18-19 February 2016

Attendees:
Josephine Anderson, Thomas Brideson, Karen Burns (Chair), Maria Cassaniti, Sue Cripps, John Feneley (NSW Mental Health Commissioner), Tim Heffernan, Cathy Kezelman, Jenni Campbell, Brian Pezzutti, Vince Ponzio, Yvonne Quadros, Alan Woodward, Eugene McGarrell, Erica Roy, Bradley Foxlewin (NSW Deputy Mental Health Commissioner), Fay Jackson (NSW Deputy Mental Health Commissioner), Robyn Shields – Day 1 (NSW Deputy Mental Health Commissioner)

Apologies:
Adrian Piotto (Mental Health Commission of NSW)

Secretariat:
Elizabeth Burford (Mental Health Commission of NSW), Samantha Knaggs (Mental Health Commission of NSW)

Guests:
Sarah Hanson, (Executive Officer, Mental Health Commission of NSW), Catherine Lourey (Special Advisor, Mental Health Commission of NSW), Julie Robotham (A/Executive Director, Mental Health Commission of NSW), Kerri Lawrence (Manager Strategic Engagement and Innovation, Mental Health Commission of NSW), Gabrielle Lloyd – Day 1 (A/Manager Communications and Stakeholder Relations, Mental Health Commission of NSW), Carlton Quartly – Day 1 (Manager Systems Monitoring and Review, Mental Health Commission of NSW)

Facilitator:
JulieAnne Anderson - Day 2

1. Acknowledgements

  • Thomas Brideson provided an acknowledgement of country.
  • Tim Heffernan provided an acknowledgement of people with lived experience of mental illness.
  • Karen Burns welcomed attendees.
  • John Feneley outlined the purpose and aims for the workshop.

2. Environmental scan

Sarah Hanson provided background on the changes in the policy environment that have been identified by the Commission as having a potential impact on the Living Well reforms. These included release of the Premier priorities, social housing reform, domestic and family violence initiatives, changes to the Mental Health Act 2007, Aboriginal health reforms, commencement of the Disability Inclusion Act 2014, and a number of changes at the national level.

Participants identified or emphasised the following issues:

  • A lot more work needs to be done to build relationships across and between mental health, domestic violence and homelessness.
  • The current focus on child abuse and domestic and family violence needs to be translated into real action.
  • There is concern about the impact on low cost aged care facilities of the proposed requirement to have registered nurses in all aged care facilities.
  • E-mental health, and the role of technology more broadly, is relevant across all areas of mental health reform. Policies and processes are lagging far behind the technology.
  • Big data presents big opportunities for service planning and provision. The sector needs to get better at accessing, linking and using this resource.
  • Findings that wellbeing is declining for children and young people.
  • The need/ increasing trend to develop consortia and pool joint funds to deliver services and prospect of for-profit providers entering this space.
  • Suicide prevention strategies.

3. Commonwealth’s response to the national review of mental health programs and services

Catherine Lourey gave a presentation on the Commonwealth’s response to the National Review of Mental Health Programs and Services.

ACTION 2016.01: Members to provide regular feedback on the operation of PHNs in their areas.

4. National Disability Insurance Scheme (NDIS)

Kerri Lawrence provided a presentation on the NDIS.

Discussion centred around three main areas:

  • Survival for NGOs including issues around adequate funding and the burden of complying with complex regulatory frameworks.
  • The possibility of, or challenges facing, consumer run services entering the NDIS sector.

5. The Commission's year in review

Julie Robotham presented a paper on the Commission’s year (2015) in review.

The main focus of feedback was how Council members and the Deputy Commissioners can assist with the Commission’s community visits.  The main points to come out of this discussion were:

  • The Commission needs the support of Council members when going into communities.
  • Visits should not be just about key people, but also about interesting people who might have a different point of view.
  • When engaging with consumers it is important to have linkages back to the work of the Commission and pathways for them to engage in the broader reform conversation.
  • The Commission needs to ensure that there is a way for people outside the city to be included in Commission activities like No Offence by making them available online.

6. Monitoring and Review

Carlton Quartly and Catherine Lourey presented a paper on the Commission’s monitoring program and the Progress Report 2015.  Participants discussed the following issues:

  • Implications of using whole of population data versus drilling down to population sub-groups.
  • The advantage of a feedback gathering mechanism that doesn’t pre-determine questions, but allows service users to shape the information they give.

7. 2016/2017 Business Plan and priority areas of work

The Commissioner presented a paper on the 2016/2017 Commission business planning process.

JulieAnne Anderson facilitated a brainstorming session that resulted in participants identifying priority areas for mental health reform in the current environment. The top six issues were:

  • Supporting emerging workforces
  • Peer and consumer design and delivery of care
  • Integrated services
  • Social inclusion
  • Trauma informed practice
  • Improving community based services.

Notes are provided on the discussion that was generated around each topic.

SUPPORTING EMERGING WORKFORCE

(Aboriginal mental health workforce and peer workforce)

  • The workforce type and number needs to be linked to the model of care.
  • Gaps in current activity include:
    • Gathering data on the actual size of the workforce and establishing targets. 
    • Developing strategies to promote emerging workforces within the government and community sectors.
    • Reporting on the data, evidence, and good and bad practice. 
    • Describing and showcasing models for different populations. 

PEER/CONSUMER DESIGN AND DELIVERY OF CARE 

  • There isn’t a cohesive consumer voice in relation to this issue.
  • There is a need to build capacity to influence ‘person-led’ approaches.
  • Gaps in current activity include:
    • Building a case for and sharing knowledge on consumer-led/consumer-centred models of care.
    • Ensuring consumer participation in influential roles.
    • Building the peer workforce including outside the health system. 

INTEGRATED SERVICES

  • Integration is different from collaboration and colocation.
  • Need system and information/data architecture to enable integrated work approaches.
  • Need to break down the “bounded” models of care.
  • Provider funding mechanisms differ and focus varyingly on activity or outcomes.
  • The interface needs to be sustained across agencies - employers, housing, health, mental health, and GPs.
  • Integration needs to be top down and bottom up.
  • Gaps in current activity include:
    • Bringing about culture change.
    • Resolution of issues of roles and authorisation to work differently.
    • Documenting good examples and the elements of success; mapping barriers and opportunities. 
    • Piloting models of integrated services.
    • Establishing a business case related to better outcomes and value for money.

TRAUMA INFORMED PRACTICE

  • There is rhetoric around trauma informed practice, but there is not a real understanding of what it actually is and it is not embedded in service delivery.
  • Embedding trauma informed practice in service delivery is an opportunity to bring together a wide range of areas – refugee communities, workplace bullying, frontline/first responders, legal and justice issues, and violence against women.
  • Gaps in current activity include:
    • Drawing together the relevant organisations to develop the conversation.
    • Showcasing examples in which trauma informed practice is truly embedded.
    • Ensuring research is undertaken specifically to support trauma informed practice in Aboriginal communities, refugee communities, criminal justice and children.
    • Advocating to have trauma informed practice embedded in service delivery through standards.

IMPROVING COMMUNITY BASED SERVICES

  • Community based services are offered by multiple agencies at both the State and Commonwealth level. This creates problems in terms of co-ordinated and meaningful responses. 
  • Current gaps in activity include:
    • Advocacy for transparent public reporting of mental health data.
    • Advocacy for inclusion of a mental health focus in public health promotion activities, and nationally for an anti-stigma campaign.
    • Bringing together international evidence regarding what has worked in mental health promotion, to support advocacy and activity.   

SOCIAL INCLUSION

  • Exclusion can occur in multiple contexts: work, home, technology, relationships, family, town planning, cultural background and may be an important determinant of becoming unwell.
  • Inclusion is not simply the absence of stigma and discrimination.
  • Initiatives like Relationships Australia’s Neighbour Day are examples of inclusion.
  • Schools can be hubs for the social inclusion of children and families. TAFEs can be hubs for the inclusion of people who have not fared well at school.
  • Gaps in current activity include:
    • Use of wellbeing indicators in addition or as an alternative to GDP.

 8. Close of meeting

Last updated: 5 April 2017

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