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Overview adf mental health strategy Morton

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Overview adf mental health strategy Morton

  1. 1. MENTAL HEALTH REFORM IN THE AUSTRALIAN DEFENCE FORCE Resilience and Recovery JOINT HEALTH COMMAND David Morton
  2. 2. JOINT HEALTH COMMAND Professor David Dunt – Public Health Physician Report submitted 4 Feb 09, released to the public on 1 May 09 Report included 52 recommendations 49 recommendations were accepted unconditionally three partially accepted Government committed $83M over the next four years Mental Health Reform
  3. 3. Mental health service delivery Post traumatic mental health Suicide prevention and depression initiative Resilience and prevention Operational mental health Alcohol, tobacco and other drugs DMH clinical program E-Health Research Facilities Transition Families Rehabilitation Enablers Reform Goals •Improving mental health governance •Improving mental health policy •Enhancing the mental health workforce •Improving mental health training •Prevention strategies •Enhanced research and surveillance •Rehabilitation and return to work programs •Transition services •Families •Facilities Vision: To optimise mental health and wellbeing in the ADF
  4. 4. OBJECTIVES AREAS OF ACTION STRONG FOUNDATION ADF Members have a strong foundation to deal with the challenges of military service Selection and Training Prevention Command and Leadership Families and social support OPERATIONAL RISKS Mitigate the risks of operational deployment with a focus on prevention & early intervention Research & Surveillance Resilience Building Education and awareness Screening Early Intervention RECOVERY Mental health care and rehabilitation system that delivers evidence-based practice in a multi-disciplinary environment Workforce Policy to Practice Assessment and treatment Rehabilitation Transition Facilities RELATIONSHIP and PARTNERSHIPS Cultivate partnerships that inform and support contemporary practice / interventions Member/family and provider Member/ Command/ Health Provider National Engagement International Engagement
  5. 5. Area Health Service MO, Allied Health, MH & Rehab Regional MHT Single Service MH Assets DCO Inpatient Facilities Chaplaincy MHP&R (Policy Reform and Governance) CMVH ACPMH ADF CMH Transition Contracted Health Providers Command Garrison Health Operations (Service delivery) Regional Health Director
  6. 6. Military Occupational Mental Health Model - Strengthen Resilience and Enable Recovery Unit-Focused Healthcare-Focused • Selection • Skills • Knowledge • Cohesion • Leader Behaviors • Basic Resilience Training Foundation • Peer Programs • Surveillance • Targeted Resilience Training Occupational Risk Individual Reactions • Psychological Screening • MH First-Aid • Mental health training • Ceremonies Early Intervention • Assessment • Treatment • Family Engagement • Clinical and Occupational rehabilitation • Psycho- education Treatment/ Recovery Behaviors Emotions Thoughts Physical Reactions Shared Responsibility Context: Culture, Environment, Social Support, Families Service Member and Command
  7. 7. Menal Health Review Goals  Improving mental health governance. Second generation of the Mental Health Strategy including a robust evaluation system. Improving mental health policy. Breaking down stigma, by demonstrating that Defence’s goal is to treat and rehabilitate wherever possible, and that discharge on health grounds is the last resort. Mental Health Reform Goals
  8. 8. Mental Health Reform Goals  Enhancing the mental health workforce. The first priority has been enhancing the mental health workforce with Joint Health Command increasing the dedicated mental health workforce by 50% across the country over the next three years. This will significantly increase the personnel to deliver both primary health care but also develop mental health programs especially in the areas of health promotion and prevention.
  9. 9. Enhanced Workforce MHP&R ADF Centre for Mental Health Outpatient Residential Treatment Tele-psychiatry, Training Health Professionals Regional Mental Health Teams Coordinate Local Networks, Outpatient Treatment Programs Coordinate Critical Incident Support, Complex Case Management Coordinate Prevention Strategies Local Multi-disciplinary Teams
  10. 10.  Prevention strategies. A program has been developed and is being implemented that will strengthen the psychological resilience of serving personnel allowing them to cope more effectively with life, deployment and military stressors. The ADF’s “BattleSMART”, Self Management and Resilience Training program has been developed to teach Commanders and individuals, effective stress management and positive coping strategies. Mental Health Reform Goals
  11. 11. ADF Life Cycle Projects • Government initiated to improve the health and wellbeing of ADF members and veterans • Three key ADF Mental Health Projects – Longitudinal Resilience Study – Development of ADF Resilience Training – Mental Health Screening
  12. 12. BattleSMART Self Regulation and Resilience Training
  13. 13. Menal Health Review Goals  Enhanced research and surveillance. The pre, during and post deployment psychological support currently offered by the ADF is currently being reviewed. All personnel undergo psychological on return to Australia and at three to six months. However, the ADF believe these processes would be more effective with greater family engagement and environments which reflect a positive attitude to seeking mental health assistance. Mental Health Reform Goals
  14. 14. Research & SurveillanceResearch & Surveillance
  15. 15. RESILIENCERESILIENCE
  16. 16. ADF Resilience Study • Prospective Longitudinal Study • Being conducted in collaboration with ACPMH • Help us unpackage resilience
  17. 17. Project LASER
  18. 18.  Developed in conjunction with the Australian Centre for Posttraumatic Mental Health  Framework to mitigate and alleviate possible psychological injuries following a critical incident Critical Incident MentalCritical Incident Mental Health SupportHealth Support
  19. 19. Suicide PreventionSuicide Prevention •• Annual Awareness ProgramAnnual Awareness Program •• Peer TrainingPeer Training –– ASIST &ASIST & Keep Your Mate Safe (KYMS)Keep Your Mate Safe (KYMS) •• Provider Up skilling (Risk Assess)Provider Up skilling (Risk Assess) •• Policy and doctrinePolicy and doctrine •• All Hours Support Line (ASL)All Hours Support Line (ASL)
  20. 20. Alcohol Tobacco & otherAlcohol Tobacco & other Drugs (Drugs (AToDSAToDS)) •• Annual Awareness ProgramsAnnual Awareness Programs •• Peer TrainingPeer Training -- Keep Your Mate Safe (KYMS)Keep Your Mate Safe (KYMS) •• Provider Up skillingProvider Up skilling •• Policy and doctrinePolicy and doctrine •• Treatment ProgramsTreatment Programs –– Outpatients treatmentOutpatients treatment programs (OATP)programs (OATP)
  21. 21.  Improving mental health training. By increasing the mental health workforce the ADF will now have the mechanism to ensure that a broad and comprehensive mental health literacy program can be delivered to serving personnel. Mental health literacy will ensure that service personnel know when, where and how to seek care. Furthermore, Defence is establishing an ADF Centre of Mental Health which will become a centre of excellence in the area of military mental health programs and training of mental health professionals and providers. Mental Health Reform Goals
  22. 22. Menal Health Review Goals • Families. A member’s family is often the first to see changes in the serving member therefore Joint Health Command have embarked on a major project to inform families on mental health issues and to train health care providers in family friendly practice. •Facilities. New and improved facilities to co-locate services. Mental Health Reform Goals
  23. 23. • Rehabilitation and return to work programs. Enhancing the ADF Rehabilitation Program through better case management by medical officers and improving the training of caseworkers. • Transition services. Ensuring the transition service arrangements adequately provide seamless transition from military to civilian life for individuals with mental health. Mental Health Reform Goals
  24. 24. ADF Rehabilitation Program Purpose: Reduce the impact of injury or illness on the ADF JOINT HEALTH COMMAND
  25. 25. Biopsychosocial Model for Rehabilitation MemberMember PCMCommand Psychosocial RiskFactors •Injury, pain, mobility •Treatment & Rehabilitation • Personal characteristics •Job, work setting, •Organisation & Industry •Family & friends attitudes •Expectations of others Return to work outcome
  26. 26. ADF Paralympic Sports Program Assist ADF members to regain functional independence, physical fitness & an active & healthy lifestyle through adaptive sport •Improve amputee care •Advance personal fitness goals •Coaching & mentoring •Equity & empowerment •Mateship & teamwork JOINT HEALTH COMMAND
  27. 27. Transition Transition support is provided to ADF members by Transition Support Services. Regional ADF Transition Centres assist all separating ADF members to access information relevant to their needs as well as with transition administration. Transition Centres These centres provide information on, and link members into, Defence and government support services, such as ADF Rehabilitation Program, Defence Community Organisation, Department of Veterans’ Affairs, ComSuper and Centrelink. JOINT HEALTH COMMAND
  28. 28. Transition Initiatives SIIP Review - a gap analysis to support evidence based practice to delivering integrated and streamlined welfare, treatment, rehabilitation and compensation LifeSMART (an adaptation of BattleSMART) for ADF members who are transitioning from Defence to civilian life. Stepping Out Program run by Veterans and Veterans Families Counselling Service (VVCS) This program is a free, 2-day program developed for ADF members and their partners, who are about to, or have recently separated from the military. JOINT HEALTH COMMAND
  29. 29. Next Steps and Challenges • ADF Mental Health Strategy and implementation plan • Shape response to individual need and ADF capability • Model of service delivery- Operations to Garrison continuum • Building integrated and multidisciplinary teams –Broaden beyond psychologists and GP’s –Confidentiality, Record keeping & Sharing –Mental health awareness and training –Co-location of services and resources –Moving to internal rehab provider model • Stigma – Language, relevance, recovery focus • Impact of multiple deployments • Emerging PTS, Alcohol, depression, sleep, anger, relationships • Engaging in family sensitive and inclusive practice JOINT HEALTH COMMAND
  30. 30. Questions?
  31. 31. Contact details: David.Morton3@defence.gov.au (02) 6266 3897 JOINT HEALTH COMMAND
  32. 32. JOINT HEALTH COMMAND

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