Speaking frankly...                                       

Competition in mental health services - be careful what you wish for

Two of the key recommendations of our pre-Budget submission this year are to urgently address the gaps opening up in the mental health service system, and to address unprecedented levels of funding uncertainly – which is holding back co-investment and undermining mental health workforce and development.

With this in mind, I have noticed a growing trend in our public reform discourse to suggest that where such problems exist, greater competition between services is the answer.

This seems to be especially true when we talk about NGO services, perhaps because so many other parts of the system are protected from competition by public funding (hospitals and related services), many clinicians (through Medicare privileges) and government departments (who are often monopoly funders).

The discourse often begins with the largely mythical history of NGO’s basking in overly generous block grants, delivering fragmented and inadequate services, and somehow pocketing, or otherwise wasting substantial surpluses. 

Enter competition. Primary Health Networks release tenders for services and only select the most efficient services – killing off the fat cats in the process. The NDIS places selection of services firmly in the hands of individual service users, yielding more efficient and effective services and programs.

Now let me say that as in any sector, some NGOs have performed badly. In almost all cases this could have been better managed if funders had actively monitored and managed their contracts. In too many cases, services and programs have not adequately met the needs of those who use them, but in many cases this is because individual and isolated governments, and government departments, purchase services in isolation from each other, and maintain barriers that do not allow NGOs to integrate programs from separate funders or collaborate properly with organisations that are not party to individual funding agreements.

But if we are placing the future quality and distribution of future services in the hands of competition alone, we need to be aware of some pitfalls.

Competition alone does not overcome the barrier of multiple, isolated funding streams.

Competition targeting NGOs alone cannot overcome the barriers to integration with clinical and publicly funded services.

Competition alone does not endow consumers with equal information and power, undermining the power of the consumer with what market economists call “information asymmetry”.

True competition would create a market in which shortages of high quality services demanded by consumers (both regionally and nationally) would yield an increase in price, but this part of competition is currently constrained by rationing.

If we are to improve service integration, our attention should be focussed closely on disintegrated funding streams, poor planning, short term and ad hoc agreements, poor contract monitoring and management, and destructive forms of rationing.

On our current trajectory I fear we risk throwing important NGO programs and workforce out with the proverbial bathwater. And to do so would deprive future consumers of the quality, choice and control to which they are rightly entitled.

Frank Quinlan
Chief Executive Officer
 

Video: Minister for Health Greg Hunt MP at Parliamentary Advocacy Day

I'm pleased to share the final video instalment of our 2017 Parliamentary Advocacy Day coverage, being The Hon Greg Hunt MP addressing delegates on the day. Once again, please share the video through your own networks and social media platforms.

Meet a Mental Health Australia Member

Neami National

Neami National is a community mental health service supporting people living with mental illness to improve their health, live independently and pursue a life based on their own strengths, values and goals.

They provide services in diverse communities in Western Australia, Queensland, South Australia, Victoria and New South Wales, ranging from the inner-city and suburbs to regional and remote areas.

Their Vision is 'Full citizenship for all people living with a mental illness in Australian society', and their Mission is 'Improving mental health and wellbeing in local communities'.

Web - http://www.neaminational.org.au/
Facebook - http://www.facebook.com/NeamiNational
Twitter - http://www.twitter.com/NeamiNational

Become a Member of Mental Health Australia

As the peak body for the mental health sector in Australia, Mental Health Australia is uniquely placed to influence the national debate on mental health issues and achieve our vision of mentally healthy people and communities. Representing more than 100 organisations in the mental health sector, find out more about Membership at the link below.

Parliamentary News

Leaders unite for inaugural 'Stop Suicide Summit'

Lifeline will host the inaugural National Stop Suicide Summit in Sydney on 1 May 2017, with leaders from a range of backgrounds coming together to offer 'new thinking and new solutions' to the national suicide emergency. Lifeline Australia Pete Shmigel said that the summit is about taking a whole-of-community approach to the whole-of-community issue, and having a discussion beyond the traditional mental health focus. "With about a million interactions across our 13 11 14 crisis line and online Crisis Support Chat service last year, we know better than most the complex personal support needs, social and economic challenges that Australians are struggling with," Mr Shmigel said.

New headspace centre for Whyalla 

The Turnbull Government will establish a new headspace mental health service in Whyalla, South Australia to provide ongoing support to young people in the region. This service will provide a welcome boost to local mental health services, in an area previously identified as being of high need. Federal Member for Grey, Rowan Ramsey, said the Whyalla community will benefit from this new headspace.
 

 

Time for a national rural health strategy 

Labor supports the development of a national rural health strategy and associated implementation plan, as part of ensuring there is clear and targeted action towards closing the gap in health outcomes between Australians living in rural areas and their metropolitan peers. Shadow Minister for Health Catherine King announced Labor's support for a strategy at the National Rural Health Conference in Cairns, calling on the Government to join in bipartisan support.

 

Dysfunctional mental health system urgently needs much more than money

Professor Ian Hickie has challenged the sector to reform what he says is a dysfunctional system instead of just seeking additional funding to paper over the cracks and support ineffective programs. In an editorial in the latest edition of the Sax Institute’s journal Public Health Research & Practice, Professor Ian Hickie said: Increased funding for expanded mental health services is crucial, but unless we overhaul the system and have the courage to defund ineffective programs, we will be throwing good money after bad. Professor Hickie, who is Co-Director of Health and Policy at the Brain and Mind Centre at the University of Sydney, and a Commissioner on Australia’s National Mental Health Commission, is the guest editor of the journal’s latest issue, which focuses on mental health.

Support program for people impacted by early stage dementia on the North Coast

People living with early stage dementia on the North Coast, as well as their support person or carer, will benefit from additional information and support thanks to a free Alzheimer's Australia NSW educational program. The Living with Dementia program is set to be hosted at Taree, Coffs Harbour, Forster and Port Macquarie over the coming months, giving people impacted by dementia a chance to connect and share with other people in similar circumstances. The Hon. John Watkins AM, CEO Alzheimer's Australia NSW said, "A diagnosis of dementia can be overwhelming and can leave people unsure of where to turn."

Summit marshals community action to reduce ice supply, demand and harm

The Palaszczuk Government has gathered more than 150 health experts, drug and alcohol service providers, law enforcement officials, community representatives and affected families in Rockhampton today to marshal an action plan to confront the insidious and devastating drug, ice. Opening the Summit today, the Premier said the Government's draft plan of 65 actions, was consistent with the national strategy, to reduce supply, reduce demand and minimise harm from ice, and she outlined the investment priorities for a dedicated funding almost $50 million. "Ice is a cheap, potent, and easy-to-access drug that is a national scourge - indeed it is a global scourge."

Reminders

Save the Date - National NDIS Mental Health Conference, 16-17 Nov 2017

Towards Elimination of Restrictive Practices Forum - virtual delegate

Resources for people watching TV series '13 Reasons Why'

Call for suitable resources to add to a new online library

Article in Health Voices journal 'Health insurance and psychiatry – covered or not?'

Free 'Carers and the NDIS' workshops starting next week: NSW

Please assist Carers NSW to promote the following upcoming workshops to the families and carers you work with and through your networks.

Marrickville – 1 May & 15 May
Shellharbour – 4 May  & 18 May
Waverley – 8 May & 22 May
Ashfield/Strathfield – 11 May & 25 May
Nowra - 7 June & 21 June
Ulladulla – 8 June & 22 June
Sutherland – 13 June & 27 June
Ryde – 15 June & 29 June
Botany Bay/La Perouse - 18-July & 1 August
Port Macquarie - 20 July & 3 August
Dubbo – 10 August & 24 August
Coffs Harbour -14 August & 28 August
Parkes – 16 August & 30 August
Cowra – 17 August & 31 August
Redfern – 4 September & 18 September
Ballina – 6 September & 20 September
Grafton – 7 September & 21 September
Griffith – 10 October & 24 October
Leeton – 11 October &  25 October
Wilcannia – 1 November & 15 November
Broken Hill – 2 November & 16 November
Tweed Heads – 6 November & 20 November
Balranald – 22 November & 6 December
Deniliquin – 23 November & 7 December
Queanbeyan – 30 November & 14 December

Full information and flyers on each workshop can be found in the Education & Training Calendar on their website.

2017 Annual Symposium 'Innovation in mental health' -
Early Bird registrations closing 30 April 2017

Early Bird pricing for at the One Door Mental Health Annual Symposium in Sydney 'Innovation in Mental Health' is closing on 30 April 2017.

On the agenda is Professor Niels Buus (Professor of Mental Health Nursing at Sydney University), an internationally renowned expert in Open Dialogue. CEO of Suicide Prevention Australia Sue Murray will also join us to share what is to come on our path towards a national suicide prevention strategy. 

Do not miss these, and many other, industry leaders at the One Door Mental Health Annual Symposium. Download the program here.  Saturday 20 May - 9 am - 4 pm, Aerial UTS Function Centre, Ultimo, Sydney 
For more information or to book online click here.  

'Healing Voices' - a social action documentary screening 4 May in Melbourne

The new social action documentary 'Healing Voices' will screen at Cinema Nova in Melbourne on 4 May 2017.The documentary explores the experience labelled as 'psychosis' and will feature live Q&A with members of the mental health community.

 

Invitation to attend the Australian Social Value Bank (ASVB) Social Impact Measurement Training Series

Daniel Fujiwara, a global leader in Social Impact Measurement (SIM), will visit Australia to deliver a series of training sessions in Melbourne, Canberra and Sydney in April/May 2017. 

The ASVB believe that within the current Australian context anyone in the business of helping people; government, corporate, philanthropic and not-for-profit alike, is going to have to start being able to demonstrate the value of the social impact they create. The ASVB supports organisations to assess and measure their social impact in a resource appropriate and proportionate way making SIM accessible and achievable to all organisations.