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Table 2 Application of policy levers to reform priority areas across the NMHS 1992-2012

From: An analysis of policy levers used to implement mental health reform in Australia 1992-2012

  Organisation Regulation Community education Finance Payment
First Plan (1993-98) SS HR&CA HR&CA SQ&E  
Mainstream mental health service management Review consumer rights and responsibilities National Community Awareness Program Separate budget for mental health
SS HR&CA   R&SA
Shift acute beds to general hospitals Review mental health and anti-discrimination legislation Increase recurrent mental health spending
RCN SS R&SA
Formalise consumer/carer consultation Remove cross-border transfer anomalies Increase community-based and general hospital funding
SS SQ&E R&SA
Case Management system National Mental Health Information strategy and National Minimum Dataset Review Medicare Agreements
SS SQ&E  
Increase ambulatory workforce Independent evaluation steering committee and National Mental Health Commission
  SQ&E
Annual National Mental Health Reports
SS
Review interagency protocols to support continuity of care
Second Plan (1998-2003) SS SQ&E HR&CA SS SS
Shift acute beds to general hospitals National Standards for Mental Health Services Review media portrayal of mental illness Redirect funds released from deinstitutionalisation towards community-based services New funding models to improve referral links between primary and secondary providers
RCN SS HR&CA   SS
Formalise consumer/carer consultation Review interagency protocols to support continuity of care Mental health education in schools Review Medicare Benefits Scheme (MBS) items and introduce new MBS items to support referral between health practitioners
SS SQ&E HR&CA R&SA R&SA
Grow 24-h staffed community based residential services New outcome measures Mental health training for health professionals, in particular frontline workers Review allocations under the general health budget for Federal and State/Territory Governments Specialised funding models for rural and regional populations
R&SA     
Increase treatment rates for mild and moderate mental illness
R&SA
Improve mental health curricula for Indigenous health workforce
R&SA
Specialist youth early intervention centres (e.g. Headspace, Early Psychosis Prevention and Intervention Centres (EPPIC)
R&SA
Specialised service models for special needs populations
Council of Australian Governments (COAG) Action Plan (2006) R&SA SQ&E R&SA   R&SA
24-h 7 day mental health telephone service COAG Mental Health Groups in each jurisdiction Review mental health content in tertiary health degrees Mental Health Nurse Incentive Program
R&SA SQ&E HR&CA R&SA
Increase web-based mental health resources Publish official Progress reports annually Mental health training for health professionals, in particular frontline workers Flexible employment schemes and funding models for rural and regional areas
SS    SS
Consolidate youth mentoring and early intervention programs into a single program Review existing MBS items and introduce new MBS items to support referral between health practitioners
R&SA  
New youth early intervention projects
RCN
Family Mental Health Support Service
RCN
Increase mental health respite services for carers
R&SA
Step-up and step-down community facilities
ISS
Community Coordinators
SS
Increase day-to-day living support programs and Personal Support program
RCN
Increase Personal Helpers and Mentors service
SS
Disability Employment Services group
R&SA
Increase supported places in University mental health degrees, particularly to Indigenous students
R&SA
Increase Indigenous health workforce
R&SA
Additional funding to drug and alcohol service providers
2011-12 Budget SS SQ&E   R&SA R&SA
Care Facilitator scheme National Mental Health Commission National Funding Pool for States/Territories Reduce Medicare rebate for General Practitioner mental health plans and introduce tiered rebate system
RCN SQ&E   R&SA
Additional Personal Helpers and Mentors and places in Family Mental Health Support Services Fund research into improving data sets and performance accountability Reduce annual number of rebated consultations with allied psychological services
R&SA SQ&E R&SA
E-health portal for mental health Annual Report Card on mental health reform Expand Access to Allied Psychological Services scheme
R&SA SQ&E SS
Additional Headspace and EPPIC sites Australian Early Development Index tool and an expert group in child mental health Review wage-subsidy schemes and Disability Support Pension
R&SA SS  
Routine Health and Wellbeing checks for 3 year olds National Partnership Agreements and new Service Planning Framework
RCN  
National Mental Health Consumer Body
  1. Key Priority Areas: Human Rights and Community Attitudes (HR&CA), Responding to Community Need (RCN), Service Structures (SS), Service Quality and Effectiveness (SQ&E) and Resources and Service Access (R&SA)