Recommendation 05

What the Royal Commission said

The Royal Commission received evidence from people with lived experience, clinicians and experts about the need for Victoria to rebalance its mental health system towards community-based care.

Recognising this, the Royal Commission's vision for Victoria's future mental health and wellbeing system is one that prioritises community-based treatment, care and support. A system where most Victorians that experience a mental health challenge can access their treatment, care and support through services that are delivered in the community - preferably their own community, or where this is not possible, a community close to where they live.

Community-based mental health and wellbeing refers to treatment, care and support that is provided in the community instead of in a hospital.

Across Victoria, this means significant expansion and reform to existing community mental health services, as well as establishing new service types that offer consumers genuine community-based alternatives to hospital and crisis care.

Area mental health and wellbeing services

In the new mental health and wellbeing system, these services are now called:

• Infant, Child and Youth Area Mental Health and Wellbeing Services for Victorians aged 0-25, and
• Adult and Older Adult Area Mental Health and Wellbeing Services for Victorians aged 26 years and older.

There are three major reform streams to Area Mental Health and Wellbeing Services.

First, all Area Mental Health and Wellbeing Services will be funded at levels that allows them to meet most of the demand and provide community-based treatment, care and support of the right type, duration and intensity to support people to recover.

While this will be a 10-year journey to achieve this goal, the first tranche of new funding started on 1 July 2021. Over the next four years, this will see the capacity of Area Mental Health and Wellbeing Services expanded significantly. Large numbers of new clinicians and support workers, across all the key disciplines, will be recruited by metropolitan and regional and rural services. As these new clinicians and support workers come on board, Area Mental Health and Wellbeing Services will be able to see more people, and much earlier in the mental health challenges that people are experiencing. This will lead to better outcomes for Victorians seeking help.

Second, the Royal Commission indicated that Area Mental Health and Wellbeing Services should deliver treatment, care and support through a range of delivery modes including:

• site-based care (such as centres or clinics);
• telehealth;
• digital technologies; and
• visits to people's homes and other places (including targeted assertive outreach).

As long as it is safe to do so, this means that in the future Victorians will have much more choice about how they receive their treatment, care and support.

Each Area Mental Health and Wellbeing Service is also looking for ways that it can offer more appointments outside of the standard business hours. This will help Victorians, especially families and young people, access their treatment, care and support at a time that suits them and importantly, minimises the need for them to miss school or work, just to access the help they need.

Third, the Royal Commission made a range of recommendations about the types of treatment, care and support that people can access through Area Mental Health and Wellbeing Services.

In the future, as well as providing clinical mental health and wellbeing services, Area Mental Health and Wellbeing Services will also offer fully integrated:

• alcohol and other drugs treatment, care and support
• wellbeing supports (previously called psychosocial supports).

This means that the person reaching out for help will be able to get all their needs met by the Area Mental Health and Wellbeing Service, rather than having to use multiple services and different clinicians in different organisations.

Their treatment, care and support will also be integrated and coordinated, with all of the clinicians and support workers that are helping them regularly talking to each other and together with the person about the best treatment, care and support for them.

The Department for Health and Area Mental Health and Wellbeing Services are in the process of working through when the expanded range of treatment, care and support will be available. A key consideration is the time to develop the new models of care needed, as well as engage new workforces and put training and development programs in place.

Local mental health and wellbeing services

Local Mental Health and Wellbeing Services, delivered in a variety of settings, will be where people first access the system and receive most of the help that they need. People will be able to self-refer to a Local Mental Health and Wellbeing Service or access one via a referral, such as from their General Practitioner.

Treatment, care and support provided by Local Mental Health and Wellbeing Services will be free and they will open across extended hours so that people can access them more readily.

As part of the Royal Commission reforms, there will be three types of Local Mental Health and Wellbeing Services in Victoria. The Local Mental Health and Wellbeing Service a person will access will depend on their age, as the treatment, care and support provided within the locals is tailored to a person's age.

What are we doing?

For infants and children aged 0-11 years, three Infant and Child Health and Wellbeing Hubs are being established as the start of the network of Local Mental Health and Wellbeing Services for this age group.

These hubs will help infants and children who are experiencing an emotional, behavioural and/or developmental challenge, and their families. The hubs will welcome these families in and provide the treatment, care and support that the family needs within the one hub. There will be initially three of these hubs, embedded in three local communities. Announcements about where these hubs will be located will be made by the end of 2021.

For young people aged 12 to 25 years, headspace centres around Victoria form the Local Mental Health and Wellbeing Services. Headspace centres help thousands of young Victorians each year with mental health and physical health, alcohol and other drugs and work and study. Headspace centres are funded by the Commonwealth Government. Victoria is working with the Commonwealth to support headspace centres in their important role in Victoria's new mental health and wellbeing system.

For Victorians aged 26 years and older, the Royal Commission recommended the establishment of 50-60 Adult and Older Adult Local Mental Health and Wellbeing Services across Victoria. Like the other Local Mental Health and Wellbeing Services, these will be located in local communities and open for extended hours to make it easier for people to access the help that they need.

The establishment of the first six Adult and Older Adult Local Mental Health and Wellbeing Services is being fast-tracked. These will be located in Benalla, Brimbank, Frankston, Greater Geelong, LaTrobe Valley, and Whittlesea. These first of these will open from mid-2022, with all six open by the end of 2022.