Josey Anderson, Lyn Anderson, Tom Brideson, Jenni Campbell (Chair), Maria Cassaniti, John Feneley (NSW Mental Health Commissioner), Irene Gallagher, Peter Gianfrancesco, Tim Heffernan, Daya Henkel, Cathy Kezelman, Eugene McGarrell, Rod McKay, Brian Pezzutti, Jenna Roberts, Jaelea Skehan, Alan Woodward
Elizabeth Hewitt (Mental Health Commission of NSW), Louis Parry (Mental Health Commission of NSW)
Cathy Baker (Mental Health Commission of NSW), Rachel Green (LifeSpan), Niels Buus (St Vincents Hospital/University of Sydney)
- Tom Brideson provided an acknowledgement of country.
- Cathy Kezelman provided an acknowledgement of people with lived experience of mental illness. As part of this the recent death of Anthony Foster was noted. Mr Foster was an avid campaigner for survivors of child sexual abuse, and his death was noted with sadness by all.
2. Commissioner update
The Commissioner provided an update on recent highlights in the work of the Commission.
The Commissioner recently gave evidence before a hearing of the Royal Commission into Institutional Responses to Child Sexual Abuse in relation to the mental health impacts of child sexual abuse.
The Commissioner also recently gave evidence to the senate inquiry into the National Disability Insurance Scheme (NDIS).
The Commissioner recently had a productive meeting with Mr Brad Hazzard, Minister for Health, and Minister for Medical Research.
A discussion was held in relation to the Government’s announced review into seclusion, restraint and observations across the NSW mental health system. It was noted that the review is headed by the NSW Chief Psychiatrist, and that the panel will include Dr Robyn Shields (Deputy Commissioner, NSW Mental Health Commission).
3. Primary Health Networks
Jenni Campbell gave a presentation on Primary Health Networks (PHNs). Information provided included:
- There are 31 PHNs in Australia, and 10 in NSW.
- Generally, PHNs align with Local Health Districts (LHDs), but there are some border issues, such as for Albury.
- Mental health, Aboriginal health, aged care, population health, workforce and e-health are priority areas.
- PHNs are commissioners unless there is a market failure (there is a clear process for declaring a market failure). No knowledge of this having yet occurred.
- Mental health priority areas are children, young people, people at risk of suicide, people with or at risk of severe mental illness, low intensity mental health services, psychological services for hard to reach groups and Aboriginal and Torres Strait Islander people.
- The regional mental health integration plan is due in March 2018. There is an indication that these should be 3–5 year plans. These were originally due in September 2017, but an extension has been given so that the regional plans can reference the Fifth National Mental Health Plan.
- There are 10 lead sites in Australia, and 3 in NSW (Murrumbidgee, North Coast and Central and Eastern Sydney).
- PHN funds are almost completely flexible.
- PHNs have been provided with the planned National Mental Health Service Planning Framework (NMHSPF).
- The NMHSPF is an initiative of the Fourth national mental health plan, which sets an agenda for collaborative government action in mental health.
- The NMHSPF will aim to achieve a population based planning model for mental health, and will establish targets for the mix and level of the full range of mental health services.
- There are state and national suicide prevention trials underway.
- The Commonwealth has put forward a mental health advisory panel, which is intended to support PHNs.
- Murrumbidgee are looking at ways to embed lived experience at every level, including requiring services applying for tender to demonstrate they have included lived experience in the development of their proposal.
4. Suicide prevention
Cathy Baker gave a presentation on interactive suicide data, available on the Commission’s website:
- Suicide in NSW – by Aboriginal status: http://nswmentalhealthcommission.com.au/publications/suicide-in-nsw-by-aboriginal-status
- Suicide in NSW – by age: http://nswmentalhealthcommission.com.au/publications/suicide-in-nsw-by-age
Rachel Green gave a presentation on LifeSpan. Information provided included:
- There are 4 trial sites in NSW (Newcastle, Illawarra Shoalhaven, Murrumbidgee and Central Coast).
- Each site has a six month planning stage and then two years for implementation. Newcastle is in the implementation stage and Illawarra Shoalhaven is in the planning phase.
- LifeSpan have developed a rationale for program selection
- It is important to have good lines of communication, including with police and schools.
- LifeSpan facilitates the knowledge-sharing process, and hosts events to enable trial sites to come together and share information.
- It was recently announced that Black Dog Institute will receive $3 million of Commonwealth funding. The funding will enable LifeSpan to share insights learned from the trials.
- LifeSpan is looking at how the core framework changes in different contexts.
- They have entered into a partnership with the Centre for Rural and Remote Mental Health, looking at how the framework adapts for regional areas.
- The funding received will enable the framework to be adapted for the LGBTI population.
- The framework will enable a focus on Aboriginal suicide prevention.
- Two target sites will focus on LGBTI suicide prevention.
- There have been some challenges around access to data, but these are getting ironed out, which means subsequent trial sites will be better placed to conduct audits.
- The intention is that the sites will engage with workplaces and local businesses.
- LifeSpan is encouraging trial sites to form MoUs with local champions.
Alan Woodward gave a presentation on research conducted by Lifeline’s research partner, Melbourne University. Information provided included:
- The creation of PHNs provides an opportunity to look closely at suicide rates around the country.
- The data is able to show suicide rates by employment status, gender, marital status, method of suicide.
- Suicide is not limited to those of lower socio-economic status.
- The significant regional variation between factors means that localised responses are needed.
5. Statutory review
There was a discussion about the Commission’s statutory review. This is a review of the legislation, and a review of the Commission’s work.
6. Open Dialogue
Niels Buus gave a presentation on Open Dialogue. Information provided included:
- Open dialogue can be considered:
- Integrated care;
- A social network intervention; and
- A treatment philosophy.
- A one-size approach doesn’t fit all.
- The model primarily focuses on early intervention and crisis management, but can most probably be applied in all clinical settings.
- Open-ended (non-totalising) language is used. Staff talk ‘with’ rather than ‘at’ or to’ service users.
- The model aims to ensure that people are better at learning about themselves, and gives them a voice to solve their own issues.
- There are seven key principles:
- Immediate help;
- A social network perspective;
- Flexibility and mobility;
- Psychological continuity;
- Tolerance of uncertainty; and
- The model runs on the principle of ‘You’ve called the right people.’
- The available data shows positive outcomes.