Mental health reform is happening 

The Australian Government has made a number of announcements about the future of mental health services. The College is actively engaging with the Department of Health, the Primary Health Networks (PHNs) and other key stakeholders to ensure that the voices of mental health nurses are heard in this process, and that we are involved the decisions relevant to our members.

Reform is also happening across the health system in the management of chronic disease and alcohol and other drugs. We are working to involve mental health nurses in the discussions that are relevant to our role.

Below you will find a summary of the key documents regarding mental health reform, updates from the College, and comments from other organisations. If you have any questions about our work on these issues please contact our Policy and Stakeholder Engagement Manager Alexandra Anderson on 02 6285 1078 or email This email address is being protected from spambots. You need JavaScript enabled to view it. You can also keep up to date by signing up to the Primary Mental Health Care Special Interest Group and eList.

Release of Guidance Document for the Primary Health Networks on Commissioning Mental Health Nursing Services

The Australian College of Mental Health Nurses have been working in collaboration with the Department of Health to develop a Guidance document for the Primary Health Networks (PHNs) on the commissioning of mental health nursing services in primary care.

The document has now been finalised and is now available for your information and to support the Primary health Networks with their commissioning of mental health nursing services. We encourage you to circulate the Guidance document to your colleagues, employers and contacts at your PHN who may also find this reference useful.

We hope you find the document helpful and we encourage you to contact our Policy and Stakeholder Engagement Manager, Alexandra Anderson, who is happy to be contacted should you wish to discuss anything further.

Relevant documents and resources:

Department of Health information on MHNIP including claim forms and guidelines from 1 May - 30 June 2016.

https://www.health.gov.au/internet/main/publishing.nsf/Content/work-pr-mhnip

Department of Health PHN Circulars - http://www.health.gov.au/internet/main/publishing.nsf/Content/PHN-Circulars

Contributing Lives, Thriving Communities - Review of Mental Health Programmes and Services - http://www.mentalhealthcommission.gov.au/our-reports/contributing-lives,-thriving-communities-review-of-mental-health-programmes-and-services.aspx

Government Response to Contributing Lives, Thriving Communitieshttp://www.health.gov.au/internet/main/publishing.nsf/Content/mental-review-response

Department of Health Factsheet on the Government Response - http://health.gov.au/internet/main/publishing.nsf/Content/mental-review-fact

Ministerial Press Release on Mental Health Reform - https://www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2015-ley151126.htm 

A Healthier Medicare for chronically-ill patients - Press Release from the Prime Minister and Health Minister - http://www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2016-ley021.htm 

Primary Health Care Advisory Group Report: Better Outcomes for people with Chronic and Complex Health Conditions - http://www.health.gov.au/internet/main/publishing.nsf/Content/primary-phcag-report

Ministerial Press Release on Ice, Alcohol and Other Drugs - http://www.fionanash.com.au/Media/MediaReleases/tabid/84/ID/1367/A-new-action-plan-to-tackle-ice.aspx

PHN information, news and contacts - http://www.health.gov.au/internet/main/publishing.nsf/Content/PHN-Home

Australian Health Care Reform Alliance Health Reform Summary March 2016
 

Updates from the College: 

 

5 July and 11 July 2016 – Update to the Primary Mental Health e-list and Tuesday Times - Reminder regarding MHNIP session payments for June to be submitted by 15 July

Reminders provided that claims for MHNIP sessions up to 30 June 2016 must be submitted to the Department of Health by 15 July or claims won’t be paid. The letter sent to EOs was also provided and MHNIP letter can be accessed here

 

17 June 2016 - Update to the Primary Mental Health e-list and 21 June Tuesday Times – MHNIP payments from the Department of Health

The ACMHN have been advised by a number of Credentialed Mental Health Nurses (CMHN) working in the Mental Health Nurse Incentive Program (MHNIP) that there has been a delay in processing and receiving payments for sessions submitted to the Department of Health.

The ACMHN have spoken to the Department of Health so we could advise people on what the situation is.

The Department of Health have advised that there were delays in finalising their payment system but that they expect payments will go out this week (week beginning 20 June 2016). They also told us to advise that the payments will essentially be batched so that all payments can go out quickly and be received next week.

The Department of Health are also trying to follow-up as quickly as possible any issues that may have related to payments submitted to DHS prior to the changes, but were not processed by DHS. They will call any CMHN directly where this is the case, and likewise for any similar problems for payments submitted to Department of Health.

They have assured is they are processing as fast as possible as we know the problems this causes for people. 


31 May 2016 – Update from Kim Ryan, CEO ACMHN on meeting with the Department of Health

Just a couple of points. It is very clear that the arrangements through the PHN’s are all different some things seem to be going well for some and others still seem confused and not totally clear on what the end game is here, keeping services to the consumer.

The 6% is the percentage taken off the total funding provided to the PHN for the MHN services (MHNIP) to cover the operational costs it was not clear until yesterday to me that the 6% is out of the MHNIP money. They are being told to ensure the consumers continue to get CMHN services. There has been an underspend, and they have told them they can use other funds if needed to keep services to the consumers. If there are 10 clients in the PHN that is receiving CMHN services then 10 clients need to get MHN Services. The DOH assure us there is enough funding to maintain services. I know it is confusing and I know it is hard to make sense of and obviously in some PHN’s it seems to be more difficult.

There are 31 PHNs and in all reality each PHN will determine their own commissioning and contracting process. There will no longer be sessional payments and in many instances. In some PHN’s the nurses have sorted out what arrangements they will have with the PHNs others haven’t and in some instances may still need to work with the PHN to sort it out, a bit like back in the beginning when people had to sort it out with the EOs. People seem to be coming up with many different ways to sort this out.

We have developed a document – which is currently with the Department for approval – which will provide guidance to PHNs on commissioning CMHN. We will also prepare alongside this a document for CMHN providing advice on how CMHN can work with PHNs.

People should not be holding up signing contracts as their PHN is likely to have different arrangements to another person’s or PHNs. We will not have clear answers on payments as each PHN may be different. There is communication occurring between the PHNs through forums such as the AHHA and the PHN alliances, and more formally through Department convened PHN CEO meetings, and these sorts of issues will be discussed. However this is a moving feast and there are some things that neither us, the Department or the PHNs will be able to give you an answer to at the moment.

The changes occurring are big and it is going to be ‘messy’. We are doing as much as we can to raise with the Department any significant issues effecting the ability of people to continue services and at time just seeking further info and they have given us an undertaking that they will deal with each case and PHN. I am continuing to go to as many PHN meetings as I can to talk MHNIP, CMHN and PHN’s, off to the Gold Coast on Thursday.

I know some of you are very anxious and I know some of you are very excited about the opportunities ahead. We will keep you informed, send us an email or call, we are in regular discussion with the DOH and we can raise issues as they arise. We will ask the DOH to try and progress the commission documents as fast as they can. Some of you who have made arrangements and are happy maybe share your experiences they might assist someone else to sort out theirs.

Thanks to you all for working with us to keep the undisputed important CMHN’s services to the consumers, we don’t want this to go backward but steam ahead.

 

30 May 2016 - Update from Kim Ryan, CEO ACMHN on meeting with the Department of Health

As Amanda let you know, we met with Natasha Cole, First Assistant Secretary, Health Services today – who is managing the mental health funding transition to the PHNs.

We gave examples to the Department where inconsistent information is being given from PHNs to nurses – in terms of what the Department have communicated. We also raised our concerns, again, that you can’t give a PHN the same amount of funding and expect them to do more.

The Department said that 6% has been taken out of PHNs existing MHNIP budgets for operational costs, however the Department believe there is an adequate amount of funding to keep providing existing service or session levels. They said there was an under-spend.

They said they have explained to all PHN CEOs that the 6% is an administration fee and should not affect their service levels – as they have the same amount of sessions being given to them that they were already using. That is, the budgets they have been given for MHNIP reflects what they were already using. The Department also said those PHNs that are saying the 6% means there will be a reduction in service will be told they need to provide the same level of service.

We will be providing the cases nurses have reported to us to the Department, along with name of the relevant PHN, and the Department have given us an undertaking they will speak to these PHNs and address any problems that are occurring.

If nurses do have any cases or examples of problems occurring, as we have said before, please do bring them to us – if you haven’t already - and we will speak to the Department. You can also contact the Department directly if you’d prefer.

Regarding claiming for sessions from 1 July, the department also said they have told the PHNs that they should be working on this now – they have said this needs to be done and communicated well before end of June 2016. If your PHN hasn’t been in touch with you or the EO you work through, please let us or the Department know.

As I said if you have any issues please let us know as we will continue to meet with DOH on a regular basis.

 

30 May 2016 – Department of Health Claiming Process – Q&A from the Department of Health

The Department of Health provided the ACMHN with a Q&A on the Department of Health claiming process for MHNIP up until end of June 2016.

Download document

 

4 May 2016 - ACMHN Budget update

The one certain thing we can say about this budget that it is very much an election budget – no great new initiatives or spending announcements, and much that we already knew was happening. It’s probably safe to say the spending initiatives will be announce in the coming weeks as a part of the election campaign, which is likely called at the end this week.

Initiatives which had already been announced in the transfer of mental health program funding to the PHNs and the Health Care Homes to coordinated chronic disease were ‘re-announced’. They are now in the budget as measures the government must report against. There is no specific mention of any of the programs, such as MHNIP. There does appear to be a change or reduction in funding in 2019-20, and we are seeking some explanations on this.

There is about $21.3million for the trial of Health Care Homes – there is no detail as yet about how these will work or what role mental health will have in this new initiative. We would assume, given the significant rates of mental illness and other chronic illness that there will have to be a role, but as I have said, very limited details about how this will work.

There is some funding for a new mental health digital gateway which the government has said will aim to streamline access to existing information, advice and digital mental health treatment and include a centralised telephone and web portal. The government has been implementing this in aged care, where there have been some teething problems, so it will be very interesting to see how this progresses.

The other new money which relates to mental health is $40million for veteran’s health and suicide prevention. I have included this link as the veterans’ health funding is not through health but the Department of Veteran’s Affairs http://minister.dva.gov.au/media_releases/2016/may/va035.htm

There is $800,000 for an online service for perinatal depression, which, however welcome, does not match the funding taken out of such services a few years ago. There is also $10.5 million from 2016 to 2020 to address Fetal Alcohol Spectrum Disorder.

There are savings predicted through the Medical Benefits Scheme (MBS) review to amend or remove some items. I know mental health nurses continue to raise the issue of not being included in Better Access or being able to access some Medicare item numbers. The ACMHN has raised this on a number of occasions including in our most recent Federal Pre-Budget submission (link below). However given the move to reduce MBS items and the cashing out trails for Better Access, this is a fight we unfortunately are unlikely to win.

http://www.acmhn.org/news-events/budget

There is reference to the Rural General Practice Grants Program, where grants are provided to rural general practices to build infrastructure, increase levels of training and teaching and more opportunities to inform rural communities about healthy living. The grants of up to $300,000 from the government must be matched by the practice. It now states that patients will have access to GP’s allied health professionals, Aboriginal health practitioners and nursing practitioners (I can’t tell if they mean practicing nurses or nurse practitioners) with increased levels of teaching and training.

The comment I have made is that it’s not a very humanitarian budget. We are again seeing people on the Disability Support pension (DSP) targeted, which impacts on the people we care for as mental health nurses. Over the next 3 years up to 90,000 DSP recipients will have their DSP eligibility reviewed for their capacity to work. We know a significant number of these people will be people living with a mental illness, and it is seems to be an issue which comes up before an election.

There are also proposed changes to university fees in a discussion paper accompanying the budget, which include:

  • Increasing student fees but with limits on how much can be charged; 
  • Allowing universities to set their own fees for some elite courses; 
  • Requiring students to pay back their loans faster after graduating;
  • Recovering HECS debts from deceased estates; and
  • Retaining a 20 per cent cut to university course funding.

These are just points raised in a discussion paper not in the budget, however any such changes will have an impact on people making a decision about what they study and impact on people on lower incomes. This impacts all of us in the health professions, particularly attracting students to study and in particularly undertaking post-graduate studies. This links to comment from Universities Australia. https://www.universitiesaustralia.edu.au/Media-and-Events/media-releases/Budget-cuts-to-university-equity-programme-deeply-disappointing--Universities-Australia#.VylfD00w-70

If there is any other news or updates we will provide them to you. There is a useful summary of the health budget on The Conversation which I have included a link to below.

https://theconversation.com/federal-budget-2016-health-experts-react

Will keep you posted.

 

7 April 2016 - Excerpt from Kim's CEO Update

The Mental Health Reform agenda continues to change. We are continuing to meet with the Primary Health Networks (PHNs) to discuss the role of mental health nurses and the work they have been undertaking through the MHNIP.

The Department of Health’s Mental Health Reform Stakeholder Group has now met twice to provide advice and feedback on the guidance documents being provided to the PHNs. It is envisaged that this group will continue to meet over the course of this year.

The group will be charged with providing input into the governance advice being developed for the PHNs. There continues to be more that we don’t know than what we do know. We are working with the Department of Health, the PHNs, and a small working group of MHNIP nurses to develop models of MHNIP that could work in the new PHN structures. We have developed a section the website to keep you all updated on the Mental Health Reforms at http://www.acmhn.org/news-events/mental-health-reform.

3 March 2016 - Update included in Tuesday Times 
Mental health and the PHNs - an update from the Department

The Department of Health has provided an update to the PHNs regarding the implementation of the mental health reforms. The update includes information about:

  • Needs assessment and planning
  • Approach to mental health needs assessment and planning.
    • 2015-16 Requirements 
    • Mental Health Needs Assessment
  • Regional operational Mental Health and Suicide Prevention Plan
  • 2016-17 Requirements 
    • Mental Health Needs Assessment
    • Mental Health Activity Work Plan
    • Regional Mental Health and Suicide Prevention Plan – developed with LHNs and other stakeholders
  • Update on other developments in mental health

For the full update visit:
http://www.health.gov.au/internet/main/publishing.nsf/Content/PHN-Circular2_Mental

1 March 2016 – Update sent to the Primary Health Care email list regarding the Mental Health Reform Stakeholder Group meeting

The below information was included for this update:

Kim Ryan attended the Mental Health Reform Stakeholder Group meeting on 22 February. Out of the meeting, the Department of Health has provided the below information to update the sector and this link to information presented on the day. 

Since the Government’s Response to the Review of Mental Health Programmes and Services was announced on 26 November 2015, implementation arrangements have progressed across key elements of the Government’s reform package.

  • Importantly, funded organisations were provided with advice in December 2015 about funding arrangements to apply to their projects from 1 July 2016. This includes Mental Health Nurse Incentive Programme, Partners in Recovery (refer below and attached), Day to Day Living, Mental Health in Rural and Remote Areas, Access to Allied Psychological Services, Suicide Prevention, headspace and the Early Psychosis Programme.
  • There will be a period of transition as existing funding arrangements between the Department and organisations are replaced by commissioning arrangements through PHNs. The Department is talking directly with affected organisations and PHNs to support effective transition arrangements. 
  • Effort is focusing on the priorities for 2016-17 implementation, including the expanded role for PHNs, programme transition arrangements, development of new suicide prevention arrangements and child and youth arrangements.
  • The level of funding flexibility from 1 July 2016 will vary across programme areas and in general this move will occur gradually, with many arrangements for delivery of services remaining effectively unchanged in 2016-17. A phased implementation approach over the next three years is being used to implement the more complex aspects of the reform package, including clinical care coordination packages for severe and complex mental illness.
  • A package of detailed guidance material is being developed to assist PHNs in the successful delivery of system change reforms. The guidance material is intended to support the delivery of key mental health objectives while allowing for flexibility and innovation. It is anticipated the detailed guidance package will be provided to PHNs in late March 2016.

To further support implementation of the reform package, a Mental Health Reform Stakeholder Group has been established to support sector engagement, inform implementation issues and enable feedback to the Department and PHNs. The Group has discussed the importance not only of providing detailed guidance to PHNs, but also of ensuring information flows over time to the broader non government sector about reforms, and to support mental health professionals as partners in implementation of the reform process. 

PHN lead sites are also being established to trial more complex aspects of the stepped care approach and to inform broader roll out in later years. An Expression of Interest process has been undertaken to select the lead sites and applications are currently being assessed. Selection of sites will aim to provide coverage across multiple jurisdictions and across metropolitan and rural areas, and enable development of: severe packages of care (including for youth); low intensity service models; and innovative models of stepped care.

Extension of the Partners in Recovery programme

The PIR programme has been extended for up to three years to support the transition of programme funding to the National Disability Insurance Scheme (NDIS). National rollout of the NDIS commences from 1 July 2016, with full rollout to be achieved by 2019-20.

The extension will ensure service continuity for programme clients until NDIS rollout is completed in each jurisdiction. Funding arrangements will take into account the timeframes for transition of eligible clients to the NDIS and implementation of continuity of support arrangements for clients found not eligible for the NDIS.

The Department will work closely with organisations to support ongoing service delivery and the transition of programme clients to the new arrangements.

  • PIR funded organisations will continue to be block funded by the department through the transition. Programme contributions to the NDIS will be ‘in-kind’ during this time.
  • Each PIR funded organisation will support the transition of eligible programme clients to the NDIS in line with the transition schedule for their jurisdiction.
  • PIR Organisations will continue cross-sector collaboration to improve the service system for people with severe and persistent mental illness with complex, multi-agency needs.
  • System reform and capacity building activities will take into account the Australian Government response to the national review of mental health programmes and services and NDIS rollout.
  • Existing PIR boundaries will be maintained during NDIS transition. 

Further information on the funding extension process will be provided to PIR Organisations, together with programme guidelines for the transition period, in March 2016.


23 February 2016 - Update included in Tuesday Times
MHNIP Guidelines

The Federal Government's mental health reforms will create change for the Mental Health Nurse Incentive Program (MHNIP). The Deparment of Human Services has updated the MHNIP Guidelines page with the latest information about the process.

You can access the information on the Department's website at
https://www.humanservices.gov.au/health-professionals/enablers/mental-health-nurse-incentive-programme-guidelines.

Last week the Department of Health also issued an update on MHNIP. You can access the update online at
http://www.acmhn.org/images/stories/News/180216_MHNIPupdate.pdf

22 February 2016 – Update sent to the Primary Mental Health Care email list with information from the Department of Health on how the mental health reforms through PHNs will apply to MHNIP
This document was ciruclated.

10 February 2016 – Update from Kim Ryan, ACMHN CEO in CEO Update on mental health reforms
The update notes the following key points:

A very productive and positive meeting was held with Health Minister Sussan Ley’s Adviser on mental health. The adviser was very supportive of the Mental Health Nurse Incentive program (MHNIP) and the role of mental health nurses more generally. The meeting included a discussion that mental health nurses would be supportive of much more flexibility about what they can do under MHNIP and for them not to be limited to what the guidelines currently say, particularly where it related to their scope of practice. We know mental health nurses can do much more than the guidelines indicate at the moment.

It was clear from the meeting that the Government intends to have a completely flexible approach to the funding once it transitions to the flexible funding pool. The pool will be managed by the Primary Health Networks (PHNs) and is estimated to amount to $370m in 2017/2018. It is still unclear how this will all work and what the commissioning process for MHNIP will look like.

Meetings have been held with a number of PHNs to discuss how the commissioning may work, and to inform them of how MHNIP works. Some of them, such as the NT, don’t have MHNIP at present so it’s important to fill them in. We are meeting with as many PHNs as possible.

For more information about the mental health reforms visit http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-review-change.

Meeting held with the Mental Health Services Branch of the Commonwealth Department of Health. We raised and sought clarification around a number of issues including MHNIP and the mental health reforms.

We let them know that there has been a great deal of discussion between the mental health nurses currently working in MHNIP about how the reforms are going to affect their work and the clients. It was noted that the Department is very keen to work with the ACMHN on the reform process for MHNIP, and asked us to pass them information and issues which come up through discussions with the PHN and the MHNs. We offered to develop guidelines on how MHNIP might work in the new commissioning role of the PHNs and they agreed this would be helpful.

The Department has written to all PHNs providing the contacts for MHNIP providers, and mental health nurses were encouraged to contact the PHN in their area. From discussions with the PHNs it was clear that they would be very happy to meet MHNs in their area.

In line with the mental health reforms the Commonwealth Government is establishing a Mental Health Reform Stakeholder Group. I have very little information around the role or activities of the group at the moment, but the first meeting will take place on 22 February 2016. Usually these are confidential groups, but I will keep you all informed as best I can.

 

3 February 2016 – Update from Kym Ryan, ACMHN CEO to Primary Mental Health Care email list on the mental health flexible funding pool with PHNs
The update notes the following key points:

  • The Department of Health is still working through the changes
  • The flexible funding pool means that the funds associated with a number a program such as MHNIP, ATAPS, Support for Day-to-Day Living in the Community, Headspace, Personal Helpers and Mentors (PHaMs), Mental Health Services in Rural and Remote Areas (MHSRRA) will all be rolled in to one pool for the PHN to use as they have determined through their scoping of what the local community needs are.
  • The PHN will be able to commission services from who is available and can provide a service they are looking for, and MHNIP as it now exists may not continue in that format for the future including that PHNs may be able to commission services from a variety of people, and eligibable organisations as we know them now might not be required
  • May need to consider how mental health nurses can get together in a consortia type arrangement, as it might be difficult for a PHN to commission from every individual nurse working in MHNIP.
  • The Department of Health are working to achieve a more equitable distribution of MHNIP funding across the PHNs so that PHNs across the country can include mental health nurse services.
  • The estimated Flexible Funding Pool in 2017-18 is $370m
  • Some PHN are currently looking at how they can provide MHNIP we have already spoken with the NT who want to provide MHN service but currently don’t because they haven’t had a nurse and are considering how it might work in a remote area.
  • It is our continued goal to meet with the PHN’s and highlight the work of mental health nurses and we will continue to work with the Department of Health to look at how this will work in the future for PHN’s, mental health nurses and the community.
  • This link outlines the time frames - http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-review-change

 

2 February 2016 – Update from Kim Ryan, ACMHN CEO to Primary Mental Health Care email list on meeting with the Department of Health
As I indicated earlier in the week Amanda and I met with Department of Health today, the Mental Health Services Branch. We raised and sort clarification around a number of issues around MHNIP as well as the Mental Health Reforms.

We let them know that there has been a great deal of discussion between the mental health nurses currently working in MHNIP about how the reforms are going to affect their work and the clients they work with. Firstly, I can let you know that the Department are very keen to work with the ACMHN on the reform process for MHNIP, including for us to pass on to them information and issues which come up through the process. They are also seeking our advice on developing the guidance that will go to PHNs about the changes and how mental health nursing working in primary care and commissioning through the PHN’s will look in the future. I will be giving more thought about that and will indeed seek advice as we go along.

There are still many details being worked through including around the guidance that will be provided to PHNs and the support that will be provided to them, but we have been assured that the Department is in regular contact with PHNs, including fortnightly meetings, and that they will be working with the PHNs through the whole transition process, particularly those that are less experienced or in a more difficult position. Some of the PHN’s we have spoken to are clearly more organised and mature than others and this is probably because some were Medicare locals.

It was confirmed that the timeframe for the flexible pool to start is 2017-18, but that they expect the transition will be an incremental process and they want to ensure the process is done properly. As for now the guidelines for MHNIP haven’t changed and they are aware that some PHN’s are commissioning services directly from nurses and while that isn’t really the intention in the future they understand that that is what will happen during the transition phase.

The Department has written to all PHNs providing the contacts for MHNIP providers, so again we would encourage you to contact the PHN in your area as this letter will give them a further prompt. As I have said before, we see this reform process as an opportunity to direct PHNs and the Department as to how we think MHNIP should work and encourage PHNs who do not have mental health nurses in their area to see what an essential service this is. They once again reinforced that they want mental health nursing services more broadly spread across the country and in places where there are no services like the NT.

I think they are looking at a loosening of guidelines and provide greater opportunities for nurses, but we shall see.

The Department have said they will provide information and updates to the ACMHN, and we have said we will also do the same for them. One of the good things about this reform process is it seems that everyone involved is willing to work together to make these changes work, and we will be doing the same. I think the DOH need our help which of course we are happy to provide.

We want to work closely with the DOH to take full advantage of opportunities for nurses to work across many other areas and to their full scope of practice.

All in all I felt it was a very positive meeting

Please keep in touch as any issues emerge let us know so we can feedback to the DOH.

 

20 January 2016 – Update from Kim Ryan, CEO ACMHN to the Primary Health email list providing an update on the mental health reforms
To give you a quick update on the mental health reforms, on 19 January Amanda and I met with Minister Sussan Ley’s adviser on mental health. It was a very positive and productive meeting - he was very supportive of the MHNIP and the role of mental health nurses more generally. As I’ve mentioned in previous CEO Updates, I have also started meeting with PHNs across the country.

It was clear from the meeting with the Minister’s adviser that the intent of the Government is to have a completely flexible approach to the funding once it transitions to the flexible funding pool. This would essentially mean that PHNs establish their own processes of commissioning services. It is unclear, however, how the transition to the flexible pool will occur and the exact timeframe for this. There is an acknowledgement that there will need to be some level of guidance for PHNs through this transition, and we have agreed to work with the Government to look at what those transition arrangements might be for MHNIP.

Currently the PHNs are funded to continue with the MHNIP through a commissioning model – what this looks like is not exactly clear. I know from some of you that some MHNs have already made arrangements with the PHNs for MHNIP services.

There is strong support for mental health nurses and MHNIP from the Minister’s office, and for providing opportunities to look at different ways mental health nurses may be able to work with PHNs. I mentioned to Minister Ley’s adviser that mental health nurses would be supportive of much more flexibility about what they can do under MHNIP and for them not to be limited to what the guidelines currently say, particularly where it related to their scope of practice. We know MHNs do much more than the guidelines indicate at the moment. However, in order to support the mental health nurse workforce and delivering quality mental health care to consumers, some level of guidance to PHNs is needed.

The support we’re noting from the PHNs and from the Minister’s office may offer the opportunity we have long been calling for to allow mental health nurses to work to their full scope of practice. We will be working through all available opportunities to do this, and all initial discussions indicate this will be welcomed.

I am in the process of organising a meeting with the Department of Health to discuss MHNIP and the mental health reforms further, and I will also be keeping in frequent contact with the Minister’s office. I think there a number of things that the Government are not clear on yet, and in the meeting with the Minister’s office we raised a few issues that they seemed keen to investigate further.

I fully understand there is concern about the mental health reform changes particularly relating to the MHNIP, and we have made it clear that the ongoing uncertainty the nurses (and to a lesser extent, doctors) have had to work with over a number of years is unfair for all involved.

I think there are opportunities for mental health and nurses moving forward and we will need to work together to provide guidance and clarity to the Government and the PHNs on the role of MHNs. We’ll also start looking again at what the MHNIP evaluations and the National Mental Health Commissions’ reports indicated on how we can enhance the program.

Amanda Bresnan, our new Policy and Stakeholder Engagement Manager, is taking the lead on this work for the College. We will be continuing to keep you in the loop about the process through CEO Updates and our regular member communications, but if you would like to talk to us in more detail please get in touch with Amanda or myself in the national office.

 

15 January 2016 – Update from Kim Ryan, CEO ACMHN to Primary Mental Health Care email list regarding meetings with the Minister for Health’s Office, the Department of Health and PHNs
Kim Ryan provided an update on meetings being arranged and held with PHNs, including that the PHNs were very supportive of MHNIP; and meetings being held with the Minister for Health’s office and the Department of Health. This noted that issues around the uncertainty of the new arrangements would be raised.

 

22 December 2015 - Update included in Tuesday Times
Mental health reform in rural and remote Australia

On 17 December 2015 the National Rural Health Alliance held a webinar talking about the rural and remote implications of the Government's intended mental health reforms. The speakers were Ian Hickie AM, Mental Health Commissioner; Frank Quinlan, Mental Health Australia, and Russell Roberts, a rural and remote mental health service consultant.

A recording of the presentation and the slides will soon be available on http://ruralhealth.org.au/

 

1 December 2015 - Update included in Tuesday Times
Mental Health Reform: It's happening!

On Thursday 26 November 2015 Prime Minister Malcolm Turnbull and Health Minister Sussan Ley announced a structural reform package for mental health. Details about the reforms are still being announced, however, the Government's response to the Review of Mental Health Services and Programmes, and a factsheet about the reforms can be accessed on the Department of Health website at
http://health.gov.au/internet/main/publishing.nsf/Content/mental-review-response.

The College is still discussing the impact of the reforms for mental health nurses and MHNIP with the Department. We noted in our initial response to the announcement that we are keen to work with the Government and the Primary Health Networks to ensure that nurses are involved in the implementation and evaluation of the changes. You can listen to Kim's interview with Nursing Review on the reforms on the Nursing Review SoundCloud.


26 November 2015 - ACMHN Press Release & media coverage

Additional CEO Updates

Please visit this page for CEO Updates prior to 15 January 2016 - http://www.acmhn.org/news-events/ceo-updates - please note that this page is restricted to ACMHN members.

Comments from other organisations:

The comments below come from some of the key stakeholders in the Australian mental health sector. This list is a snapshot only and may not be the current position of the organisation listed.

Mental Health Australia - https://mhaustralia.org/our-work/mental-health-reform

Black Dog Institute - http://www.blackdoginstitute.org.au/newsmedia/newsdesk/index.cfm

Young and Well Cooperative Research Centre - http://www.youngandwellcrc.org.au/plugging-technology-into-mental-health-system-a-no-brainer/

MindHealthConnect - http://www.mindhealthconnect.org.au/news/mental-health-reforms-announced

AMA - https://ama.com.au/psychiatrists-newsletter/mental-health-reform-1

Headspace - http://headspace.org.au/news/headspace-statement-on-mental-health-reform-package/

RichmondRPA - https://www.richmondpra.org.au/richmondpra-applauds-commonwealth-mental-health-reforms

AASW - https://www.aasw.asn.au/practitioner-resources/mental-health-reform-2016

OECD - http://www.oecd.org/australia/australia-should-build-on-the-mental-health-reform-to-strengthen-employment-outcomes-of-people-with-mental-health-issues.htm

OzHelp Foundation - https://ozhelp.org.au/ozhelp-welcomes-mental-health-reform-package-but-cautions-against-over-reliance-on-digital-tools/