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 Aim:
To lead the
development of a mental health system which brings about a reduction in the impact of
mental illness on the lives of individuals, their families and the community and to bring
about a significant decrease in the incidence and prevalence of mental illness.
Achievements
New Mental Health Act passed The Mental Health Act 1996 will be proclaimed in November 1997 and is set to significantly improve mental health care by enabling involuntary treatment to occur in the community as well as hospitals, enabling the approval of a greater range of inpatient units for involuntary treatment and providing for more rigorous means of appeal and review of involuntary orders. During 1996/97, work in preparation for implementation of the Act has involved consumers, carers and providers and included:
Swan Child and Adolescent Clinic opens
The Ministerial Task Force on Mental Health recognised services for children and adolescents are often scattered and isolated. Many areas in the State, and in the metropolitan area, were receiving low levels of service relative to their needs. The Mental Health Division is localising services so that people can access mental health facilities closer to where they live. A new child and adolescent mental health clinic opened at Midland to provide a local service within the Swan Health District for children with severe mental or emotional problems. A new and much-needed service, it will provide clinical mental health services to the Swan and Kalamunda area. The need for this facility had been acknowledged by all service providers in the Swan area as children were previously referred to a clinic at Warwick or the East Victoria Park campus. At Bentley Hospital a 12-bed inpatient unit for adolescents was developed, including construction of a new office building on the site. Child and adolescent community services were expanded in Bunbury and Lower Great Southern Health Services and at Graylands. Planning was initiated to expand service provision in the southern metropolitan area and services are expected to be established in 1997/98. Expansion of community services for the elderly in Lower North Metropolitan, Swan, Inner City, Fremantle, Armadale/Kelmscott, Bentley, Lower Great Southern and Bunbury Health Services. Other rural areas were allocated funds to enable the provision of additional clinical and support and education. The positions in the Lower Great Southern and Bunbury are the first positions outside the metropolitan area. There is a plan to consolidate these in 1997/98. Rooming-in units A special care and rooming in unit was officially opened at Esperance by Health Minister Kevin Prince in April 1997. The new facility accommodates seven patients with mental health problems and for some, prevent the need to travel to Graylands Hospital for treatment. The unit is staffed by a number of general nurses with special training and support from a specialist mental health nurse. The system was based on a similar model in Taree, northern New South Wales, which was highly successful at reducing the length of stay and severity of illness for patients. Enabling the patient to remain in their own community, the Esperance facility also has provision for family members to stay overnight. The success of the Esperance facility led to the proposed opening of similar units in Albany and Geraldton in 1997/98. Expansion of supported accommodation Housing stability reduces the need for inpatient care and enabling people with a chronic mental disorder to participate in community life. The Independent Living Program was expanded by 70 places in 1996/97 and with another 70 places allocated by Homeswest for 1997/98 there are now 230 places Statewide. The Health Department provides funding for tenancy management and social support for residents which are delivered by non-government agencies. These services were expanded in the metropolitan and some country areas and a new service was established in Albany. New areas to be established in 1997/98 include Esperance, Kalgoorlie, Narrogin, and Geraldton. Crisis and respite care
Community support services In a move to strengthen the role of the non-Government sector, 20 services received funding to enable either an extension of community support service provision or the establishment of new services. Areas which benefited from this were Fremantle, Rockingham/Kwinana, Armadale/Kelmscott, Swan, the north metropolitan area, Albany, Geraldton, Kalgoorlie, Esperance and the Southwest.
The WA Association for Mental Health received additional funds to extend its peak body and system advocacy roles. Additional funding provide for expansion of Aboriginal Community Support Service in the lower north, east and south eastern metropolitan area. Recruitment initiatives show success Adult mental health services have gained most from the successful recruitment of psychiatrists from overseas and increased intake of the psychiatric training program. The Department is continuing to recruit psychiatrists from interstate and overseas to overcome a widely acknowledged shortage in Western Australia. In 1996/97, 16 psychiatrists were recruited and the local training program was expanded by eight places. A further 10 graduates are expected over the next year. There is still a need for overseas and interstate recruitment, however the focus will be on psychiatrists who have specialised in child and adolescent and elderly psychiatry and those prepared to work in rural and remote areas. During 1997/98, the Department will implement initiatives to address problems in retaining experienced clinical psychologists and in recruiting mental health nurses. This includes providing scholarship support to registered nurses undertaking postgraduate study in mental health nursing.
Centres of Excellence Several joint university and Health Department initiatives have promoted applied research and service improvement. The Centre for Primary Care links the University of Western Australia Department of Psychiatry and Fremantle Hospital. Its role is to research models for increased involvement of primary carers in mental health service provision and training and education of primary carers in assessment and treatment of mental disorders. To date the focus has been on general practitioners training. Two senior research positions have been established at the Child, Adolescent and Youth Psychosocial Research Centre with links between the University of Western Australia Department of Paediatrics and the TVW Telethon Institute of Child Health Research based at Princess Margaret Hospital. The research, training and consultancy concentrates on the prevention of mental health problems and includes co-ordination of youth suicide prevention activity through the WA Youth Suicide Advisory Committee and a longitudinal evaluation of a program to reduce conduct disorder. The centre complements the work of the Centre for Child and Adolescent Psychiatry established in 1995/96 within the University of Western Australia Department of Psychiatry at Princess Margaret Hospital. Staffing of the Unit of Mental Health for the Elderly was expanded through the recruitment of an Associate Professor in 1996/97. The unit is based within the University of Western Australia Department of Psychiatry at Sir Charles Gairdner Hospital. A Statewide Unit in Forensic Psychiatry was formed, providing as involves a link between the Graylands Hospital based Frankland Forensic Unit and the University of Western Australia Department of Psychiatry. The unit is expected to be fully established in 1997/98. Centre for Clinical Research in Neuropsychiatry One of the highlights of Mental Health Week in October 1996 was the official opening of the newly established Centre for Clinical Research in Neuropsychiatry. Situated at Graylands Hospital, the research initiative was a collaboration between the Hospital and the University of Western Australia. It aims to conduct basic and clinical research in neuropsychiatry which is internationally competitive and based on a concept linking together research, clinical teaching, community service and dialogue with consumers. The unit has clinical and research staff funded by Graylands Hospital or by research grants and postgraduate students. New boundaries Local mental health service needs were prioritised with the establishment of new boundaries for regions. six rural and four metropolitan regions were established - The rural regions are: South West, Great Southern, Goldfields, Midwest, Midlands, and North West. The metropolitan regions are : North Metropolitan, South East Metropolitan, East metropolitan and South West Metropolitan. This process will ensure that the populations of regions will receive comprehensive services operating within statewide priorities. Consumer views Planning progressed for the development of a Consumer Participation Plan to provide guidelines and recommendations for the ways in which consumers and carers can participate at all levels within the mental health sector. The first Consumer Forum was held and consumers and carers were invited to participate on all Divisional advisory groups. Six places were sponsored for participation in the annual Mental Health Services Conference and a Consumer Representative Training Program started. Youth priority The Mental Health Division continued to contribute to State/Commonwealth partnerships. Programs for the prevention of youth suicide have identified Kimberley, Goldfields and Peel as priority areas for development of rural services and it is expected that these will be established in 1997/98. Key reports:
Focus on Aboriginal health Commenced development of a joint Aboriginal mental health program with Office of Aboriginal Health. Information systems A report on information systems necessary to support community based mental health services was completed. LAMHIS (Local Area Mental Health Information System) is currently being trialled and will be installed throughout the State as an interim measure to provide patient care and management data to community and hospital - based mental health services. Hostel licenses The Private Sector Licensing Unit of the Health Department took over the incorporation of psychiatric hostels licensing and standards monitoring. |
