The Mental Health and Wellbeing Outcomes and Performance Framework helps us to measure the performance of Victoria’s Mental Health system by focusing on the impacts for the people using the system and the wider community.
The Framework will show us how all our reform initiatives are working together to support the best possible mental health and wellbeing outcomes for all Victorians.
It measures the impact of the mental health and wellbeing system, and the difference that it makes for Victorians. It will do this by:
- providing a clear picture of what a high-quality, contemporary mental health and wellbeing system looks like
- measuring the impact of mental health and wellbeing services from the perspectives of consumers, families, carers, kin and supporters
- translating data into meaningful person-centred reporting
- holding mental health and wellbeing service providers to account and support them to improve their performance over time.
How the Framework was developed
The Royal Commission into Victoria’s Mental Health and Wellbeing System recommended the development of an outcomes framework as Recommendation 1 of its final report in February 2021.
The Royal Commission outlined that existing performance frameworks such as the Mental Health Performance and Accountability Framework focused too narrowly on measuring the delivery of mental health services, and not enough on the outcomes of services for consumers and carers, as well as the whole Victorian community.
To address that, the Royal Commission recommended the Framework be designed in partnership with people who know the system best - consumers, carers, families and supporters, the mental health workforce and those in allied sectors.
More than 300 people with experience of the mental health system contributed to the development of the Framework during a series of workshops in 2022. The workshops were attended by people with lived experience, diverse communities, and other stakeholders helping to inform the high-level structure of the Framework. Furthermore, between August and October 2022 Victorians gave feedback on the draft framework via an Engage Victoria survey.
As a result of this extensive consultation, the Framework puts consumer and carer experience as the central element of service performance. Over time, the Framework aims for consumers to notice improvements in the safety, appropriateness, effectiveness, accessibility, and connectedness of mental health and wellbeing services.
The structure of the Framework
The Royal Commission said that the Framework must align with the Outcomes Reform in statement which lays out the Victorian Public Service’s outcomes approach and the architecture for implementing these outcomes.
The Framework uses the outcomes architecture to frame data around the impact on mental health and wellbeing. Over time, this will change the way that performance is measured and reported on across the mental health and wellbeing system, to make sure it is working to support better mental health and wellbeing for all Victorians.
The architecture of the Framework is tiered to provide a direct link from the “big picture” at the top, to the details of how to measure impact:
- Vision: the big picture, aspirational statement that describes what government wants to achieve for the community.
- Domains: provide a logical structure for grouping related outcomes. Organising by domains helps ensure frameworks cut across traditional policy divisions, as emphasised in the Commission’s report.
- Outcomes: articulate what success looks like and reflect the ambition for the reformed mental health and wellbeing system. They are clear, unambiguous statements about the things that matter to people and communities.
- Indicators: are the changes that need to happen to achieve a desired outcome. Indicators reflect the key drivers and influences on progress towards an outcome.
- Measures: provide granular, specific detail about how to measure the concept outlined in the indicator. Measures are the detail about how progress will be tracked.
The four domains are a central element to the Framework, which categorise our reform priorities and what we aim to achieve.
Domain 1: People and communities are enabled to experience the mental health and wellbeing they want
This domain presents an overview of the factors contributing to the mental health and wellbeing of both individuals and communities. Understanding these factors means we can support improved system performance and public accountability.
Domain 2: People are supported by mental health and wellbeing services to live the life they want
This domain focuses on how the performance of services impacts the experiences of consumers and families, carers, kin and supporters.
Domain 3: People in the mental health and wellbeing workforce are adaptive and collaborative and bring together diverse knowledge, skillsets, and experiences
This domain is dedicated to measuring and managing the skills, distribution, and wellbeing of the workforce, including the lived and living experience workforces.
Domain 4: System structures and leaders drive real change and accountability
This domain will support leaders to better collaborate, manage and be accountable for improving services in Victoria’s actively changing mental health and wellbeing system
The full list of outcomes in each domain, and indicators in each outcome, can be found in the document above. Measures are not included in this document as they are still in development.
The scope of the Framework
The Outcomes and Performance Framework is a framework for the Victorian Government.
It includes:
- any aspects of mental health care funded, partially or wholly, by the Victorian Government. This includes mental health care in hospitals, area-based services, Mental Health and Wellbeing Locals, and more, as well as the workforce delivering those services.
- other major responsibilities of the Victorian Government as they relate to mental health and wellbeing, such as schools and the justice system.
- a population-level focus in Domain 1, to better understand the mental health and wellbeing of all Victorians.
It does not include:
- aspects of mental health and wellbeing care that are private or funded by the Australian Government, such as GPs and Medicare, the National Disability Insurance Scheme, and private psychologists/counsellors.
How the Framework will be introduced
Implementation will be gradual and sequential given the breadth and scope of the Framework. Each implementation action will support a different part of the mental health and wellbeing system to begin using the Framework to monitor and achieve better outcomes.
Some of these areas of work may include:
- Developing better and more insightful reporting about progress and achievements across the mental health and wellbeing system.
- Supporting the Mental Health and Wellbeing to report on community outcomes that hold government accountable for delivering a better mental health system.
- Transitioning from the current Mental Health Performance and Accountability Framework, building towards an outcomes-based approach across the entire reform agenda.
- Developing guides and tools to support the use of the Framework.
- Supporting development of new data and systems to comprehensively monitor and improve the performance of the system.
There will be no changes to service planning or funding requirements for the 2024-25 financial year. As required by the Royal Commission, the Framework will be reviewed and updated over time to keep pace with changing needs and expectations. Although the outcomes in the Framework have been designed for long-term relevance, it may be necessary to update the indicators and measures as the system evolves and changes
What this means for consumers and carers
The Outcomes and Performance Framework is a measurement and reporting tool, which focuses on consumer and carer experience as the central element of service performance. You might notice services asking a few more questions, or a few different questions, to make sure they understand how you were affected by the service, and how the service can improve in the future.
In the longer term, the aim of the Outcomes and Performance Framework is to help mental health and wellbeing services feel safer and more welcoming, provide high-quality and effective care and support for all consumers and carers, as part of a connected and accessible mental health and wellbeing system.
What this means for service providers
The Framework will be rolled out gradually to make sure it supports services and their delivery. During the initial phase, it will run alongside the current Mental Health Performance and Accountability Framework. This means services can keep reporting and using data as they currently do to improve practices while the new framework is being implemented.
For the 2024-25 financial year, there won’t be any changes to service planning or funding because of the new framework. Baseline data will be developed for the Framework by shadow reporting with existing mechanisms such as the Performance and Accountability Framework.
The Department will work closely with services to ensure any future changes to data collection, reporting, or oversight to support implementation of the Framework are clearly communicated, understood, and useful. The goal is to implement the Framework in partnership with service providers, making sure it is practical and sustainable.
If you have questions about how this affects your service, please contact mhwd.outcomesevidenceperf@health.vic.gov.au.
Reviewed 09 December 2024