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John Mendoza, ConNetica - Obsessive Hope Disorder Report
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John Mendoza, ConNetica - Obsessive Hope Disorder Report


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Adjunct Professor John Mendoza, Managing Director, ConNetica delivered this presentation at the 15th Annual Health Congress 2014. This event brings together thought leaders and leading practitioners …

Adjunct Professor John Mendoza, Managing Director, ConNetica delivered this presentation at the 15th Annual Health Congress 2014. This event brings together thought leaders and leading practitioners from across the Australian health system to consider the challenges, implications and future directions for health reform.

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  • 1. What is Obsessive Hope Disorder? The move to deinstitutionalise the provision of mental health care is arguably one of the most important public policy ‘decisions’ of the post- war era in Australia. It has had profound impacts on our society and most particularly those affected by mental illness, their families and the workforce. … Yet the results are at best mixed.
  • 2. Key Research Partners
  • 3. 48 Partner Organisations Crowd Funded
  • 4. The reality is after 30 years we still have stand alone psychiatric hospitals – costing $500m per year Exhibit A - Baillie Henderson Hospital, T’wba
  • 5. • Five major research elements – systematic analysis of the National Mental Health Reports & Evaluations – A thematic analysis of 80+ invited ‘perspectives pieces’ – Consumer, carer & community surveys – A systematic analysis of 32 statutory authority reports 2006-12 – A thorough literature review ‘on where are we now’ • Four commissioned studies: – Examination of the research investment in mental health – A study of the workforce and its journey – A focus on 1 special population – CALD – A review of accountability and mental health reform Obsessive Hope Report: what went into it
  • 6. Systematic Analysis of National Mental Health Strategy and Plans 1st National Mental Health Plan 1993 2nd National Mental Health Plan 1998 3rd National Mental Health Plan 2003 4th National Mental Health Plan 2009 1st Evaluation Report1997/8 2nd Evaluation Report 2003 3rd Evaluation Report 2008 Focus Area 1: Improving accountability to enable reform • Reporting • Monitoring performance • Information & data management • Evaluation
  • 7. 7
  • 8. A systematic review of 32 independent audits of mental health and associated services by statutory authorities 2006-12. The 32 reports incorporated in this review were obtained via a multi-stage systematic search of the publications posted on the websites of each of the following Australian (National), State and Territory statutory authorities. The Findings Areas requiring improvement: 1. Mental Health Awareness 2. Prevention 3. Community based mental health care 4. Crisis response 5. Emergency unit response 6. Inpatient care 7. Housing 8. Social Security 9. Immigration detention 10. Veteran’s program 11. Child protection services and children at risk 12. Restraint through taser use
  • 9. The Community Surveys Two community surveys - conducted in April/May 2013 to gather the views of the sector (providers, consumers, carers, family members and other interested stakeholders) regarding experiences of care with mental health services. Survey 1. Community Review of Mental Health Services in Australia A total of 477 surveys were received with 86% from individuals and 14% from organisations.
  • 10. The Findings - Survey One Have national priorities been implemented or supported in your local area? Yes No Yes No Have national priorities been implemented or supported in your state/territory? National Priorities were early intervention, integrated AOD-MH services, a wider spectrum of acute & community based care, MH promotion, national standards implementation consumer participation, research investment et al
  • 11. Survey 2. Consumer and Carers Direct Experiences of Mental Health Care in Australia A total of 561 surveys were received with 87% being from people who had received treatment (directly or indirectly) in the previous 12 months. • More than two thirds (mostly consumers) reported that they were treated with dignity ‘nearly always’ or ‘always’ (69%). • Less than half (43%) felt that they were able to access adequate services for their mental health problem ‘always’ or ‘nearly always’. However, results were more favourable for consumers (48% of consumers felt they were able to access adequate services always’ or ‘nearly always’ compared with only 29% of carers & 28% of family or close friends). • Majority (86%) were able to find a health professional to talk about their concerns.
  • 12. The Perspectives Report The 81 perspective essays within the Obsessive Hope Disorder Report are an incredibly rich pool of experiences and analyses spanning the last thirty years & future.
  • 13. Key themes and Drivers: A theory on Australia’s mental health “reform gap”.
  • 14. WHO Service Organisation Pyramid for an Optimal Mix of Services for Mental Health.
  • 15. Psychiatric hospital care 10% PBS 12% Primary Care 18% Private psychiatric Hospitals 3% Community managed mental health services (NGO) 9% Community public mental health services 18% Long Stay units 3% Mental health promotion 2% Self care Unknown $$ Totals Federal funding - 37% State funding - 59% Private funding – 4% + Childs Play- A representation of Australia’s Mental Health System, funding percentages and sources.
  • 16. 1. What is the prevalence of mental health problems/illnesses in Australia? 2. What do we know about the health of people with mental illnesses? 3. How well are services responding to mental health needs of Australians? 4. How well are services responding to that level of need? 5. What is the current state of mental health services in Australia? 6. How many Australians’ have access to care? 7. What is the quality of that care? 8. What is level of awareness & understanding of mental health/illness? 9. What are the outcomes achieved from these services? 10. What reforms have been implemented by Aust Government since 2006 to respond to widespread concern about mental health services? Assessing the state of mental health services in Australia
  • 17. • Incremental change as key advisers advocate, is not supported by evidence or fiscal reality. Must be TRANSFORMATIONAL CHANGE • Continuing with the same approach, governance, accountability, workforce – NOT AN OPTION. • Times up for small cadre in control! Must have genuine community advise to Gov and increasing control • Failure to reform is now a major drag on nation’s productivity • Continuing to invest greatest share of MH funds into acute care – crazy! Five key implications from OHD evidence
  • 18. A better way- The Manifesto for change We strongly believe that OHD can be cured, that mental health reform is both practically possible and enjoys overwhelming community support. From the evidence and the analysis presented in the Obsessive Hope Disorder Report, the key to curing OHD is immediate attention to five urgent areas of reform Governance Quality of care Our workforce Research and evaluation Funding
  • 19. Governance 1). A Study to Establish Cost of Mental Illness. 2). A National Review of Roles. 3). National Mental Health Commission as a Statutory Authority. 4). A National Audit of Mental Health Programs. 5). The National Mental Health Report Card. 6). Independent Program Evaluations. 7). Model Legislation and Legal Processes. 8). Discrimination Law. 9). Inquiry Recommendations.
  • 20. Quality of care 10). A National Service Framework. 11). National Models of Care. 12). Investment in e-therapy and online services. 13). Employment Policy.
  • 21. Our workforce 14). A National Mental Health Workforce Institute. 15). A National Workforce Plan. 16). New Roles.
  • 22. Research and evaluation 17). A National Institute for Translational Research in Mental Health. 18). Prioritised Funding for Research.
  • 23. Funding 19). A Fair Allocation of Funds. 20). Examine Funding Models. 21). Funding Directed to Evidence Based Services.
  • 24. Buy your copy today e-version or print