Mental Health
Mental Health
is health
A shared approach to mental health
March 2011
Mental health is health
For too long mental health has been seen as something other than a health issue.
For too long we have seen mental health treatments separated from general health,
leading to greater isolation and stigmatisation.
For too long we have allowed a diagnosis of mental health to define a person, rather than
define and treat a condition that affects their health and life.
But mental health is a health concern like any other – and we need to embrace that, both
as Government, and as a community.
In NSW, there are more than 1.1 million people living with mental health concerns. While
this affects them, it also impacts on their families, friends, workmates and carers; we need
to ensure that mental illness is only ever an element of life, not a definer.
That’s why we are investing in integrating mental and general health care.
That’s why we have focussed on expansion of services that support those living with a
mental illness, as well as their families and carers.
That’s why we’ve been working with both small and large organisations to help them
support the mental health and wellbeing of their employees.
That’s why we continue to invest in numerous mental health promotion, prevention and
early intervention measures.
And because mental health, like general health, is a life-long and holistic process, we are
expanding mental health support to include specialist services for mums and bubs,
children and adolescents, older people and families.
This has all been underpinned by continued record investment in mental health, this year
totalling $1.2 billion.
We know that building peoples’ resilience and intervening early can prevent mental
illnesses from taking hold. We also know that providing appropriate support for those
living with a mental illness helps them to remain active members of our community.
This $98 million policy will help deliver on our five key priorities:
1. Improving outcomes for people with a mental illness
2. Reducing the rate of hospital readmissions within 28 days
3. Reconnecting people with a mental illness to employment and their community
4. Reducing rates of suicide and self harm; and
5. Expanding specialist mental health services across the lifespan, from perinatal period
and childhood and adolescence, through to family and older person’s mental health
services.
ACTION:
New perinatal mental health service
Invest $13.6 million to set up an eight-bed mother and baby inpatient unit, allowing
mothers to maintain the close bond with their baby while receiving the care and support
they need to be well again
Invest $16 million to expand maternity and post-natal home visits to support mothers at
risk of post-natal depression
Reducing homelessness
Invest $20.8 million to double the number of packages available through the highly
regarded Housing and Accommodation Support Initiative (HASI), bringing the total to
2,200 packages delivered across NSW. HASI helps people with a mental illness to
maintain independent tenancies and receive ongoing mental health care and support in
the community
Tackling depression
Continue our $1.2 million a year investment in beyondblue – the national depression
initiative – to continue the delivery of services here in NSW, in partnership with
government, schools and community organisations
We are increasing the mental health literacy of our community through education in our
schools, workplaces and in the community.
We know that the earlier we intervene, the greater the opportunity there is for a person
living with a mental illness to complete their studies and/or maintain their employment,
remain engaged in their community and experience reduced rates of admission to hospital.
Early intervention and prevention initiatives provide the best opportunity for people to stay
well and receive the care they need.
NSW Labor is committed to a robust research agenda and continues to invest in some of
the world’s top mental health researchers. These top researchers are currently working to
better understand the nature of mental illness, to develop cures and more effective
treatment options, and develop techniques to identify and diagnose mental disorders as
early as possible.
In 2006, the NSW Labor Government announced the landmark $939 million New Direction
for Mental Health package. This major investment in mental health has resulted in large
scale growth of our mental health workforce and inpatient and community-based services
across the State.
Firstly, the rapid growth of services has highlighted the nationwide shortage of mental
health nurses and clinicians. This presents an ongoing challenge in recruiting to the
growing number of services being provided across the State.
NSW Labor recognises the need to expand community-based mental health services.
The NSW Labor Government has invested heavily in the expansion of inpatient services to
ensure we have the capacity for our increasing population.
We will ensure our community-based services are strong and meet the ongoing
needs of those living with a mental illness. This will help people to manage their
illness in the community and reduce the rate of readmission to hospital.
The NSW Labor Government has been progressively expanding capacity across both the
inpatient and community sector.
NSW Labor will continue its efforts to further reduce the rate of suicide, particularly in at-
risk groups. We will do this by implementing the initiatives outlined in the NSW Suicide
Prevention Strategy.
Currently, NSW has the lowest rates of suicide in the country, however we all know that
every suicide has a deep and lasting impact on families and the whole community and that
is why we will keep working hard to reduce rates further.
LABOR OPPOSITION
Since Labor came to Government the mental No investment - The mental health budget has
health budget has tripled, and now stands at a increased threefold since the Opposition were in
record $1.231billion for 10/11. Government. ($356mil in 94/95)
There are now 2,636 mental health beds across The Coalition has failed to make any alternate
NSW (as at June 10). We’ve delivered 547 mental health policies since the 2007 election.
additional mental health beds since 2001, with Even their 2009 social policy framework Smarter,
another 108 to come on line by the end of stronger, healthier, safer made ZERO policy
2010/11. suggestions to improve outcomes for people with
a mental illness. There were no surprises then,
that the Start the Change policy document
(launched Sept 2010) continued the trend of their
lacklustre efforts in mental health with yet again,
ZERO policies in this vital area.
Delivered the landmark $939 million New The Council of Social Services NSW (NCOSS)
Direction for Mental Health Package (announced said in their submission to the Coalition on their
in 2006). policy Smarter, Strong, Healthier, Safer, “we
For the first time 82% of new money was believe that the Coalition’s three policy proposals
directed towards community based care for and areas of investigation are inadequate and
patients, instead of in-patient care. will not achieve their healthier policy goals or
social policy priorities.” (pg.6)
The mental health workforce has increased by On 2 December 2010 the NSW
20% in the past six years, with more than 8,600 Liberals/Nationals announced $2 million annual
mental health workers across NSW. funding for Lifeline
More than 50 rural hospitals are set up with The Coalition Mental Health Policy suggests a
telepsychiatry services providing expert mental Mental Health Commission but provides no detail
health care closer to home and reducing the on how this would be funded, its structure,
need for unnecessary hospital transfers. 1,480 governance, responsibilities or interface with
assessments have been held since 08/09 Government
The $38 million Housing and Accommodation
Support Initiative (HASI) has delivered over
1,100 placements, helping people with a mental
illness to maintain independent tenancies and
receive ongoing mental health care and support
in the community
861 mental health nursing scholarships provided
since 2005 and 485 professional development
scholarships for NGO workers in the Mental
Health sector
Developed and implemented the new Mental
Health Act 2007. The Act incorporates greater
emphasis on consumer, carer and family
participation in treatment plans and promotion of
community integration and engagement for
people with a mental illness.
Also developed and implemented the Mental
Health (Forensic Provisions) Act 2008, the most
significant reforms in forensic mental health in
NSW, moving the process for decisions relating
to the care, treatment, detention and release of
forensic patients from the Minister to a panel of
medical and legal experts. The Act also
strengthens the role of victims in Tribunal
hearings.
When young mothers experience mental health problems, it can be during the perinatal
period and they can be successfully cared for in the community.
International and national experts say that admitting a mother and baby together promotes
optimal bonding, attachment and breastfeeding during the crucial period of early infant
development.
In addition to this, it can avoid the trauma of separation which affects both mother and
baby. Studies have also shown that joint admissions of mother baby leads to a shorter
duration of admission, lower relapse rate and improved maternal competence.
NSW Labor will set up a specialist mother baby unit, allowing care and supervision
of mother and newborn (up to 12 months old), enables simultaneous care for both a
mother’s mental health and the development of her identity as a mother.
The development of parenting skills can also aid recovery through increased confidence
and positive self thought. The unit will be located in Western Sydney, a region with the
highest birth rate in the NSW.
A new eight-bed perinatal mental health service, funded at $3.4 million a year, will
support families and carers by engaging them in education, self care, relapse
prevention and referrals to local community supports.
NSW Labor will also expand maternity and post-natal home visits to support mothers at
risk of post-natal depression, investing $16 million to expand the number of nurses
providing these home visits, ensuring mums receive ongoing and sustained care in the
home.
ACTION:
Invest $13.6 million to set up an eight-bed mother and baby
inpatient unit, based in Western Sydney, allowing mothers to
maintain the close bond with their baby whilst receiving the care
and support they need to be well again
Invest $16 million to expand maternity and post-natal home visits
to support mothers at risk of post-natal depression
We know that 50 per cent of people living with a mental illness showed recognisable
symptoms before age 15 and only some 25 per cent of young people access any mental
health services even though 65 percent will require mental health support
Each acute psychotic episode diminishes the long term capacity of the individual, resulting
in a compounding effect of disability. Early intervention can reduce the severity and
frequency of these episodes, maximising the capacity or level of functioning of the
individual now and in the future.
Early intervention and prevention services for young people help ensure greater
understanding and management of their illness. Supporting greater stability in a person’s
mental illness has flow on effects to key areas such as education, employment,
relationships and community engagement.
That’s why NSW Labor will invest $14 million in the establishment of specialist Assertive
Community Response Teams, who will develop targeted interventions and provide swift
and customised care to children and adolescents in the community.
Improving the long term health outcomes for the individual reduces the burden of disease
on the individual, their family and carers and the community. It will also ease the pressure
on public health services, particularly acute and inpatient care.
ACTION:
Invest $14 million to set up Assertive Community Response
teams in three pilot sites in Western Sydney, the Hunter and the
Illawarra. These Assertive Community Response teams will
develop and deliver tailored community-based mental health
interventions for children and adolescents
For many people living with a mental illness, accessing and maintaining safe and
affordable housing is a key foundation in stabilising their lives and their illness.
To respond to this need, the Housing and Accommodation Support Initiative (HASI) was
implemented by the NSW Labor Government.
HASI is a state-wide partnership between NSW Health, Housing NSW and non
government organisations and ensures the provision of housing, clinical support and
rehabilitation for people with a mental illness.
The program has to date supported more than 1,100 people across NSW, with assistance
ranging from low to very high levels of support. The NSW Labor Government also
implemented a specialised HASI program providing culturally specific support for
Aboriginal people living with a mental illness.
NSW Labor will invest a further $20.8 million to double the number of HASI packages,
bringing the total to 2,200 people living with a mental illness and at risk of homelessness
who will receive this vital support.
HASI is having great success in re-engaging participants with their local community and
reducing hospital readmissions. A longitudinal study into HASI Stage One by the
University of NSW identified an 81 per cent reduction in the participants time spent in
hospital and emergency departments, 85 per cent remained with the same housing
provider, 94 per cent had established friendships and 73 per cent were participating in
social and community activities.
This award winning initiative is, in just six years, a $38 million program supporting more
than 1,000 people with a mental illness to stay well and experience an improved quality of
life.
ACTION:
Invest $20.8 million to double the number of packages available
through the highly regarded Housing and Accommodation
Support Initiative (HASI) over four years, bringing the total to
2,200 packages delivered across NSW - HASI helps people with
a mental illness to maintain independent tenancies and receive
ongoing mental health care and support in the community
NSW Labor recognises the unique challenges that impact on the mental health of those
living and working on the land in rural NSW.
The impacts of severe environmental conditions such as flood and drought have had a
significant impact on the resilience of rural communities. Geographical and social isolation
add to the difficulties and challenges facing many rural and farming families. This can have
a considerable toll on those struggling to manage their mental health and wellbeing.
Increasing access to local inpatient and community-based mental health services is a key
commitment of NSW Labor.
Boosting the number of Declared Mental Health Facilities will allow people to receive care
closer to home, in local hospitals. This means less travel time for the individual, as well as
their families and carers who provide that crucial familial support.
For families in regional and remote parts of NSW we know these are tough times, both
economically and environmentally, which is why the delivery of vital mental health services
remains a top priority for NSW Labor.
ACTION:
Invest $5.92 million to expand the number of Declared Mental
Health Facilities throughout rural and regional NSW – meaning
that patients can be treated closer to home
Around 750,000 people in NSW identify themselves as carers, with around one in 10 of
these carers helping someone with a mental illness.
Since many people fulfilling this role do not readily identify themselves as a “carer”, the
Australian Bureau of Statistics estimates the actual number of mental health carers in
NSW may be up to 110,000.
Caring for someone with a mental illness is a task undertaken with great love and
compassion and is very satisfying when loved ones are thriving. However in the difficult
times, caring for someone with a mental illness can cause physical and emotional
overload, frustration and poor health.
NSW Labor will invest an additional $8 million in the NSW Family and Carer Mental Health
Program, which provides funding to non-government organisations and all Local Health
Networks to support families and carers of those living with a mental illness.
The program aims to ensure that families and carers have access to appropriate
information and options for support at all points within their caring journey at the time they
need it, and ensuring information and support is delivered in a sensitive and evidence-
based manner.
The NSW Family and Carer Mental Health Program, already funded at $4.96 million a
year, also provides support to young carers who face particular challenges in completing
their secondary education, maintaining social networks and getting into paid employment.
This comes on top of the issues often encountered by other carers, such as isolation and
feelings of helplessness. By supporting young carers, the program is helping to prevent
long term disadvantage and health problems in young carers.
NSW Labor is committed to supporting this initiative which delivers education and training,
advocacy, individual and peer support and promotes greater participation of families and
carers in the treatment and recovery of their loved ones. By educating families and carers
about mental illness and providing them with coping strategies, they are more able to help
mental health consumers manage their illness, thereby helping to prevent acute
admissions and enabling consumers to integrate better into the community.
ACTION:
Commit an additional $8 million to the Family and Carer Mental
Health Program – which funds non-government organisations
(NGOs) to provide ongoing services and support to families and
carers of those living with a mental illness
Driving a strong research agenda will help in the delivery of a best-practice model of care
where clinicians and mental health workers are exposed to some of the latest research
and evidence-based information to help in the treatment of those living with a mental
illness.
NSW Labor is determined to continue its support of mental health researchers and their
efforts to improve the treatments available to those living with a mental illness, as well as
those working to find a cure. Advancements in the field of mental health research will
deliver improved outcomes for some of the community’s most vulnerable members.
The Chair of Schizophrenia Research is the first position of its kind in Australia and is
undertaking groundbreaking research into the effectiveness of new medications in the
treatment of schizophrenia.
The NSW Labor Government has been very proud to support her role and this potentially
life-changing research and NSW Labor will continue that support, with $2 million towards
the position from 2011/12-2014/15.
NSW Labor will also invest $3million in the establishment of a Mental Health Clinical
Academic Research Program designed to provide support those with outstanding potential
for development as a researcher. The program will drive collaborations and foster the
exchange of ideas between mental health researchers, as well as helping to ensure the
latest evidence-base is disseminated to Local Health Networks.
NSW Labor’s continued investment in mental health research has already secured five of
the world’s top 10 leading mental health researchers working in our universities and
research institutes. We are world leaders in mental health research and our continued
investment in this field will ensure that tradition continues.
ACTION:
Continue to invest $500,000 a year to secure here in NSW world
leading Schizophrenia researcher, Professor Cyndi Shannon
Weickert, as the Chair of Schizophrenia Research and support
the groundbreaking research being undertaken in the hope that it
will lead to improved treatments for schizophrenia and one day, a
cure
Invest $3 million to establish a Mental Health Clinical Academic
Research Program to support the development of career
researchers within the area of mental health
We know of the high prevalence of mental health disorders in older people and in
particular, high rates of major depression, anxiety disorders and behavioural and
psychological symptoms associated with dementia.
According to current estimates, there are about 71,400 people with dementia in NSW
(Access Economics, June 2005). Approximately 11 per cent of this group (Brodaty et al,
2003), or 7,850 people will experience severe behavioural and psychiatric symptoms
Specialist Mental Health Services for Older People (SMHSOP) support and care for older
people with acute mental illness and/or severe behavioural and psychological symptoms of
dementia and/or mental illness.
The delivery of four additional beds in the Specialist Older Persons Mental Health Unit at
the Calvary Mater Hospital in Newcastle, will result in an increase in direct care nursing
hours and additional dietetics and clinical psychology support and will bring to 22 the total
number of specialist beds available in the Unit.
NSW Labor is determined to increase the ability of Local Health Networks to respond to
the needs of older people with complex mental health problems and their families and
carers.
ACTION:
Commits $3 million to expanding the Specialist Older Persons
Mental Health Unit at the Calvary Mater Hospital in the Hunter
We know that those with co-morbid mental illness and substance use disorders are likely
to experience more severe and chronic medical, social and emotional problems than if
they had a single disease or disorder.
A ‘snapshot’ data survey conducted in 2005, found that about 10.7 per cent of 2,769 NSW
Health mental health clients with an identified diagnosis also had a known drug or alcohol
disorder.
NSW Labor will invest $6.9 million in the establishment of two Drug and Alcohol
Involuntary Treatment Centres in NSW.
The Centres will provide for the short-term involuntary treatment of persons with severe
substance dependence for up to 28 days and up to three months, if required, with the aim
of improving their health and safety, followed by six months of assertive aftercare. This is a
significantly different approach from the long-term hospital solution offered by the
Inebriates Act 1912.
The Evaluation of the Involuntary Treatment Unit Trial at Nepean Hospital concluded that it
was more effective for providing drug and alcohol treatment to the target group and was
more consistent with contemporary values regarding human rights and dignities of
severely substance dependent people.
ACTION:
Invest $6.9 million to establish two Drug and Alcohol Involuntary
Treatment Centres in NSW - the centres will provide short-term
involuntary treatment of persons with severe substance
dependence with the aim of improving their health and safety,
followed by six months of assertive aftercare
In Australia, there are around one million adults and 100,000 young people living with
depression each year.
An Australian Burden of Disease study estimated that in 2006, more than 600,000 people
across NSW suffered from depression and/or anxiety, which is why NSW Labor is
determined to continue its investment in initiatives that support those living with
depression.
Nationally, depression is currently the leading cause of non-fatal disability, yet less than 50
per cent of people with depression receive medical care. Depression-associated disability
costs the Australian economy $14.9 billion annually, with more than 6 million working days
lost each year.
NSW Labor will invest a further $4.8 million in beyondblue and its efforts to raise
awareness of depression and related disorders in NSW, enabling communities to respond
effectively and individuals to receive the care they need.
ACTION:
Continue our $1.2million a year investment in beyondblue – the
national depression initiative – to continue the delivery of services
here in NSW, in partnership with government, schools and
community organisations
The NSW Labor Government has maintained a strong commitment to building the State’s
network of inpatient mental health services. This includes providing a range of specialist
services to support people across the stages of an acute episode and their subsequent
recovery through mental health intensive care and high dependency units, acute and sub-
acute units and day-units to assist in the transition from inpatient to community-based
care.
NSW Labor will deliver a number of new state-of-the-art inpatient services across New
South Wales and will continue its strong record of integrating mental health services into
the wider health setting, recognising that mental health care is strengthened through easy
access to other health services such as physical health care.
The $64.7 million expansion of the Campbelltown Mental Health Service will include the
redevelopment and expansion of existing inpatient services to include an additional 70
beds and will provide a mix of acute services and enhanced specialist care.
The new Psychiatric Emergency Care Centre at Blacktown Hospital and the Safe
Assessment Room at Mt Druitt Hospital will provide a separate space for specialist
assessment and monitoring of mental health patients presenting to emergency
departments and reduce delays in accessing care and delivering better outcomes for
patients.
A new 20-bed sub-acute acute unit at Wyong Hospital will form part of the major
$120million expansion of Gosford and Wyong Hospitals, whilst new services to be
delivered at Liverpool Hospital will form part of the massive $289.9 million stage 2 works in
the major redevelopment of Liverpool Hospital.
ACTION:
Providing a state of the art inpatient mental health system to
increase access to intensive support when people need it. This
includes a new Psychiatric Emergency Care Centre at Blacktown
Hospital, a Safe Assessment Room at Mt Druitt Hospital, a 20-
bed sub-acute unit at Wyong Hospital, an additional 70 beds at
Campbelltown Hospital and new mental health services as part of
the Liverpool Hospital redevelopment
Authorised and printed by Michael Lee, 377 Sussex Street Sydney NSW 2000.