| Budget 2011 |
Budget 2011: Analysis of Mental Health reformThe Federal Budget included a total of $2.2 billion over 5 years for National Mental Health Reform. This is made up of $1.5 billion of new funding and $700 million of previously announced funding. There were also savings of $580.5 million arising from changes to the Better Access program. The main elements of the package are:
Fact Sheets on changes to Better Access The Government has released two Fact Sheets outlining the changes to the Better Access program: Changes affecting the cap on sessions Changes affecting GPs and MBS items
Mental Health Nurse Incentive Program The Mental Health Nurse Incentive Program did not receive any additional funding under this Budget. The program is being evaluated over the next 12 months and the College, along with other stakeholders, will be involved in the evaluation through a stakeholder reference group. How has the National Mental Health Reform package been received? The commentary on the mental health measures in the Budget have been mostly favourable. In an environment where there were very few areas of the budget with new spending, mental health has attracted a significant amount of new investment. There are some cautionary notes sounded by journalists and leaders in the sector, but these have not detracted from the overall positive response. Professor Patrick McGorry said: "Although the scale of this initial reform investment does not yet fully reflect the level of unmet need, the Prime Minister's package is nonetheless well balanced, smartly targeted and lays the groundwork for future reforms." The Opposition has focussed it's criticism on the time it will take for the money to be spent. There will be very little new money spent in 2011-2012, but in 2012-2013 there will be a total of $368 million spent, with the amount increasing in each of the following years. While the criticism is valid, the spending timeframe will have the benefit of ensuring that the sector have time to be part of the implementation process. Another area of criticism has been from the AMA and the Australian Psychological Society over the changs to Better Access. ACMHN members who deliver services under the MHNIP may be indirectly affected by the reduced payment GPs will receive for Mental Health Care plans, as GPs also do these plans for patients they refer to the MHNIP. There will be many challenges ahead as the new programs and services are implemented. There will also be opportunities for Mental Health Nurses particularly in the expansion of ATAPS and the coordinated services for people with severe mental illness. Detailed information on the measures The full details of the Mental Health and other budget measures is available at http://www.budget.gov.au/. Below are extracts from the Budget information pack on the main elements of the National Mental Health Reform package. A $571.3 million investment over 5 years in more and better coordinated services for the severely mentally ill The Gillard Government will invest $343.8 million over 5 years in better coordination and more services for the severely mentally ill – so that 24,000 Australians trying to manage a severe and persistent mental illness will, at last, have assistance to access properly co-ordinated, more comprehensive care and support. Patients and families of people with severe mental illness will have one point of contact for all of their care needs, meaning less frustration and anxiety for families who live in constant fear of a call from the emergency department when things go wrong, or despair when they can’t navigate the maze of government and nongovernment services on their own. Medicare Locals or large Non-Government Organisations (NGOs) will be responsible for providing the care coordination in Medicare Local regions. These organisations will receive funding to provide coordination services, and flexible funding to purchase or broker additional clinical and non-clinical services for people with severe mental illness in their areas where there are service gaps and unmet need. The Government will also provide $227.6 million over 5 years to expand successful community mental health programs: Support for Day to Day Living in the Community and the Personal Helpers and Mentors providing support for the mentally ill and mental health respite. This expansion will assist an additional 18,000 people over five years through the Support for Day to Day Living in the Community program, and employ 425 new community mental health workers, called ‘personal helpers and mentors’, to work one-on-one with people with mental illness across Australia. New personal helpers and mentors will assist around 3,400 people with severe mental illness reconnect to health care, the workforce and the community. Personal helpers and mentors provide practical, intensive support to help participants set and achieve personal goals, such as finding suitable housing, using public transport or improving relationships with family and friends. $220.3 million over 5 years to strengthening primary care and better targeting services through to those most in need To better ensure mental health services are targeted to those who need them most, the Government will invest $205.9 million over 5 years in funding more psychological services through an expansion of the Access to Allied Psychological Services (ATAPS) program. This investment will more than double existing funding provided through this program. This investment will be used to target hard to reach areas and groups that are currently underserviced, such as children, Indigenous communities and socioeconomically disadvantaged communities – providing treatment for an additional approximately 185,000 people over five years. The Government will also invest a further $14.4 million over 5 years in e-mental health, to establish a single mental health online portal. This will provide easy, ‘one stop’ access to evidence-based online psychological therapy to approximately 45,000 people over five years. Online mental health therapy provides an alternative means of accessing services for people who can’t, or don’t want to, access a service provider face-to-face. A $491.7 million over 5 years boost to services for children and young people The Government will invest $419.7 million over 5 years to expand mental health services for teenagers and young adults through providing more funding to the successful headspace and Early Psychosis Prevention and Intervention Centres (EPPIC) programs pioneered by former Australian of the Year Professor Patrick McGorry. Funding will be provided for an additional 30 headspace centres, bringing the total number of headspace centres around Australia to 90. The Budget will also provide additional funding for existing headspace centres – helping them to better service existing demand. At full operation, the 90 centres will have the capacity to assist approximately 72,000 young people around the country. The Government will provide funding, and seek matching contributions from the States and Territories, to provide 12 EPPIC centres. In addition to the four additional centres committed to in the 2010 Budget, this will deliver 16 new EPPIC centres around the country. The Government will also invest $11.0 million over 5 years in building strong and healthy kids, to help build resilience and identify emerging mental health problems early. This will include the development of a health check for children at three years old (replacing the existing four year old check) which will include markers of social and emotional development. The number of Family Mental Health Support Services will also double from 40 to 80, with an additional investment of $61.0 million over five years. These services operate alongside family relationship services and provide a way for families to get help for their children who are showing early signs of problems, or at risk of mental illness, outside of the clinical mental health system. These new support services will provide more than 32,000 children and young people with support such as counselling, and support in their own home to help them attend school and build better relationships with family and friends. Strengthening transparency and accountability – now and for the long-term The Gillard Government is strongly committed to planning more effectively for the future mental health needs of the community, creating greater accountability and transparency in the mental health system and giving mental health prominence at a national level – with the establishment of Australia’s first National Mental Health Commission. The National Mental Health Commission will be established within the Prime Minister’s portfolio, and through her will report back to the Parliament – bringing a truly whole-of-government focus to the task of mental health reform. Mental health reform will not be achieved overnight. Accordingly, the Government is also developing a ten year Roadmap for Reform of Mental Health. The Roadmap, to be further developed in consultation with stakeholders and the States and Territories, will create a vision for long-term reform of the mental health system. Working with the States and Territories The Australian Government cannot deliver mental health reform alone. The Gillard Government will provide an incentive for the States and Territories to increase investment in their areas of responsibility by making $201.3 million over five years available in a competitive funding pool for the states. The Government will seek co-investments from States and Territories for priority projects in these areas. The funding will be flexible to meet particular service gaps in each state and territory, including supported accommodation and admission and discharge from hospital as priority areas for investment. More investment in these areas can help prevent the cycle of crisis hospitalisation and homelessness that too many people with severe mental illness face. Through our investments in the regional priority round of the Health and Hospitals Fund, the Government is also providing $78.5 million for four mental health infrastructure projects. The Government is already providing for about 300 sub-acute beds or bed equivalents for mental health patients around the country through existing COAG investments. Through the upcoming COAG meeting, the Government will continue to work with the States and Territories to strengthen services in these important areas. Strengthening social and economic participation People with mental illness have very low workforce participation rates – 42 per cent compared to almost 83 per cent of people without disability. The Government will improve social and economic participation for people with mental illness through providing $2.4 million over 5 years to employment services to better equip them to help people with mental illness into jobs. The Building Australia’s Future Workforce package involves investment, including measures to support the very long-term unemployed, and disability support pensioners, many of whom have a mental illness. As part of our broader Building Australia’s Future Workforce reforms, the Government is also expanding funding for training and flexible supports for job seekers, new and expanded wage subsidy programs for job seekers with disability, and measures to encourage Disability Support Pension (DSP) recipients, back into work, where they have some work capacity. The saving include a redirection of $580.5 million from the Better Access program to the measures outlined above, achieved through:
A recent evaluation of this program showed that while the Better Access program has improved treatment rates for people with mental health disorders such as anxiety and depression, many of the most disadvantaged Australians are still not accessing the services they need. In the current fiscal environment, it is appropriate to redirect a proportion of the more than $4 billion which is otherwise projected to be spent on this program over the next five years, to services which are targeted to those people most in need.
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