WAAMH Response to State Budget: mental health

We welcome the recent pre-State budget announcement on mental health spending in Western Australia and acknowledges there are positive measures included in the announcement, and the significant increase in overall spending into the mental health budget.

However, the rate of growth in spending on prevention and community support continues to fall relative to the rate of spending in acute services.

WAAMH is concerned the longer this persists the further WA will fall behind in the optimal mix of services people require access to, to address their mental health needs and relieve pressure on our acute mental health services.

These most recent commitments do not appear to progress the optimal mental health service mix Western Australians urgently need for an affordable and sustainable mental health system, that puts people at the centre of their experience and recovery.

WAAMH continues to advocate for its members and people with lived experience for an increase in mental health prevention and community support that would keep the pressure off our hospitals long-term and reduce mental health related ambulance ramping by providing the proverbial fence at the top of the cliff.

Detail: $495m for the Mental Health Commission

WAAMH will be able to do a comprehensive analysis, including an assessment of the spend across service streams relative to the optimal service mix, when the State Budget is released on 9 September 2021.

Detail: $7.9M for Child and Adolescent Mental Health Services

WAAMH particularly welcomes the urgent $7.9m for Child and Adolescent Mental Health Services. The WA Better Choices. Better Lives ten-year mental health plan recognises that community treatment services for infants, children and adolescent are particularly under resourced. WAAMH anticipates that future proposals to Government resulting from the current Child and Adolescent Taskforce will include further capacity given the increased demand on services, however this must be coupled with investment in non-treatment, non-clinical support that provides children with a range of recovery options for both them and their families.

Detail: $36 million for the Active Recovery Teams

WAAMH is pleased to see $36 million for the Active Recovery Teams across several locations, including regional locations in Geraldton and Northam. The ART model was designed to bring community treatment and community Alcohol and Other Drug or mental health supports together to target people who regularly return to hospital because their needs are poorly met once they leave hospital. This was particularly highlighted by the Auditor General’s report on Access to Adult Mental Health Services. It is especially important during the pandemic to ensure that we are doing what we can to avoid people presenting to hospital unnecessarily- so it is good to see this group prioritised. We look forward to further detail on those teams including how much is going to treatment and how much to non-clinical community support services. WAAMH is including both Geraldton and Northam and their surrounds in our current regional community support needs project.

Detail: $24.6m for emergency mental health centres in Rockingham and Armadale localised community mental health support needs.

WAAMH welcomes the $24.6m for emergency mental health centres in Rockingham and Armadale. We know that emergency departments can be traumatising places for people experiencing distress. We also know people can wait hours and late into the night and sometimes days to be assessed when they present to emergency departments. However, WAAMH would support a model that provides an alternative to emergency departments that is available 24 hours-day, and that keeps people away from hospital environments.

Detail: 109 mental health hospital beds

WAAMH acknowledges the creation of a further 109 mental health inpatient hospital beds and that these are intended to move people out of emergency departments more quickly. However, we recognise that there are persistent issues impacting on patient flow which need to be immediately addressed, including chronic underfunding of prevention and community-based recovery services. This would ensure that our mental health inpatient resources are focussed on those in need and that people’s recovery is not hampered by having to spend extended periods in hospital beyond what is clinically required. It is important that we monitor this as a measure of the performance of the mental health system as a whole.
WAAMH looks forward to working with the government to overcome barriers to patient flow, including ensuring that people with psychosocial challenges are able to make use of the National Disability Insurance Scheme (NDIS) to appropriately meet their needs, and increasing access to supported accommodation options. WAAMH hopes to see future expansion of non-clinical community mental health supports to build the recovery pathways people need as they leave hospital and complement publicly delivered treatment services.

Detail: Investment in primary prevention

WAAMH is disappointed there is not a stronger investment in primary prevention. The current funding commitments put prevention behind in the optimal mix target of 5 per cent of the Mental Health Commission budget, as outlined in the Better Choices. Better Lives ten-year mental health plan and the Sustainable Health Review Final Report. The rate of growth in acute and intensive services is outstripping the rate of growth in prevention. Prevention investments will change the trajectory of demand, but the longer we delay the longer it will take to ease pressures on the mental health system.

Detail: Community Support

WAAMH continues to call for increased and additional investments in prevention and community support to achieve the optimal mix of mental health services to meet Western Australia’s needs as set out in the Better Choices. Better Lives ten-year-year mental health plan, and reiterated in the Sustainable Health Review Final Report and now the Infrastructure WA draft strategy. We must now look at developing and growing alternative mental health supports in the community so that we do not need to rely on expensive infrastructure such as hospitals. We must meet people’s needs earlier and closer to home, so they can achieve better outcomes and our mental health system is sustainable and affordable.

Detail: $129.9m Youth package

WAAMH welcomes the 30 packages for psychosocial support packages for young people aged 16-24 to assist more young people living in the community, either independently or in the family home, to increasingly participate in and contribute to community, social, and economic life.
WAAMH also welcomes the youth long-term housing and support program to provide young people with access to long-term accommodation alongside coordinated clinical, psychosocial and alcohol and other drug supports to assist them with their recovery and with living independently in the community.

Upcoming opportunities

In light of the Productivity Commission report and the Victorian Royal Commission findings, WAAMH is now focussed on the negotiation of the National Partnership Agreement as the next opportunity to boost investment into prevention and community support. This boost in investment is essential because it is not possible to divert resources away from other parts of the system. Worldwide research supports the need for greater Government investment into non-clinical, person-centred supports that give people dignity and respect.