‘Victoria on the Move’: Mental Health Services in a Decade of Transition 1992-2002

2003 ◽  
Vol 11 (1) ◽  
pp. 62-67 ◽  
Author(s):  
Graham Meadows ◽  
Bruce Singh

Objective: Australia adopted a national mental health strategy in the early 1990s and each State has had to go through its own implementation process in the intervening years. The present paper describes the process of reform in services in Victoria, and ventures explanations as to why the process may have been more comprehensive and successful than in other States. Conclusions: Victoria adopted a Statewide ‘framework’, defining structural elements of area-based services, with rational resource distribution. A transitional process involving a population health approach and relatively rigid implementation of a tightly specified service framework, within a political environment that favoured strong health services management, was successful in achieving desired structural reforms in this State. This was undoubtedly at the cost of promoting a model of public mental health service delivery that is generally rationed so as to accept only a restricted range of types of referral. New initiatives from the current State government are explicitly targeted to correcting this situation.

1997 ◽  
Vol 5 (4) ◽  
pp. 167-169 ◽  
Author(s):  
Gordon Parker

In the last few years, the Commonwealth and many of the states have worked at developing principles of service delivery for the public mental health sector. Whiteford [1] has described one key initiative, the National Mental Health Policy, with the initial five-year Strategy due to end in mid-1998. The Strategy was developed collaboratively, involving and respecting the views of many of the key groups, and a number of impressive documents and policy decisions have been developed. Many of its central components represent important advances, are non-controversial and are generally accepted, and are presumabl immutable planks that will underpin the next phase of the Strategy – subject to its funding. As for any strategy, there are issues that may benefit from review and revision, and I would like to focus on service models and funding.


1996 ◽  
Vol 4 (6) ◽  
pp. 322-323
Author(s):  
Marilyn Wise ◽  
Carole Wood ◽  
Harvey Whtteford

In 1994, Australian Health Ministers agreed that promoting mental health and preventing mental illness was one of the four priority national health goals [1], Australia's National Mental Health Strategy includes among its aims the promotion of mental health and prevention of mental illness [2]. To date, the main focus of activity under the Strategy has been on the structural reform of the mental health service delivery system.


2019 ◽  
Vol 17 (2) ◽  
pp. 29-31
Author(s):  
Sarah J. Parry ◽  
Ewan Wilkinson

Mental health services in Cambodia required rebuilding in their entirety after their destruction during conflict in the 1970s. During the late 1990s there was rapid growth and development of professional mental health training and education. Currently, basic mental healthcare is available primarily in urban areas and is provided by a mixture of government, non-government and private services. Despite the initial rapid growth of services and the development of a national mental health strategy in 2010, significant challenges remain in achieving an acceptable, standardised level of mental healthcare nationally.


2007 ◽  
Vol 41 (10) ◽  
pp. 784-791 ◽  
Author(s):  
Timothy Wand ◽  
Kathryn White

The purpose of the present paper was to review the current models of mental health service delivery used in the emergency department (ED) setting. A search was conducted of the nursing and medical literature from 1990 to 2007 for relevant articles and reports. Consideration was also given to the global and local context influencing contemporary mental health services. Wider sociopolitical and socioeconomic influences and systemic changes in health-care delivery have dictated a considerable shift in attention for mental health services worldwide. The ED is a topical location that has attracted interest and necessitated a response. The mental health liaison nurse (MHLN) role embedded within the ED structure has demonstrated the most positive outcomes to date. This model aims to raise mental health awareness and address concerns over patient-focused outcomes such as reduced waiting times, therapeutic intervention and more efficient coordination of care and follow up for individuals presenting to the ED in psychological distress. Further research is required into all methods of mental health service delivery to the ED. The MHLN role is a cost-effective approach that has gained widespread approval from ED staff and mental health patients and is consistent with national and international expectations for mental health services to become fully integrated within general health care. The mental health nurse practitioner role situated within the ED represents a potentially promising alternative for enhanced public access to specialized mental health care.


1995 ◽  
Vol 29 (3) ◽  
pp. 394-402 ◽  
Author(s):  
Gavin Andrews

Objective: The purpose of the study was to review the information in a Consultancy prepared for the National Mental Health Policy which suggested that half of the people with serious mental illnesses were untreated, while persons with “mental problems” were being overserviced by the specialist mental health services. The fate of the large group of persons with mental disorders of mid-range severity was not addressed. Method: Epidemiological data was reconciled with the service patterns of the clinical workforce and the extent of the unmet need estimated. Results: It was estimated that 25–30% of the Australian population meet criteria for a mental disorder in any year, yet less than one third will receive treatment. Of those that are treated, three quarters will receive their treatment from general practitioners and the remaining quarter will be treated by either the public mental health services, the addiction services, or private psychiatrists. The problem is that less than one half of those with serious mental disorders and only two thirds of those with chronic and disabling disorders appear to be being treated by anyone. Even if there were no slippage of services away from these serious and chronic groups of patients, there would still be a workforce shortfall, especially in rural and remote areas. Conclusions: Strategies to remedy this shortfall that involve psychiatrists, clinical psychologists and general practitioners are noted, and the need for a National Mental Health Survey to provide accurate data is stressed.


2012 ◽  
Vol 29 (2) ◽  
pp. 63-76 ◽  
Author(s):  
France Talbot

Self-administered therapies (SATs) have been promoted as a way to increase access to evidence-based mental health services. Recent meta-analyses and literature reviews suggest that SATs with clinical guidance are more effective than SATs with no contact for the treatment of anxiety and depression. However, little attention has been paid to the role of nonguidance contact, contact that does not involve the provision of assistance in the application of specific therapy techniques such as emails to encourage treatment adherence. The present article examines the impact of nonguidance contact on the outcomes of SATs for anxiety and depression. Electronic databases were searched to identify studies conducted over the past two decades by independent research teams that have tested cognitive-behavioural SATs over multiple trials. Findings suggest that the involvement or guidance of a therapist is not essential for SATs to produce significant benefits as long as nonguidance contact is provided. It is suggested that even very minimal levels of nonguidance contact increase SAT's outcomes by motivating treatment engagement and improving adherence. The benefit of SATs that can be accessed directly by large numbers of individuals and that do not require therapist involvement to ensure efficacy can potentially significantly increase the cost effectiveness and quality of mental health service delivery.


2003 ◽  
Vol 11 (2) ◽  
pp. 180-184 ◽  
Author(s):  
Chris Lloyd ◽  
Robert King

Objective: To clarify the meaning of consumer and carer participation in mental health services, to identify reasons why consumer participation is important both to consumers and to services, and to discuss barriers to participation and ways of overcoming these barriers. Conclusions: Consumer and carer participation has been promoted as part of the National Mental Health Strategy and has the potential to empower consumers and their carers and to improve mental health services. Barriers to consumer participation include professional staff attitudes and resource allocation. Guidelines are provided to assist services to address these barriers and increase the level of consumer and carer participation in both clinical decision-making and service development.


2003 ◽  
Vol 37 (6) ◽  
pp. 735-740 ◽  
Author(s):  
Brian Draper ◽  
Tanya Jochelson ◽  
David Kitching ◽  
John Snowdon ◽  
Henry Brodaty ◽  
...  

Objective: To compare the perceptions of aged care services, adult mental health services and mental health services for older people regarding aspects of mental health service delivery for older people in New South Wales, Australia. Method: The NSW Branch of the Faculty of Psychiatry of Old Age in association with the NSW Centre for Mental Health, sent a postal survey to all aged care services, adult mental health services and mental health services for older people in NSW. The survey canvassed issues ranging across service profiles, regional variations, availability of resources, processes of care, views on working relationships between services, difficulties and gaps experienced, and ways to improve co-ordination and service delivery. Clinical issues such as the management and practice of psychiatric disorders of old age, educational/training requirements and skill and experience in working with older people were explored. Results: An overall response rate of 86% was achieved, including 95% from aged care services (n = 58), 74% from adult mental health services (n = 62) and 90% from mental health services for older people (n = 20). Only 59% of aged care services and adult mental health services considered that their local mental health services for older people provided an adequate service; resource and budget limitations were portrayed as the main constraint. Mental health services for older people varied widely in structure, settings and activities undertaken. Access to mental health beds for older people was also variable, and alongside staffing levels was considered problematic. Lack of staff training and/or inexperience in psychogeriatrics posed a challenge for aged care services and adult mental health services. Conclusion: Relationships between aged care services, adult mental health services and mental health services for older people are affected by lack of access to psychogeriatric staff, resource limitations of mental health services for older people, and inadequate liaison and support between the service types. Joint case conferences, education, increased funding of mental health services for older people, and cross referrals were considered ways to address these issues.


Author(s):  
JOSEPH P. MORRISSEY ◽  
HOWARD H. GOLDMAN

Three major cycles of reform in public mental health care in the United States—the moral treatment, mental hygiene, and community mental health movements—are described as a basis for assessing the shifting boundaries between the mental health, social welfare, and criminal justice systems. Historical forces that led to the transinstitutionalization of the mentally ill from almshouses to the state mental hospitals in the nineteenth and twentieth centuries have now been reversed in the aftermath of recent deinstitutionalization policies. Evidence is suggestive that the mentally ill are also being caught up in the criminal justice system, a circumstance reminiscent of pre-asylum conditions in the early nineteenth century. These trends shape the current mental health service delivery system and the agenda for policy-relevant research on issues involving the legal and mental health fields.


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