National mental health policies and strategies

The Australian Government and all state and territory governments share responsibility for mental health policy and the provision of support services for Australians living with a mental disorder. State and territory governments are responsible for the funding and provision of state and territory public specialised mental health services and associated psychosocial support services. The Australian Government funds primary care and out of hospital specialised care through the Medicare Benefits Schedule and also funds a range of services for people living with mental health difficulties. These provisions are coordinated and monitored through a range of initiatives, including nationally agreed strategies and plans.

The importance of good mental health, and its impact on Australians, have long been recognised by Australian governments. Over the last 3 decades these governments have worked together, via the National Mental Health Strategy, to develop mental health programs and services to better address the mental health needs of Australians. The National Mental Health Strategy has included five 5-year National Mental Health Plans which cover the period 1993 to 2022, with the Council of Australian Governments (COAG) National Action Plan on Mental Health overlapping between 2006 and 2011.

Recent national developments

The Independent Hospital Pricing Authority, an independent government agency established by the Australian Government as part of the National Health Reform Act 2011, has developed the Australian Mental Health Care Classification (AMHCC) Version 1.0. The development of the AMHCC is intended to improve the clinical meaningfulness of the way that mental health care services can be classified, leading to improvements in the cost-predictiveness of care and support the implementation of new models of care.

A staged implementation of the National Disability Insurance Scheme (NDIS) began in July 2013. People with a psychosocial disability who have significant and permanent functional impairment will be eligible to access funding through the NDIS. In addition, for people with a disability other than a psychosocial disability, funding may also be provided for mental health-related services and support if required.

In 2014, the Australian Government requested the National Mental Health Commission (the Commission) to undertake a wide ranging review of existing mental health programs and services across the government, non-government and private sectors. The review’s report was released in June 2015 and was considered by a Mental Health Expert Reference Group established by the Australian government’s Department of Health to provide advice to inform the Australian government’s response to the review.

Subsequently, a further series of mental health reform activities have been initiated, including the transfer of responsibility for a range of Australian Government mental health and suicide prevention activities to the Australian government’s Primary Health Networks (PHNs) from 1 July 2016. The role of PHNs is to lead mental health planning and integration with states and territory, non-government organisation, NDIS providers, private sector, Indigenous, drug and alcohol and other related services and organisations. In addition, 12 PHNs have been established as suicide prevention trial sites, originally scheduled to operate for 3 years.

In August 2017, the Fifth National Mental Health and Suicide Prevention Plan was agreed by Health Ministers. The Commission has responsibility for reporting on the implementation progress of the fifth plan

In the 2019 Federal budget, the Australian Government announced a number of mental health-related measures, providing $736.6 million for mental health and suicide prevention initiatives over seven years. Significant measures include $373 million for additional services through headspace, for service improvements, additional centres and extension of the Early Psychosis Youth Services program, $114.5 million over 5 years to fund a trial of 8 adult community mental health centres, and $5.2 million over 4 years for measures in relation to Aboriginal and Torres Strait Islander suicide (Parliament of Australia, 2019).

Response to COVID-19 pandemic

All Australian governments have progressively been responding to the mental health impacts of the COVID-19 pandemic as they have become better understood.

In March 2020, the Australian Government expanded Medicare-subsidised telehealth service to allow Australians to access health services from home or place of care and help limit the potential exposure of patients and health practitioners to the virus. This included new temporary MBS items for service providers to provide telehealth services, either by videoconference or by telephone, as a substitution for existing face to face MBS consultation services (Department of Health, 2020). The Australian Government subsequently announced additional funding for crisis lines (Lifeline, Beyond Blue and Kids Helpline), digital and online services, and support for healthcare professionals.

State and territory governments have also introduced various mental health support packages to better support the mental health and wellbeing of their residents. Typically additional funding has been made available to both government and non-government services to either boost funding for existing services or enable new and innovative mental health services. This has included provision for existing specialised mental health services to explore COVID-19 safe methods of service delivery and support for new and existing clients.

In May 2020, National Cabinet endorsed the National Mental Health and Wellbeing Pandemic Response Plan and the Australian Government committed an additional $48.1 million in support of its priority actions. Also in May, the Australian Government appointed Dr Ruth Vine as Australia’s first Deputy Chief Medical Officer for Mental Health.


References

Department of Health 2020. Medicare Benefits Schedule Book, effective March 2020. Canberra: Department of Health.

Parliament of Australia 2019. Health, Budget Review 2019–20. Viewed 26 June 2019.