Evaluation of the national mental health strategy

Overview

Page last updated: December 1997

This evaluation considers the effectiveness and appropriateness of the National Mental Health Strategy since its inception in 1992. It draws evidence from a number of sources and points to five 'overarching' observations.

First, substantial change has occurred in the structure and mix of public mental health services in Australia over the period of the National Mental Health Strategy. The direction of change is consistent across all jurisdictions and in keeping with the national objectives.

Second, there is broad consensus that the range and quality of mental health services available in 1997 have improved substantially over those that existed in 1992. They are seen to be more responsive, more community oriented and better integrated with general health care than five years ago.

Third, there is a widely shared belief that the National Mental Health Strategy has been instrumental in producing, or at least, accelerating the change process.

Evidence provided by the States and Territories to the Commonwealth for the 1996 National Mental Health Report strongly supports this view. It shows that funds made available under the Strategy have been critical in expanding mental health services into the community and encouraging innovation.

Fourth, the Strategy has provided leverage to change human service systems operating outside the traditional mental health boundary, which have been previously reluctant to accept responsibility for mental health clients. Most important are initiatives taken to provide quality housing and employment, both critical in the promotion of mental health and well being.

Finally, despite the many positive developments, there is widespread dissatisfaction with many aspects of mental health services in Australia in 1997. Consumers continue to report problems with access to services, poor service quality and stigmatising staff attitudes. Many believe they have been disenfranchised by the new focus on 'serious mental illness'. Carers feel they have been left behind in service developments, while providers struggle to find ways of responding to an apparent escalation of demands upon their limited resources.

Outside the boundaries of the industry, primary care practitioners complain of the insularity of mental health providers, both public and private. They argue that little assistance is available to them in managing the burden of mental health problems in the community which do not 'qualify' for specialist psychiatric care.

For the community, the mental health system remains relatively feared and unknown and, according to consumers, continues to stigmatise and discriminate against those affected by mental illness.

A simple conclusion is that the mental health system in Australia at the commencement of the Strategy was in a poor state. While significant gains have been made, these need to be viewed against the historical backdrop. The National Mental Health Strategy has raised awareness of previously hidden problem areas and encouraged an expectation, if not a demand, that 'things should be better than this'.

It is the view of the committee that much work remains to complete the mental health policy agenda commenced five years ago.
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