and AOD specialists help consumers. As a result, people with both mental health and AOD needs can receive more coordinated and joined‑up care.
• From 1 July 2025, integrated AOD care moved to Activity‑Based Funding. This change supports more consistent and sustainable funding, helping services deliver integrated care over the long term.

Mental Health and AOD Emergency Department Hubs

• Mental Health and AOD Emergency Department Hubs have been implemented to streamline access to specialist care, improving care for people presenting with co‑occurring needs and reducing pressure on existing hospital and emergency department resources.
• These Hubs will mean people presenting at the emergency department with urgent mental health or alcohol and drug issues can be fast-tracked to specialist, dedicated care, providing them with the right support sooner, in a calm and comfortable space.
• This not only supports the community but also builds on the Royal Commission into Victoria’s Mental Health System recommendations to create a more integrated and responsive system, while easing pressure on emergency departments.

As of April 2026, 8 Mental Health and AOD Hubs are operational across Victoria, located at:

• Monash Medical Centre
• St Vincent’s Hospital
• Sunshine Hospital
• Royal Melbourne Hospital
• University Hospital Geelong
• Latrobe Regional Hospital
• New Footscray Hospital
• Peninsula University Hospital

What are we doing

Guidance for integrated treatment, care and support for people with co-occurring mental illness and substance use or addiction needs

• Working closely with people with lived and living experience, their families and supporters, service providers, and workers, the Department of Health has developed new guidance to improve care for people who experience both mental illness and substance use or addiction.
• The guidance sets out a clear, shared approach for mental health and alcohol and drug services across Victoria. It includes expectations for service providers to help ensure people receive coordinated and integrated treatment, care, and support that meets their full range of needs. This is reinforced through the Victorian Alcohol and Other Drugs Strategy 2025-35

Learn about how the Guidance will inform other reform work

• To achieve the Royal Commission’s vision for people who experience both mental illness and substance use or addiction, and for their families and supporters, integrated care needs to be built into mental health reforms across the system.
• The Integrated Treatment, Care and Support Workplan

• Alongside broader system reforms, ongoing effort is needed to support services to put the Guidance into practice, so people receive joined‑up, effective, and person‑centred care.

Learn about our engagement approach

• In developing the Guidance, the Department of Health consulted widely with people with lived and living experience and their families and supporters, workers and service providers across the mental health and wellbeing and AOD sectors. Details on the Department of Health’s engagement approach are outlined below.