Australia's National Mental Health Strategy and Deinstitutionalization: Some Empirical Results

2005 ◽  
Vol 39 (11-12) ◽  
pp. 989-994 ◽  
Author(s):  
Darrel P Doessel ◽  
Roman W Scheurer ◽  
David C Chant ◽  
Harvey A Whiteford

Objective: To determine the role of the National Mental Health Strategy in the deinstitutionalization of patients in psychiatric hospitals in Queensland. Method: Regression analysis (using themaximumlikelihood method) has been applied to relevant time-series datasets on public psychiatric institutions in Queensland. In particular, data on both patients and admissions per 10 000 population are analysed in detail from 1953–54 to the present, although data are presented from 1883–84. Results: These Queensland data indicate that deinstitutionalization was a continuing process from the 1950s to the present. However, it is clear that the experience varied from period to period. For example, the fastest change (in both patients and admissions) took place in the period 1953–54 to 1973–74, followed by the period 1974–75 to 1984–85. Conclusions: In large part, the two policies associated with deinstitutionalization, namely a discharge policy (‘opening the back door’) and an admission policy (‘closing the front door’) had been implemented before the advent of the National Mental Health Strategy in January 1993. Deinstitutionalization was most rapid in the 30-year period to the early 1980s: the process continued in the 1990s, but at amuch slower rate. Deinstitutionalization was, in large part, over before the Strategy was developed and implemented.

2002 ◽  
Vol 180 (3) ◽  
pp. 210-215 ◽  
Author(s):  
Harvey Whiteford ◽  
Bill Buckingham ◽  
Ronald Manderscheid

BackgroundAustralia commenced a 5-year reform of mental health services in 1993.AimsTo report on the changes to mental health services achieved by 1998.MethodAnalysis of data from the Australian National Mental Health Report 2000 and an independent evaluation of the National Mental Health Strategy.ResultsMental health expenditure increased 30% in real terms, with an 87% growth in community expenditures, a 38% increase in general hospitals and a 29% decrease in psychiatric hospitals. The growth in private psychiatry, averaging 6% annually prior to 1992, was reversed. Consumer and carer involvement in services increased.ConclusionsMajor structural reform was achieved but there was limited evidence that these changes had been accompanied by improved service quality. The National Mental Health Strategy was renewed for another 5 years.


2007 ◽  
Vol 13 (3) ◽  
pp. 77 ◽  
Author(s):  
Julie Henderson

This paper explores policy documents published as part of the National Mental Health Strategy for ideas about mental health promotion and prevention, to determine the extent to which these documents adopt a primary health care approach. Discourse analysis was undertaken of key policy documents to discover the manner in which they discuss mental health promotion and prevention. Three points of departure are identified. The first of these is a focus on social and biological risk factors that manifest at an individual rather than at a social level, effectively drawing attention away from social inequalities. These documents also primarily target a population that is viewed as being "at risk" due to exposure to risk factors, shifting attention from strategies aimed at improving the health of the population as a whole. A final difference is found in the understanding of primary health care. Recent policy documents equate primary health care with the first level of service delivery in the community, primarily by general practitioners, shifting the focus of care from mental health promotion with the community to early intervention with those experiencing mental health problems. This is supported by the incorporation of a biomedical understanding into mental health prevention. While recent mental health policy documents re-assert the need for early intervention and health prevention, the form of mental health prevention espoused in these documents differs from that which informed the Declaration of Alma Alta, Ottawa Charter for Health Promotion and World Health Organization's Health for All strategy.


2001 ◽  
Vol 35 (5) ◽  
pp. 639-646 ◽  
Author(s):  
Jane Pirkis ◽  
Helen Herrman ◽  
Isaac Schweitzer ◽  
Alison Yung ◽  
Margaret Grigg ◽  
...  

Objective: In Australia, mental health services are delivered by a complex web of publicand private-sector providers. There is a growing recognition that linkages between these groups are not optimal, and a concern that this may lead to poor outcomes. This paper illustrates a conceptual framework for developing, implementing and evaluating programmes concerned with linkages. Method: Drawing on theoretical and practical literature, this paper identifies different levels of integration, issues in evaluating programmes to address poor linkages, and features of useful evaluations. Within this context, it describes the method by which the Public and Private Partnerships in Mental Health Project (Partnership Project) is being evaluated. Conducted by St Vincent's Mental Health Service and The Melbourne Clinic, this is one of several Demonstration Projects in Integrated Mental Health Care funded under the National Mental Health Strategy. Results: Collaboration is hard to conceptualize and collaborative programmes usually have many players and components, and tend to operate within already-complex systems. This creates difficulties for evaluation, in terms of what to measure, how to measure it, and how to interpret findings. In spite of these difficulties, the illustrative example demonstrates a model for evaluating collaborative programmes that is currently working well because it is strongly conceptualized, descriptive, comparative, constructively sceptical, positioned from the bottom up, and collaborative. Conclusions: This model, or aspects of it, could be extended to the evaluation of other mental health programmes and services that have collaborative elements.


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.


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.


BJPsych Open ◽  
2021 ◽  
Vol 7 (4) ◽  
Author(s):  
Monica Davies ◽  
Luke Hogarth

Background The UK went into nationwide lockdown on 24 March 2020, in response to COVID-19. The direct psychiatric effects of this are relatively unknown. Aims We examined whether the first UK lockdown changed the demographics of patients admitted to psychiatric hospitals (to include gender, legality, route of admission and diagnoses), independent of seasonal variation.. Method We conducted an anonymous review of psychiatric admissions aged ≥18 years in the 6-month period after the announcement of the first UK lockdown (March to August 2020), and in the previous year (March to August 2019), in Kent and Medway NHS and Social Care Partnership Trust in-patient facilities. The number of admissions were compared, along with factors that may help to explain the psychological effects of national lockdown. Results There was no significant increase in total number of admissions or the gender percentage. However, there was a 11.8% increase in formal sectioning under the Mental Health Act 1983. This increase was sustained and statistically significant across all 6 months. A sustained decrease in admissions via the crisis team was also observed as being statistically significant. Separate diagnoses saw changes in percentage of admissions between March and May. The most statistically significant was schizophrenia admissions for men in April (18.7%), and women in March (18.4%). Conclusions Our findings highlight the effect of COVID-19 on the legal status of psychiatric admissions, and emphasise the importance of having a robust, adaptable and open psychiatric service that caters to the ongoing needs of patients, regardless of government restrictions.


Sign in / Sign up

Export Citation Format

Share Document