Pathways of recovery: 4As framework for preventing further episodes of mental illness

Evaluating and monitoring implementation and outcomes

Page last updated: 2006

The implementation of any initiative requires monitoring, review and evaluation to determine whether the required actions are taking place and outcomes being achieved. A significant initiative to enhance implementation of the 4As Framework is already available through the National Standards for Mental Health Services.15 The guiding principles for these standards are consistent with the 4As Framework.

The guiding principles for the National Standards are:

  • the promotion of optimal quality of life for people with mental disorders and/or mental health problems;

  • a focus on consumers and the achievement of positive outcomes for them;

  • an approach to consumers and carers that recognises their unique physical, emotional, social, cultural and spiritual dimensions;

  • the recognition of the human rights of people with mental disorders as proclaimed by the United Nations Principles on the Protection of People with Mental Illness and the Australian Health Ministers Mental Health Statement of Rights and Responsibilities;

  • equitable access to appropriate mental health services when and where they are needed;

  • community participation in mental health service development;

  • informed decision making by consumers about their treatment;

  • continuity of care through the development of intersectoral links between mental health services and other organisations;

  • a mental health system which emphasises comprehensive, coordinated and individualised care;

  • accountability to consumers, carers, staff, funders and the community;

  • adequate resourcing of the mental health system; and

  • equally valuing the various models and components of mental health care.
Top of pageEnsuring implementation of these principles through accreditation, funding, and monitoring of mental health services would go a long way toward implementing the 4As Framework. Admittedly, a limitation of the National Standards is that they are intended to apply only to services that identify specifically as mental health services, and a much wider range of health and human services support the implementation of the 4As Framework. However, it is important to note that some relevant sectors, such as the peer support and psychiatric disability sectors, already apply many of these principles. Wider system change is required to generalise these principles, so that they apply to all those services and sectors that provide continuing care for people who have been seriously affected by mental illness and their families and carers.

At a minimum, to monitor implementation of the 4As Framework, the following outcomes need to be independently monitored and reported by jurisdictions:
  1. Level of resourcing of the consumer support sector, and indicators of ability to meet community need.

  2. Level of resourcing of the carer support sector, and indicators of ability to meet community need.

  3. Level of resourcing of rehabilitation, disability and psycho-social support services, and indicators of ability to meet community need.

  4. Availability of self-management resources and support, and indicators of ability to meet community need.

  5. Evidence that appropriate planning processes to support integration and continuity of care are in place.

  6. Evidence of the extent to which the workforce has competencies related to prevention and recovery.