EMR Mental Health Strategic Plan

Transcription

1 EMR Mental Health Strategic Plan Eastern Metropolitan Region November 2011 Department of Health

2 If you would like to receive this publication in an alternative format, please Copyright, State of Victoria, Department of Health, 2011 Published by the Eastern Metropolitan Region, Victorian Government, Department of Health, Melbourne, Victoria. This publication is copyright, no part may be reproduced by any process except in accordance with the provisions of the Copyright Act 1968 Page 2

3 Contents 1. Introduction 4 2. Community Mental Health Planning and Service Coordination Initiative 4 3. Planning 5 4. Mental Health and other Support Services 7 5. Partnerships Community Consultation Issues, Opportunities and Enablers The EMR Mental Health Strategic Plan 17 Page 3

4 1. Introduction The EMR Mental Health Strategic Plan identifies opportunities to improve outcomes for young people, adults and older people with mental health issues living in the EMR by strengthening the capacity of the service system through coordinated planning and strong cross-sector partnership work. In this region, there is a diverse range of community organisations, cross sector partnerships, and different levels of government that are working towards a common goal of improving the mental health and wellbeing of people living in the Eastern Metropolitan Region (EMR). These organisations, partnerships and government programs all have responsibilities to improve outcomes for people with mental illness by supporting actions that increase the capacity of the service system to meet the care and support needs of young people, adults and older people with mental health issues living in the EMR. The EMR Mental Health Strategic Plan represents the work of the EMR Mental Health Planning and Partnership (MHPP) Steering Group and covers the goals of the EMR Community Mental Health Planning and Service Coordination Initiative (CMHPSCI) as well as other Department of Health (DH) cross program mental health activities occurring in the region. This plan provides demographic, service, partnership and community consultation information relating to mental health, outlines key mental health issues for the region, and identifies strategic objectives and actions to improve the mental health of people living in the EMR over a two year period, July 2011 to June Community Mental Health Planning and Service Coordination Initiative The Community Mental Health Planning and Service Coordination Initiative has played a major role in supporting EMR mental health planning and the identification of local priorities and actions. The Community Mental Health Planning and Service Coordination Initiative (CMHPSCI) commenced in April 2010 and aims to support funded services improve mental health outcomes for people by responding to local issues identified across a range of service sectors. The EMR MHPP Steering Group was established to provide the authorising environment and planning platform for the regional components of the initiative. It includes representation from those with mental health issues, carers, mental health services, community health services, local government, Department of Human Services and other community service organisations. The governance relationship between EMR MHPP Steering Group and other regional working groups is depicted on page 13. The EMR MHPP Steering Group has responsibilities for providing strategic leadership regarding the identification of local priorities and actions that will improve mental health outcomes for the EMR population. In 2010, it provided oversight for the initial planning and consultation phase of CHMPSCI in the EMR and focused on identifying key local issues by analysing service system information, socioeconomic and population data, and feedback from key stakeholders. A requirement of the initiative is that after supporting detailed planning and analysis, the Steering Group will endorse and provide oversight for two to four priority projects in the region that will improve mental health outcomes. The initiative provides resources to fund a fulltime System Development Manager position within each Department of Health (DH) regional office. The role of the System Development Manager is to coordinate planning and support the role of local partnerships in undertaking reform and innovation. The initiative Page 4

5 does not have other resources and it is expected that strategies such as collaborative partnerships, knowledge sharing and coordinated planning will be utilised to support and lead change processes. 3. Planning 3.1 Regional Characteristics When taken as a whole, the EMR is a relatively advantaged region. However, within the region, there are communities, age cohorts and areas of disadvantage that are particularly vulnerable. Targeted efforts to identified groups can enable good health and well being outcomes to be achieved. As of June 2008, the population of the EMR was over one million or almost or 20% of the Victorian population. The outer east includes the municipalities of Yarra Ranges, Maroondah and Knox. The inner east includes the local government authorities (LGAs) of Monash, Whitehorse, Manningham and Boroondara Disadvantage The outer east is considered to be the most disadvantaged area in the EMR as shown by a range of data including socioeconomic indicators, service access, and health risk (ABS census of Population and Housing 2006). Yarra Ranges and Maroondah are the most socioeconomically disadvantaged of the LGAs in the EMR. Evidence of disadvantage (as indicated by the lowest 20 th percentile in the state on the SEIFA index) is present throughout the region, with notable clusters in Bayswater, Croydon and Healesville. The outer east and Yarra Ranges in particular, has a higher utilisation of hospital emergency department services and a lower number of GPs per 1,000 population than the inner and central east. Access to health services is also hindered by poor infrastructure such as public transport. In particular, over 40% of the population in the Yarra Ranges do not live close to public transport. The life expectancy for males in Maroondah, Yarra Ranges and Knox is lower than the Victorian average. The Yarra Ranges has the highest incidence of all causes of ill health and disability, communicable diseases and injuries in the region. Maroondah and Yarra Ranges also have a higher proportion of mental health and alcohol and other drug (AOD) clients. The outer east experiences relatively high rates of family violence incidents. Knox has the highest rate of recorded family incidents involving Victoria Police in the region (613 per 100,000 in 2007/08). Knox had the ninth highest rate of family violence in Victoria in 2007/08. It is recognised that socio-economic disadvantage experienced by many people with severe mental illness is linked with poor living conditions. This can be a significant contributing factor to poor physical health Aboriginal population Almost 20% of Melbourne s metropolitan Aboriginal population live in the EMR. The Shire of Yarra Ranges has the highest concentration of Aboriginal people (924 people, 32.5% of the EMR Aboriginal population). A number of Aboriginal people also live in Knox (520 people). More than half of the region s Aboriginal population is under 25 years old. Access to culturally appropriate services for young Aboriginal people is important for the outer east areas of Healesville and Bayswater Culturally and Linguistically Diverse Populations (CALD) Approximately 20 percent of the EMR population were born overseas in a non-english speaking country. However, the distribution of CALD communities across the region is uneven. Monash (36%) and Manningham (29%) have the highest proportion of people from non-english speaking backgrounds. Page 5

6 These percentages are at least 20% higher than the metropolitan average. More recent immigrants are likely to come from China, Malaysia and India. Older residents are more likely to come from Italy or Greece. The main languages spoken in the EMR are Greek, Cantonese, Mandarin and Italian. The outer east has relatively low proportions of people born over-seas from non-english speaking countries. However, the city of Maroondah has the second largest number of Burmese humanitarian refugees in the state and has also experienced a significant increase in the number of refugees from Sudan Ageing Population Currently, the EMR has a population that is older than Victoria and Metropolitan Melbourne. In particular, the inner east has the highest proportion of people aged over 65 (17%) in the EMR. This is well above the metropolitan Melbourne average of 13%. The outer east is expected to experience a higher growth in older persons than Metropolitan Melbourne and Victoria, and the number of older people is expected to double by Hospitals and primary health services are experiencing increased demand driven by the ageing population. For example, GPs in the EMR are seeing patients aged 65+ with a mental illness in numbers well above national benchmarks. It is worth noting that while national suicide rates have declined over the decade to an average of 10 per 100,000, the rate of suicide for the 85+ age cohort is 28 per 100, Disability People with intellectual disability experience mental health issues at twice the rate of the general population (40%). Elderly people with intellectual disability have a greater prevalence of psychiatric co morbidity than younger adults and young people with intellectual disability have been found to have 3 to 4 times more mental health issues than their peers. The rate of mental illness is also higher in children and adults with more severe intellectual disabilities. A recent review has concluded that there is a lack of expertise and experience in both mental health and disability professionals to provide quality services to people with both an intellectual disability and mental health issues Housing Research by Mind Australia, indicates that almost half of adults with a severe mental illness require single accommodation. Most people with a severe mental illness will experience a number of episodes where they are unwell and unable to work. To maintain stable housing many of these people need accommodation that is affordable for someone on a disability pension. A number of studies and initiatives also show that tenancies are more likely to be successful if psychosocial support is linked to appropriate housing. The EMR has a significant public housing shortfall for disadvantaged and homeless people in the region. EMR has 9% of Victoria s public housing stock (6,000 properties). Less than 2% of EMR s public housing properties are for non-aged singles. One bedroom private rental accommodation is rarely affordable for single adults with a severe mental illness who are on a pension. When these individuals are homeless they are often offered rooming houses or Supported Residential Services. During the Nation Building program is developing approximately 700 new properties in the EMR. This initiative is offering some housing opportunities for people with mental illness. Large developments include sites at Larissa Avenue Ringwood, Tram Road Doncaster and Burwood Highway Ferntree Gully. Page 6

7 4. Mental Health and Other Support Services Mental health service provision is the responsibility of both state and commonwealth funded services which can result in a complex and fragmented system because of multiple services, poor communication and coordination, and different funding and access requirements. Eastern Health is the major provider of clinical mental health services in the EMR and provides child and youth, adult and aged persons mental health services in the LGAs of Manningham, Whitehorse, Monash, Knox, Maroondah and Yarra Ranges. Eastern Health receives state funding for clinical mental health services which is managed by the Hospital and Health Services Performance Division at DH Central Office. St Vincent s is the provider of clinical mental health services for the City of Boroondara. These mental health clinical services provide triage/intake, community based and intensive outreach assessment, treatment and support services, residential rehabilitation, acute inpatient units, primary mental health, crisis assessment and treatment services, consultation liaison as well as prevention and recovery care units. The DH regional office manages the allocation of state funding to organisations to provide Psychiatric Disability Rehabilitation and Support Services (PDRSS) such as home based out reach support, care coordination, day programs, youth residential rehabilitation and self help programs. The largest funded organisations in the region are EACH, Mind, Neami, Mental Illness Fellowship and ARAFEMI. Organisations providing PDRS services may also offer Commonwealth funded community outreach support and activity programs for people with a mental illness through the Personal Helpers and Mentors (PHaMs) and Day2Day Living programs. The DH regional office also funds community service organisations to provide Alcohol and Other Drug (AOD) services such as counselling, residential withdrawal, and residential rehabilitation. The largest funded organisations are Eastern Health Turning Point, Eastern Drug and Alcohol Service (EDAS) which is a consortium of EACH, Inner East Community Health Service (CHS) and Monashlink CHS, Salvation Army The Basin, and Youth Advocacy and Support Service (YSAS). Community Health Services (CHS) receive regional state funding to provide a range of services including Home and Community Care (HACC) services and allied health services such as counselling and case work. There is one CHS in each LGA except Yarra Ranges which has two. City councils, Royal District Nursing Services and other not for profit organisations also receive regional funding to provide HACC services to support people whose ability to live independently in the community is at risk. There is one Medicare Local and three GP Divisions in the EMR. These organisations receive Commonwealth funding to provide a range of mental health services. GP patients can be referred to allied health professionals who deliver focussed psychological strategies via Access to Allied Psychological Services (ATAPS). This program is targeted at people on low incomes, who may not be able to afford services under the MBS-funded Better Access program, where a co-payment is usually required. ATAPS also provides services for particular population groups including: children under 12; women suffering from peri-natal mental health issues; people at risk of homelessness; those at risk of suicide or self-harm. The Commonwealth also funds divisions/medicare Locals to provide support from mental health nurse to GPs who manage the treatment of people with severe mental illness. The first Medicare Locals were announced in June While the role of Medicare Locals is evolving, a key objective of these organisations is to improve access to a range of primary health and mental health services, complementing those funded by the State. The Department of Human Services (DHS) EMR funds community service organisations to provide homelessness support services such as transitional housing, initial assessment and planning (Entry Point) Page 7

8 and case management. The five Entry Points for homelessness services in the EMR are Wesley Mission Victoria, Harrison Community Services, Anchor, Community Housing Limited and The Salvation Army EastCare. The EMR Boundaries for Local Government, hospitals, mental health and other support services are summarised in the attached table. Despite some boundary issues, the EMR is relatively well placed compared to other metropolitan regions. This offers opportunities to develop strong partnerships to improve service coordination and mental health outcomes for the consumer. However, the EMR has some areas where there are boundary issues that provide challenges for service system planning and partnership work. For example, in the City of Monash, Child and Youth Mental Health Services are provided by three health services (Eastern Health, Southern Health and the Alfred). In the City of Boroondara there are three different clinical mental health providers of child and youth, adult and aged mental health services. Page 8

9 EMR Boundaries for Local Government, Mental Health Services and Key Partnerships. EMR DHS/DH Inner East Outer East LGAs Boroondara Manningham Whitehorse Monash Knox Community Health Services (CHS) Inner East CHS Manningham CHS Whitehorse CHS MonashLink CHS Knox CHS Medicare Local / GP Divisions Inner East Melbourne Medicare Local Inner East Melbourne Medicare Local Inner East Melbourne Medicare Local Greater Monash Greater Eastern PCPs Inner East PCP Inner East PCP Inner East PCP Inner East PCP Outer East PCP Mental Health Alliance Boroondara Alliance Eastern Mental Health Alliance Eastern Mental Health Alliance Eastern Mental Health Alliance Main Hospitals Attended Box Hill Box Hill Box Hill Monash Medical Centre Clinical Mental Health Services Hawthorn AMHS North Eastern CAMHS Inner Urban East (Aged Persons) Eastern Health Mental Health Eastern Health Mental Health Eastern Health Mental Health Southern Health Alfred Eastern Mental Health Alliance Angliss Eastern Health Mental Health PDRSS Outreach services EastCare ARAFEMI Neami MIF Mind Neami MIF Mind Neami Mind Neami EACH Maroondah Yarra Ranges EACH CHS Ranges CHS Yarra Valley CHS Greater Eastern Inner East Melbourne Medicare Local Eastern Ranges Eastern Ranges Outer East PCP Outer East PCP Eastern Mental Health Alliance Eastern Mental Health Alliance Maroondah Maroondah Eastern Health Mental Health Eastern Health Mental Health EACH EACH Page 9

10 5. Partnerships The EMR has had a strong focus on developing and supporting service coordination strategies through a number of strong and successful partnerships. The Eastern Mental Health and St Vincent s Mental Health Alliances include partners from clinical mental health services, PDRSS, PHaMs, AOD Services and the homelessness support services sector. The mental health alliances have developed and implemented a range of service coordination activities including the use of shared care plans to provide coordinated care for people of clinical mental health and PDRS services and PHaMs programs. The EMR Alcohol and Drug Strategy Group has been leading a service coordination project since March 2009 which has sought to support effective service coordination in the EMR AOD sector. The project has enabled them to develop a shared model for coordinated care, and develop protocols and guidelines for referral pathways and sharing of information between drug and alcohol organisations. Primary Care Partnerships (PCPs) have been supported by the department's Primary Health division to develop and implement service coordination processes to improve the way health and human services are coordinated. In the EMR there are two PCPs: the Inner East PCP and the Outer East PCP. In the EMR, service coordination practice has been successfully applied to integrated chronic disease management, improved health outcomes for disabled residents and refugees, and the aged care Active Service Model. Electronic work in service coordination is also being progressed through the EMR electronic service coordination system, the engagement of GPs in this system and the development of electronic care planning. The Inner East PCP and the Outer East PCP have identified mental health and wellbeing as priorities for their strategic plans. All local governments in the eastern region have clearly articulated and prioritised mental health and wellbeing goals as part of their Municipal Public Health Plans. The councils are actively seeking to partner and participate in partnership work around improving mental health and wellbeing for their community. For example, all councils in the EMR have committed to working in partnership to find solutions to providing youth appropriate services in the outer east. Executive management from regional local government and state government departments meet on a quarterly basis at the EMR Regional Managers Forum. The EMR Active Service Model (ASM) Alliance has been created to support the implementation of the ASM for HACC programs across the EMR. This initiative takes a wellness approach incorporating an opportunity to consider the wellbeing and mental health care needs and support requirements of older people. The ASM Alliance brings together the expertise, knowledge and experience (individual, agency, sector and partnership) of all EMR HACC funded agencies, of service delivery partners and of other key stakeholders. The ASM Alliance is a forum that seeks to promote a strong partnership approach through effective information sharing and collaborative problem solving to support the development and implementation of projects and strategies that support ASM implementation. 6. Community Consultation Youth, supported housing and service coordination were consistently identified as the top three priorities for mental health in the EMR. Since early 2010, there have been a range of consultation processes to identify priority mental health issues for the EMR including an EMR Mental Health survey in June 2010, consultation with people, carers and service providers through meetings and presentations, an EMR Community Consultation Forum in August 2010 and the EMR Mental Health Leaders Workshop February The June 2010 survey identified the main community issues regarding mental health as: Access to services and support for children and youth Page 10

11 Access to appropriate, affordable and supported housing Service coordination including referral pathways and coordinated care The EMR Community Mental Health Community Consultation Forum held on August 31, 2010 provided a further opportunity for a wide range of service providers to come together to inform the identification of priorities. People from a range of sectors including clinical mental health services, community managed mental health services, drug and alcohol services, housing and homelessness services, community health services, aboriginal services, disability services, aged care services, family violence services, cares and people participated. Once again there was strong endorsement for the top three priorities to be Service coordination, Youth (10-25) and Families, and Supported Housing. The forum noted that the needs of people from Aboriginal communities, CALD communities, and those with a dual disability should be considered within the context of each priority issue. 7. Issues, Opportunities and Enablers 7.1 Regional Mental Health Issues The main mental health issues identified by those consulted were: Access to services and support for children and youth Those consulted reported that there was a lack of accessible and appropriate mental health care for younger people and that services needed to be better linked with other services such as schools, GPs and drug and alcohol services. The outer east needs a coordinated youth mental health service such as Eastern Health Mental Health s Youth Hub in Box Hill. In addition, the EMR would benefit from a Headspace service, a national youth mental health service that provides information and access to a range of youth friendly health services Better supports to sustain tenancies During the consultation process, stakeholders identified access to appropriate, affordable and supported housing for people with mental illness as the most important mental health issue needing to be addressed at the moment. The EMR has a significant public housing shortfall for disadvantaged people in the region. Almost half of those with a severe mental illness require single accommodation and if they are experiencing homelessness they will usually be offered temporary accommodation in rooming houses or Supported Residential Services (SRSs). There is a need for people with mental illness to have access to housing with supports that include long term accommodation planning, strategies to manage at risk tenancies and social inclusion goals to assist them sustain their tenancies. Supporting the development of strong working relationships between mental health services, accommodation providers, community housing providers and other health, community and social support organisations will facilitate opportunities to identify and establish appropriate housing support models Better access to appropriate and coordinated mental health care Stakeholders reported that the mental health care system was complex and fragmented because of multiple services, poor communication and coordination, and different funding and access requirements. Mental health care services for adults with severe mental illness need to be linked with other sectors such as AOD services, primary health services, and homelessness support services. Implementing clear service coordination goals such as strong interagency relationships, timely and accurate information sharing and agreed service coordination processes will improve client outcomes by facilitating early identification of mental health issues, and improving service access and continuity of care. Page 11

12 7.1.4 Access to mental health care for aged persons Victoria s population is ageing. This issue is a particular challenge to the Eastern Metropolitan Region as the region s population is ageing at a greater rate than the Victorian average. By 2026 the number of older people in the outer east is expected to double. GPs in the EMR are seeing patients aged 65+ with a mental illness in numbers well above national benchmarks. Eastern Health reports that the growth of the ageing population in the outer east is so great that the existing service system will not cope with the growing demand. A key challenge for the EMR is to ensure that there is accessible, appropriate, and coordinated mental health care services for older people with mental health issues living in the community, now and in the future Representing the needs of people and carers Consumer and carer participation improves mental health outcomes, improves the quality of mental health care, is an important democratic right and is a mechanism to ensure accountability. There is a need to ensure that the needs and wants of people and carers are represented at all stages of service review to ensure services are consumer oriented and responsive to their needs Mental health services for Aboriginal communities Though almost 20% of Melbourne s metropolitan Aboriginal population live in the EMR, there are relatively few Aboriginal community controlled services and no Aboriginal Community Controlled Health (ACCHO) service. There is a lack of culturally appropriate health and mental health services for Aboriginal people. In particular young Aboriginal people in the outer east are a large group requiring an appropriate service The EMR would benefit from actions that support the development of Aboriginal specific mental health programs in the Healesville, Knox and Yarra Ranges local government areas. There is a need to support and build partnerships between mainstream and Aboriginal organisations, ensure Aboriginal representation at all stages of mental health service development and implementation, and increase understanding and knowledge of access pathway and preferred mental health support through consultation with Aboriginal people in the EMR Supports for CALD and refugee communities CALD groups often have poorer mental health outcomes compared to Australian born people, typically presenting to services when their illness is more severe and experiencing higher rates of involuntary treatment. Reasons for not accessing mental health services include: the stigma of mental illness, lack of information about services, fear of not being understood and services not being culturally appropriate There is a lack of culturally appropriate services for refugee communities in the outer east and workers report that they need more training to improve culturally appropriate practice. The refugee community also has a large proportion of young people and requires a cultural response appropriate for youth. A key challenge in the provision of health care is to cater for the high numbers of older people from CALD backgrounds in the central east catchment. Regional staff for HACC programs report that provisions of aged care services for CALD communities in the central east, particularly for Chinese, Greek and Italian communities, is posing huge challenges because of language barriers, cultural misunderstandings, ageing carers and delayed presentations for services Reducing barriers to community participation eg. employment and training Mental illness significantly affects the ability of affected individuals to participate in the workforce. Approximately two thirds of those with severe mental illness do not participate in the work force. Paid employment increases options and choice for recreational activities, stable and appropriate housing and better health, fitness and nutrition options. Participation in employment and community activities also improves mental health, sustains tenancies, and increases access to informal social networks and supports. Page 12

13 There is need to support partnerships between mental health specialists, other support providers, and business, and community organisations to improve access to recreational training, work and recreational opportunities. Stakeholders also commented on the need to promote community acceptance and inclusion of people with mental health problems in social and recreational activities Coordinated services for people with dual disabilities Mental health problems in people with an intellectual disability are more common than in the general population. People with a dual disability experience difficulty accessing public mental health services and tend to rely on private practitioners for clinical care. There tends to be a lack of expertise in dual disability for both mental health and disability professionals and there is a need to identify training and skill development opportunities for professionals working in the two sectors. 7.2 Opportunities in the EMR Strong Partnerships The EMR has a number of well established and functioning cross- sector partnership groups that are working in the area of mental health and well-being. Building on the work of already well established groups represents an opportunity to move forward quickly and efficiently to achieve regional goals. For example, the Eastern Mental Health Alliance has already been working on a number of service coordination goals and is in a good position to assume responsibility for progressing service coordination work for people with mental illness Leading Service Coordination The EMR has demonstrated leadership and excellence in a number of state service coordination initiatives in the areas of AOD services, primary health and mental health. The learnings of groups such as the EMR AOD strategy group, Inner and Outer East PCPs, and the St Vincent s and Eastern Mental Health Alliances provide a solid knowledge base to pursue service coordination goals and work in a crosssector collaborative manner Well-Defined Cohorts in Need Certain vulnerable groups in the EMR are relatively small and geographically contained and represent a clearly defined cohort that can be planned for effectively. For example, the Aboriginal community is primarily located in the outer east areas of Healesville and Bayswater and targeted efforts could enable good outcomes to be achieved Cross-Sector Initiatives There are a number of initiatives from a range of sectors that are progressing in the EMR and have a number of shared goals. For example, Closing the Health Gap has a goal of improving Aboriginal mental health. Implementation of the ASM model in the HACC and aged care sectors also supports goals that aim to improve health and wellbeing through consumer centred care. Bringing different projects together under common goals increases service options, prevents duplication of effort, shares learnings and offers a better experience for the consumer New Properties The Nation Building program will provide approximately 700 new properties in the EMR. This represents an unprecedented opportunity for accommodating people on low incomes a region that has historically had relatively low numbers of public housing options. Identifying strategies to improve access and supports for people with a mental illness into this housing represents an affordable option to provide safe, stable and affordable accommodation for this group. Page 13

14 7.3 Enablers The EMR is a relatively wealthy and advantaged region with generally good health outcomes. This provides scope for us to build on our strengths and ensure that no disadvantaged individuals or groups in the EMR are left behind. CMHPSCI and its associated regional structures have been established to support the role of leadership, collaborative partnerships, and detailed planning as enablers in progressing key community mental health goals and undertaking reform and innovation. The governance relationships between key regional groups, working groups and the EMR MHPP Steering Group are summarised in the diagram below Policy Context The aim of recent mental health reform is to ensure that all Victorians have the opportunities they need to maintain good mental health while also supporting people with a mental illness to access high-quality, timely care and live successfully in the community. The reform supports a positive, inclusive experience for all people with a mental illness together with their families, carers and significant others. This will be achieved through a broad mix of service development and redesign, delivery of partnerships and service coordination, strengthening of the workforce, better use of information technology and a shared commitment to whole-of-person care. Working with organisations across the EMR, the DH regional office will facilitate initiatives and programs that arise from the staged implementation of the reform Planning The DH regional office has coordinated a detailed planning and consultation process during 2010 and 2011 to identify priority mental health issues in the region. This information has guided the identification of objectives, goals and actions for the strategic plan. The MHPP Steering Group has agreed that there is scope to support future planning by utilising member s skills and resources in a range of regional activities such as monitoring activity in other watch areas and incorporating information from cross sector strategies, in addition to the oversight of the four priority projects Partnerships As a requirement of the CMHPSC Initiative, the EMR MHPP Steering group has responsibility for the identification and development of four priority projects that represent a regional response to identified mental health issues. Priority areas were chosen based on feasibility, regional strengths and feedback from the community consultation forum and the survey. Service Coordination, Youth and Sustaining Tenancies were endorsed by the Steering Group for further development because they represent the top three priorities from the community consultation forum and survey. The area of older people with mental health issues was also included because of the significant increase in service needs anticipated due to the exponential growth in population of this group. Each of these projects are supported by a working group with diverse cross sector representation. These groups are providing input into the specific project of their responsibility but are also able to inform the region of learnings and progress and support other issues related to the priority area Leadership The membership of the MHPP Steering Group includes senior representation from a range of government and community organisations. The performance and functioning of the Steering Group was assessed by HDG Consulting as part of formative evaluation process. They noted that the EMR MHPP Steering Group is a highly skilled and diverse group that is well placed to lead mental health work in the community and the state. Steering Group members indicated that the group has the potential to influence change and to contribute to mental health reform. Page 14

15 The reach and influence of the MHPP Steering Group is further strengthened by regular communication and updates regarding the regional components of the initiative to the EMR Regional Directors Group which includes regional representation from state and local government directors. The department takes an active role in supporting the various regional components of the initiative and ensuring strong leadership and advice regarding departmental planning priorities. This is supported by having the Director of Health and Aged Care EMR, chairing the MHPP Steering Group. The following diagram summarises an approach to achieving the identified objectives in the EMR Mental Health Strategic Plan. Page 15

16 EMR Regional Management Forum EMR Mental Health Planning and Partnership Steering Group EMR regional planning Youth Mental Health Steering Committee Eastern Mental Health Alliance Governance Sustaining Tenancies Working Group Mental Health and Older Persons Alliance EMR Active Service Model Alliance Outer East Youth Service Working Group Alliance Working Party EMR DH & DHS Housing Access meeting Mental Health & older People in the Central East project Box Hill Youth Hub Committee Of Management Alliance Education & Training Group EMR MH Priorities Headspace Partnership Group Youth Service Coordination Sustaining Tenancies Youth Partnerships Demonstration Project Older People Page 16

17 8. The EMR Mental Health Strategic Plan Vision Lead regional approaches to improve mental health outcomes such as access to coordinated care, long term housing security and participation in community life, for young people, adults and older people with mental health issues living in the EMR. Purpose Contribute to improved mental health outcomes for the EMR population by: Promoting partnerships that link specialist mental health services with other health, social and community services Supporting the integration of all parts of the mental health system Leading the development and implementation of the EMR Mental Health Strategic Plan Values Consumer-centred care: When a service engages with a person who has a mental illness, the person s needs, wishes and interests should inform decisions regarding the planning and delivery of services. A recovery focus: Most people diagnosed with mental illness will achieve significant improvement or recovery. This approach encompasses concepts of self-determination, self-management, personal growth, choice and meaningful social engagement. It requires a holistic orientation to mental health care. Collaborative relationships: Developing effective working relationships between organisations can improve the likelihood of organisations achieving improved outcomes for individuals. Such partnership should exist between mental health and other services and between professionals involved in work with an individual. Accountability and effectiveness: The governance structures and overall management of the Strategic Plan specify that responsibility for successful realisation of the Plan is shared by participants. Medium Term Objectives Improve early identification and intervention for young people with emerging or existing mental health problems in the EMR. Increase the proportion of young people, adults and older people with mental illness receiving treatment and care in the EMR. Improve the continuity of care for young people, adults and older people with mental illness in the EMR. Increase long term housing security for people with severe mental illness in the EMR. Increase the engagement and participation in community life for people of all ages with mental health issues in the EMR. Strategies The strategies that the EMR Mental Health Strategic Plan identifies to achieve objectives include: Page 17

18 Oversight of four priority projects The EMR MHPP Steering Group provides oversight for four local projects. Each project is supported by a working group, and has a clear action plan with well defined outcome measures. The four projects identified are: Outer East Youth Service Sustaining Tenancies in the Inner and Central East Adult Service Coordination Pathways in the EMR Mental Illness and Older People in the Central East. Other Watch Areas The meaningful participation of people and carers is a key part of the CMHPSC Initiative and reflects the values of the Steering Group. Consumer and carer participation is essential to achieve the identified mental health objectives and improve the quality of mental health care. Mechanisms have been identified to support effective consumer and carer participation in the four priority projects and on the Steering Group. However, it is also important for the Steering Group to monitor and act on issues affecting consumer and carer participation in a broader regional context. In the community consultation process it was also noted that the needs of people from Aboriginal communities, CALD communities, and those with a dual disability should be considered within each of the identified priorities or objectives. Identifying these groups in the Other Watch Areas recognises the issues theses communities experience in the EMR and provides a vehicle for consideration of issues in the regional arena. Cross-sector strategies A number of cross-sector activities and strategies have also been identified that complement the priority projects and contribute to achieving the identified objectives. For example, current activities include the Mental Health and Physical Health Initiatives and Commonwealth Health Reform. Strategies being released in 2011 include the Homeless Action Plan and the Victorian Alcohol and Drug Strategy. Activity in these arenas can be brought to the Steering Group to be synthesised and incorporated into strategic planning goals. For example, it may be possible to provide additional support to a key action in the homelessness sector to ensure that the needs of mental health people are also being considered. Regional mental health actions. The Steering Group will have the opportunity to lead action in a number of regional mental health areas such as Mental Health Week, or supporting a regional anti-stigma approach. There is also scope for the Steering Group to prepare joint responses or submissions to community consultation processes, for example, preparing a submission in response to the Victorian Alcohol and Drug Strategy. The strategies that the EMR MHPP Steering Group will adopt to achieve the identified objectives are outlined in the following diagram. Goals and Actions Goal 1: Service Coordination: Improve access to coordinated, consumer centred mental health and other support services by implementing service coordination goals including strong inter-agency relationships, timely and accurate information sharing, and agreed service coordination processes. Expand the representation of the Eastern Mental Health Alliance working group to include Primary health representation by July Page 18

19 Implement joint cross sector collaborative care planning for 250 staff from specialist mental health services, alcohol and drug services, homelessness services and primary health staff by June Improve access, information sharing and referral pathways between mental health services, AOD services, homelessness services and primary health services for people with a mental illness by June Include service coordination principles in the policies and procedures eg. job descriptions, of 75% of Eastern Mental Health Alliance partners by June Goal 2: Youth: Improve the health and wellbeing of young people in the outer east by improving access to coordinated multi-sector youth services. Support an outer east submission for a commonwealth funded Headspace by December Establish an Outer East Youth Service with an integrated multi-sectoral service delivery model for children, youth and families in the outer east by July Improve access and referral pathways to appropriate services for young Aboriginal people in the outer east with mental health issues by December Goal 3: Older People: Improve the health and wellbeing of older people with mental health issues in the EMR by improving access to coordinated mental health and other support services. Implement Mental Health First Aid training for at least 50 Home and Community Care (HACC) workers in Manningham LGA by March Improve access, information sharing and referral pathways between HACC and Aged Care services, mental health services and primary health services for older people living in the community who have been identified with mental health issues by June Implement an approach to support older people with mental health risk factors receiving HACC services participate in appropriate health and wellbeing programs in the community by June Establish an EMR Aged Persons Mental Health Alliance to provide structured opportunities for cross sector relationships, partnerships and planning for stakeholders in the older persons mental health sector, by December Goal 4: Sustaining Tenancies: Assist people with mental health issues sustain their tenancies in the EMR by ensuring appropriate planning and supports are in place. Establish a partnership model of support for at least 30 residents with mental illness in rooming houses and SRSs in the central east by December Implement an approach in at least three rooming houses or SRSs to support resident participation in the local community by June Assist at least 100 mental health people with PDRSS support obtain secure stable long term housing in public or social housing in the EMR by December Page 19

20 Goal 5: People and carers: Ensure people and carers participate and communicate effectively in regional mental health planning. Ensure all Working Groups and the MHPP Steering group have processes in place to ensure effective consumer and carer representation and participation by December Provide 6 monthly communications via consumer and carer networks and newsletters regarding the progress and achievement of goals until June Goal 6: Vulnerable Communities: Ensure the mental health needs of people from Aboriginal communities, CALD and refugee groups, and people with dual disability are considered in regional mental health planning and service development. Ensure there is appropriate CALD stakeholder representation on the older persons working group by December Ensure appropriate stakeholder representation for Aboriginal and refugees communities on the working group for the Outer East Youth Service project by December Support DHS and Primary Mental Health Care utilise learnings from the Dual Diagnosis training project to guide a change management and training program for the dual disability service system by June Page 20

21 Vision: improving access to coordinated care, long term housing security and participation in the community life, for young people, adults and older people with mental health issues living in the EMR. EMR MHPP Steering Group Strategic Plan Oversight of Priority Projects Other Watch Areas Cross Sector Strategies Regional Mental Health Activities Consumer & Carers Vic. Alcohol & Drug Strategy Mental Health Week Service Co-ordination Outer East Youth Aboriginal communities Medicare Locals Developing a regional response Sustaining Tenancies CALD & Refugees Mental Health & Physical Health Supporting antistigma approaches Older People Dual Disability Homelessness Action Plan Page 1