The Victorian Government is committed to reporting annually to parliament and the community on the performance of Victoria's state-funded mental health services.
Victoria's mental health services annual report 2018-19 is the fourth to be tabled. It provides an overview of Victorian Government-funded mental health services and the Victorians who accessed them for treatment, care and support in 2018-19. This includes a range of hospital and community-based clinical mental health services, and non-clinical services provided by mental health community support services.
Victoria's mental health services annual report 2018-19 also provides an overview of the initiatives being delivered as part of Victoria's 10-year mental health plan, including work to reduce suicide in local communities, support and strengthen our mental health workforce and improve resilience, social and emotional wellbeing and mental health in the Victorian Aboriginal community. It is critical that these initiatives continue while the Royal Commission into Victoria's mental health system continues its work.
Monitoring progress and reporting on outcomes under our 10-year mental health plan helps us understand the impact of our programs and services on people's lives over time. The report contains the 10-year mental health plan outcomes framework. The framework incorporates a range of indicators relating to system performance, clinical outcomes and consumer experience.
Year in review - public mental health services in 2018-19
The mental health data we collect helps us to understand who accesses our services and how, the service settings and the circumstances in which treatment is provided, and whether that treatment results in better outcomes. It also tells us about demand for, and use of, our services.
There were 74,794 registered clients in 2018-19 which represents a small (2.6 per cent) increase from 2017-18, spread unevenly across client groups. The increase in our largest client group, adults, is 2.5 per cent, whereas the increases in child and adolescent mental health and forensic services are above 10 per cent. There have been slight reductions in client numbers for aged persons mental health and specialist mental health services.
There is a similar picture in community clinical mental health services. A small increase in service contacts overall can be broken down to larger increases in forensic, specialist and child and adolescent mental health services. There is a small increase for adults (3.1 per cent) and a decrease for aged client contacts (down by 4.7 per cent).
Total service hours have increased by 6.5 per cent overall, but the impact varies across different client groups. For aged clients there has been a reduction of 0.9 per cent, but for forensic clients, there has been an increase of 34.4 per cent.
Consistent with previous years, the data continues to show that adult inpatient services are under significant pressure to meet demand. Hospitalisations of adults for mental illness are increasing, adult services have very high occupancy levels, and the average length of hospital stays is under 10 days. Forensic services are also under pressure, with very high bed occupancy and a relatively small number of separations.
Bringing the consumer voice into mental health services
Consumer consultants have been employed in Victorian services for more than two decades and have changed the way services, staff and consumers interact and engage with each other. Consumer consultants encourage and support service improvement and seek to ensure services provide high-quality care with compassion, respect and dignity. This role requires careful consideration of the needs of the consumer and their families or carers.
'I never thought I would be a consumer consultant; I never thought my voice would matter. After many, many years of complex mental illness, complex trauma, suicide attempts and intensive therapy I thought the best I could do was to just share my story. Now, after five years of being a consumer consultant with Alfred Mental and Addiction Health, I find that I am highly valued and regarded across the service for more than my story - my courage, my opinions and my insights are all respected.
'Hearing the experiences of consumers using our service and being able to include consumers and their experiences in service improvement, incident reviews and designing new programs and procedures is why I love my job so much. There are times where it is very difficult being the only consumer voice in a room of 40 highly educated clinicians explaining why I disagree - but I am blessed in that my colleagues have always been supportive and respectful because they see me as an equal with a different type of expertise.'
- Catherine Bennett, Consumer Consultant, Alfred Mental and Addiction Health
Improving outcomes for Aboriginal Victorians with a mental illness: demonstration project
The department has funded four demonstration projects to deliver integrated, culturally safe mental health services designed to meet the mental health, social and emotional wellbeing needs of their local Aboriginal communities. Each consortium is led by an Aboriginal community-controlled organisation in partnership with a local public health service.
The four sites began operating in 2018-19 and recruited multidisciplinary teams comprising psychologists, dual diagnosis workers, Aboriginal mental health workers, psychiatrists and cultural workers.
'The program is there to support people that are showing signs of mental ill health. And it's providing a link into our clinical services ... and also into mainstream services. In the past, Aboriginal people haven't linked into mental health services, and our programs provide a bridge for them to do that. We have seen a lot more self and community-based referrals, which has shown that they're more supportive of the program as well. Our partnership with the mainstream health services is extremely important. This provides an opportunity for us to understand each other's clinical environments ... It is very important for us to work together for the best outcomes for our clients.'
- Paul Hogarth, Team Leader, Mallee District Aboriginal Services
Delivering HOPE at Alfred Health
Under the Hospital Outreach Post-suicidal Engagement (HOPE) program, mental health professionals provide one-on-one support to people who have attempted suicide and make sure they get both the clinical and psychosocial support they need to recover.
At the heart of the HOPE initiative is an understanding that suicide prevention is most effective when integrated with broader efforts to improve social and emotional wellbeing. People who have attempted suicide are supported to address the stressors in their lives depending on their unique circumstances and needs. For example, they may need assistance finding housing or employment, or can be referred to a range of support services, such as education, training, legal support, Centrelink, drug and alcohol services or relationship and family services.
Alfred Health has established an innovative approach to providing aftercare for people discharged from hospital following a suicide attempt. The model was developed with peak consumer and carer bodies and through local and consumer and carer consultations.