Mental illness is still so stigmatised, underfunded and frustratingly ignored. Mental health is a vote changer.

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1 Mental illness is still so stigmatised, underfunded and frustratingly ignored. Mental health is a vote changer.

2 Mental health is a vote changer People want support to recover, in their own communities, with their needs and rights respected We can be important people in our community, we just need to be given a better chance. MI Fellowship participant Will you give people with mental illness that chance, Dr Napthine and Mr Andrews? Now is the time for action 2 MI Fellowship - Call to Action 2014

3 Call to action We need policies and programs that work Mental illness is still so stigmatised, underfunded and frustratingly ignored. Our Call to Action for the 2014 State Election is pragmatic, informed directly by the lived experiences of our members, participants and supporters. Equally, our approach is hopeful, inspired by what we have seen people achieve in their lives when they get the right support. We call on the Victorian Government to fund mental health support programs that can truly make a difference to the lives of people living with mental illness and their families and carers. NDIS Preserve $80m a year for specialist community mental health services in Victoria learning the lessons from the NDIS trial in Barwon. Recovery Transfer the management of 8 Community Care Units to the community sector over the next four years. Establish community-managed Extended PARCs across Victoria to prevent repeated and expensive hospital admissions. Housing Deliver the Doorway Housing and Support Project to 100 more Victorians at a cost of $20,000 per person, per year. Provide $432,000 per year to deliver technical assistance to support the roll-out of Doorway across the state. Education Provide $3m for a Well Ways Train the Trainer unit to deliver evidence-based programs to local peer workers in every region of Victoria. MI Fellowship - Call to Action

4 NDIS Stop 12,000 people from falling through the cracks We call on the State Government to: Learn the lessons from the NDIS trial site in Barwon before we roll-out the NDIS. Preserve $80m a year for specialist Mental Health Community Support Services. 4 MI Fellowship - Call to Action 2014 In the National Disability Insurance Scheme (NDIS) trial site in Barwon, funding for specialist Mental Health Community Support Services has been taken out of the health system and given to the NDIS. The Barwon NDIS trial has been an excellent opportunity to learn how the scheme works in practice, and has showed us that specialist Mental Health Community Support Services (MHCSS) should be delivered separately. As a result, vulnerable people are at risk of falling through the cracks. If separate MHCSS are not provided, fewer people will get the assistance they need to improve their mental health. We will see increases in homelessness, alcohol and drug use, mental health crises and family breakdown, resulting in issues across the whole community, including increased use of high-cost hospital services. Before the NDIS, almost 500 disadvantaged people in Barwon were receiving specialist mental health support in the community. Now they are getting disability support rather than specialist mental health recovery services. If things don t change before the NDIS goes state-wide, around 12,000 Victorians will miss out on specialist mental health community support. We support the NDIS, but it was not designed or funded to provide health services. It was funded to provide disability support.

5 NDIS If I had been able to access appropriate supports earlier, maybe less of my youth would have been wasted in isolation, hopelessness and despair. What the NDIS provides Practical assistance to participate in daily activities in the community Lifelong care MHCSS What we must not lose Skilled and specialist services to improve mental health Support and interventions when people need them Only for permanent disability For anyone with serious and disabling impacts from a mental illness Offsets the impact of lifelong impairments has a compensatory role Supports people to stay out of hospital and manage their own mental health has a rehabilitative role Supports people to pursue their goals, with assistance Supports people to pursue their goals, moving towards independence from support Not recovery oriented and no early intervention for young people Follows best-practice guidelines and national standards to promote recovery, independence and early intervention No support for people with drug and alcohol issues Provides coordinated support for people with mental illness who also have drug and alcohol issues Carers cannot independently seek support when they need it Support and services for carers and families of people diagnosed with mental illness MI Fellowship - Call to Action

6 Recovery Improve the effectiveness of mental health services (CCUs) We call on the State Government to: Transfer Community Care Units (CCUs) to community sector management with clinical support from hospitals. Transfer the management of 8 CCUs to the community sector over the next four years. Community Care Units (CCUs) provide two years of residential treatment for people diagnosed with serious mental illness and are currently run by hospitals. They should provide a home-like environment where people can learn or re-learn everyday skills necessary for successful community living. 1 But they are not working as well as they could. CCUs run by hospitals are costly, not well linked to communities and not helping people to become independent of the mental health system. Currently CCUs are more hospital-like than home-like and they are not in line with the new Mental Health Act, which strongly promotes least restrictive treatment, recovery and community participation. To ensure CCUs fulfil their aims, they should be run as a collaboration between Mental Health Community Support Services (MHCSS) and hospitals, not by hospitals alone. CCUs managed by MHCSS would reduce restrictive treatment, promote personal recovery and increase social and community participation. MHCSS organisations are: experts in rehabilitation and recovery hospitals tend to be skilled in the treatment of psychiatric illness and symptom management strongly linked to a broad range of community organisations to help people get out of services and on their feet experienced in working collaboratively without the use of restrictive interventions. 6 MI Fellowship - Call to Action 2014

7 Improve the effectiveness of mental health services (Extended PARCs) We call on the State Government to: Establish communitymanaged Extended PARCs across Victoria to prevent repeated and expensive hospital admissions. Prevention and Recovery Care (PARC) centres are a vital part of our mental health system. Their focus is on sub - acute, short stays, helping people to get control of an emerging mental health issue and avoid hospital or leave hospital earlier. However, PARCs have the potential to play a greater role in supporting people with mental illness. We propose the creation of the Extended PARC as a replacement adult residential rehabilitation. The Extended PARC would be similar to current PARCs, but with added benefits including: stays of up to nine months (PARCs are limited to 28 days) community managed with in-reach by clinical staff greater choice for people with mental illness, as encouraged by Victoria s new Mental Health Act support to stabilise, learn and re-learn life skills so that people can avoid CCU admissions and establish their lives in the community new opportunities to engage with people whose needs are not currently being met. Many people have repeated, unnecessary hospital admissions because there is no other service that is suited. Extended PARCs would fill this gap in the current mental health system and free up hospital beds. The role of the new Extended PARC 2 Community care Sub-acute care Acute care Extended care In Home Prevention & Recovery Care (PARC) In Patient Unit Extended Prevention & Recovery Care (PARC) Community Care Unit (CCU) Secure Extended Care Unit (SECU) per day $76.50/hr $451 $743 $281 $422 $538 Length of stay 28 days 7 16 days 6 9 months 2 years 5 years Hospital diversion CCU diversion MI Fellowship - Call to Action

8 Housing Open more doors to a home and health We call on the State Government to: Deliver the Doorway Housing and Support Project to 100 more Victorians at a cost of $20,000 per person, per year. Provide $432,000 per year to deliver technical assistance to support the rollout of Doorway across the state. 8 MI Fellowship - Call to Action 2014 Forty-two percent of people with mental illness are homeless or living in tenuous housing3, and a stable home is a crucial component of recovery. Our Doorway Housing and Support Project has been proven to improve health, economic and social outcomes4 as it supports people with severe mental illness to access housing in the private rental market. Designed and delivered by MI Fellowship, Doorway has received Victorian Government funding for the next four years to deliver support to people with mental illness in four regions of Victoria. Now we are asking for support to take Doorway to the next level. We call for an investment of $20,000 per person, per year to establish Doorway in three new regions in the state and deliver this program to 100 more Victorians. We will target people with complex needs, including people with mental illness who also have drug and alcohol dependence. We also call for $432,000 per year to provide technical assistance to other community service organisations to support the roll-out of Doorway across Victoria. This assistance will include the development of comprehensive Doorway practice manuals and training packages that will be available to the entire sector.

9 Education Teach and inspire people to manage their own wellness We call on the State Government to: Provide $3m over three years for a Well Ways Train the Trainer unit of expert peer educators to deliver the evidence-based Well Ways and MI Recovery programs to peer workers in every region of Victoria. Peer-led education is a powerful, evidence-based approach that can deliver enormous personal benefits and budget savings to Victoria s mental health system. Peer educators are people with their own experience of mental illness and recovery who have been trained to run structured programs that assist others to understand and live with similar issues. Peers educators can also be a family member or carer. Peer work is backed by strong evidence showing increased self-confidence, improved mental health and well-being, accompanied by less use of mental health and other services 5 and there have been widespread calls for peer support to be widely implemented, including by the National Mental Health Commission. 6 Research collaborations between MI Fellowship and Latrobe and Swinburne universities have repeatedly demonstrated that MI Fellowship s Well Ways (for carers) and MI Recovery (for consumers) peer education programs make a significant and important difference in people s lives. They: build independence from formal mental health services promote self-management and mutual support prevent crisis and higher health system costs build our future mental health peer workforce. 7 8 Every consumer in Victoria should be able to access a MI Recovery program. Every carer should be able to access a Well Ways program. Every Mental Health Community Support Service (MHCSS) should have its own team of skilled peer educators to deliver Well Ways and MI Recovery. To deliver this ask we will collaborate with all MHCSS service providers to ensure their peer educators are supported and skilled to deliver Well Ways and MI Recovery programs within their local community, and provide upfront and annual accreditation to ensure training quality and consistency. MI Fellowship - Call to Action

10 REFERENCES 1 Department of Human Services, Victorian Government. Community care (CCU) and secure extended care (SECU) units, Retrieved from 2 Victorian health policy and funding guidelines : Part two 3 VICSERV, (2008) Pathways to Social Inclusion Proposition Papers. Retrieved from 4 Nous Group (2014) Doorway Summative Evaluation November Retrieved from 5 Faulkner, A. and Bassett, T. (2010) A Helping Hand: Consultations With Service Users About Peer Support. Together 6 National Mental Health Commission, Australian Government. A Contributing Life: The 2013 Report Card on Mental Health and Suicide Prevention, Retrieved from 7 Stephens, J., Farhall, J., Ratcliff, K. and Farnan, S. (2009) Well Ways, a peer-led group education program for families of people with a mental illness, reduces negative caregiving consequences. Australian & New Zealand Journal of Psychiatry 8 Porter, C., Psychosocial Models of Recovery from Mental Illness in a Consumer Delivered Service, unpublished Masters Thesis, Latrobe University School of Psychological Sciences. About Mental Illness Fellowship Victoria Mental Illness Fellowship Victoria is a member-based, not-forprofit organisation working with people with mental illness and their families to build lives. We work with thousands of people each year who are affected by severe and persistent mental illness, delivering recovery programs and advocating for improved support and opportunities. Abwww.mifellowship.org ACN Heidelberg Road Fairfield Victoria 3078 PO Box 359 Clifton Hill Victoria 3068 T: F: E: enquiries@mifellowship.org