Evaluation of the Fifth National Mental Health Plan of the Australian Government

This paper evaluates the Fifth National Mental Health Plan of the Australian Government, including the issues it addresses, the policy formulation process, the implementation planning process, the impact of the policy, and its strengths and weaknesses. The policy aims to improve mental health and wellbeing in Australia, reduce the stigma associated with mental illness, and promote recovery. The policy focuses on early prevention, digital mental health gateways, and primary health care programs and services. The policy has the potential to benefit consumers and improve the mental health system in Australia.

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Health policy in global context

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Introduction:
Health system of Australia is the combination of funding giving by Federal and State
government, and it is also the responsibility of both the governments. This combination creates
difficulties for the patients to navigate. Instead of its complexity, universal health system of
Australia achieves good outcomes in effective manner. It must be noted that, expenditures
related to the health in Australia is almost same as the OECD average, at 8.8% of GDP. In
Australia, life expectancy at birth is the 6th highest in the OECD, at 82.2 years. In context of
meeting the challenge of rising mental diseases, Australia needs to reduce their health system
fragmentation in terms of improving the co-ordination while taking care of the patients (OECD,
2015).
The Fifth National Mental Health Plan (Fifth Plan) is developed by the Australian Health
Ministers’ Advisory Council (AHMAC) Mental Health Drug and Alcohol Principal Committee
(MHDAPC). The policy of the health department reflects the nationality agreed priority areas
and actions for the next five years in terms of achieving the integrated system of mental health.
This policy mainly builds on the foundation which is set by almost four previous National
Mental Health Plans, and also by previous state and territory mental health and suicide
prevention plans, and national health and mental health reform efforts. A national consultation
process in terms of developing the Fifth Plan will initiate in November 2016 (Department of
Health, 2012a).
The main aim of this assignment is to critically evaluate the Fifth National Mental Health
Plan of the Australia government. Structure of this assignment includes the comprehensive
overview of issues, policy formulation process, evaluation of implementation planning process,
impact line of the policy in context of any other similar policy, and strengths and weakness of the
policy. At the end, brief conclusion is stated to conclude the paper.
Overview of Issue
The actual issue in context of this policy is the preferment of the mental health and well-
being of the community of Australia, and provide these health services to all the community
members in equitable manner in context of preventing the development of the issues related to
health and mental illness. This policy mainly aims to decrease the effect of mental health issue
and mental illness, which further includes the stigma effect on the individuals, families, and
whole community. This policy also focuses on the promotion of the recovery from mental health
issues and mental illness. It also deal with one more issue that is assurance of the rights of people
related to the mental health problems, and also enable them in participating in the society in
meaningful manner (Department of Health, 2015).
Various stakeholders are there which relate to this process that are patients, government
organizations, non-government organizations, community groups, etc (WHO, no date).

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Generally, these stakeholders are categorized into four groups and the interest and influence of
these groups are stated below-
 First and most important group is the group of patients and community member, because
these are the one who get directly affected by the policy framed by the health ministry.
Influence of this group and related interest of this group related to the policy is high. As
policy makers hold the fiduciary duty towards this group to ensure their advantages from
the policy, because they are the one for whom policy is framed.
 Providers are another group of stakeholders who also directly affects the policy, because
they are the one who are responsible to give the services to the patients and other
members of community. In other words, they are responsible to give health care services
in terms of patients and preserve the information related to them.
 Third group of stakeholders operationalize the financial elements of the framework
related to the policy and this group known as the payors. In this policy they are
responsible to enrol the patients as the beneficiaries. They do not have that much
influence on the policy framed by the policymakers.
 Policy makers are another group which is responsible to establish the framework through
which health care is given to the citizens of the country. This is the jurisdictional entity,
as in this policy it is the ministry of health (pressbooks, no date).
It must be noted that, the actual purpose of this policy developed at both national and
state level. While formulating this policy, makers recognize the range between the mental health,
issues related to mental health, and mental illness. There are number of people which experience
the matters related to the mental illness that mainly require the treatment related to clinical and
also the services given to the community. There are number of other people which mainly face
the emotional and mental health issues which directly affect their ability in fulfilling their social
obligations and also require particular services to helping them in overcoming with this issue.
Those people who are at risk because of the developing mental health issue and mental illness
can get the advantage of prevention and early intervention activities. On the other hand,
community awareness in context of the efforts related to mental health promotion mainly reduces
the stigma and discrimination (Department of Health, 2012b).
Evaluation of Formulation process and resultant policy
The commission mainly focus on giving the robust reason to reshape, readdress,
rebalance, and repackage the method related to mental health, and further reflect the risk related
to the status quo. Formulation process of this strategy mainly addresses the fundamental change
in the manner in which all these mental health programs and services are distributed. This shift
mainly involves following aspects-

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 Shifting from program and services are prevented by the program limits and also ancient
representations related to the supple and joined-up systems which mainly focus on the
requirements and opinions of the customers and also maximize their potential.
 Shifting related to disintegration, repetition, and provision gaps on the ground which is
related to the current national and state level programs distribution of this at that system
which is already deliberate and synchronized at the regional level.
 It mainly focuses on the early prevention, which means, instead of waiting for the illness
to develop or symptoms to elevate before giving the services. In other words, there is
shift towards the effective early intervention in the manner in which services and
programs formulated by ministry are delivered.
 It further shifts from the one size fits all approach, which means, all the programs mainly
focus on giving the mental health care service under the new care management program
that will targeted those services which match the needs of consumer and also make the
effective use of the staff and know-how.
 Shift from the dependence on ancient replicas of face to face service delivery in context
of use of the technology in innovate way and also the new digital ways to take care of
patients (Department of Health, 2015).
Locally planned and coordinated services related to mental health with the help of main
health networks and also the founding of the supple main health care backing pool. This
appraisal mainly recognized the disparity occurred between the national program objects, and the
main issue in the implementation is the services delivered on the ground. The review in this
context linked with the issue related to the badly intentional and integrated programs which were
mainly descended in from various works to the absence of local leadership and unbending
funding. This evaluation further concludes that, ministry hold an opportunity to create the PHN
infrastructure for getting the better targets and mental health efforts in terms of meeting the local
needs. In other words, there is no effective planning in context of this policy and this
ineffectiveness in planning further creates hurdle in the implementation of the policy.
Formulation of this policy also considers the easy way to access digital mental health
gateway. In this context, ministry believes that mental health is clinically operative in nature and
offers number of new and reliable opportunities for both government and community. It
highlights the robust proof in terms of self-guided and clinical moderated digital mental health
interventions. This is especially happens in case of depression and anxiety which is accompanied
with the digital mental health options shows similar clinical results in lieu of those face to face
therapies which are more conventional in nature.
It refocuses on the primary health care programmes and services in context of supporting
the stepped care model. Additionally, opting the stepped care approach in the system of mental
health develop opportunities for improving the primary mental health of the patient, and it also
gives support to the health professionals in terms of working with the stepped and integrated
approach. It further highlights the need to support the role of GPs in better way with the help of

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guidelines which mainly supports the stepped care approach. This command further suggests that
the individuals with the lower level needs, get direct access to the face-to-face psychological
services as this must be limited for those who fails to respond to the first line response such as
the digital mental health services (Department of Health, 2016).
Evaluation of implementation of planning process
Change is the most important approach of the Australian government, which means, real and
meaningful change in the delivery of the mental health services play important role. It also
promotes the early prevention and improvement of the system for the benefits of all the
Australians. Government is pleased in informing this reform policy, but also realise that the
changes in this policy are required and need to be implemented in such way as it avoids the
disruption to service continuity for consumers and providers alike. At the end all the departments
worked with the stakeholders for ensuring the successful implementation of this policy.
Ministry further established the mental health expert reference group to give advice on the
substantial system issues which is identified by the review. It further targeted the consultations
groups which include the experts related to the Indigenous issues and suicide prevention, and this
is accompanied with the other government agencies which mainly resolve the challenges related
to the implementation and identification of the opportunities. This consultation process is central
to informing this response (Department of Health, 2012a).
Those programs which are funded by the commonwealth in terms of this policy also need proper
implementation of the planning process stated in terms of these programs. No real evidence in
terms of the policy implementation is found which clearly states that particular services and
programs were not adding the value or they should be defunded because of the lack of impact.
Instead of this, it is found that effectiveness of the services and programs are negatively impacted
because of the poor design of the policy planning, and ultimately this result in the poor
implementation and results. It must be noted that policy design is not guided by the consistent
and consolidated frameworks, and the decisions taken by the policy makers fails to support the
decisions of the government. Regional integration helps in bringing together the mental health
policy and services in terms of meeting the needs of the individuals at local level in effective
way, and this must be done by using the resources in best manner and also in coordinated way.
Those people who are suffering with the severe and complex mental health issues, new approach
of the assessment will be developed and innovative models through which funding follows the
needs of consumers will be implemented (Department of the Premier and Cabinet, 2015. The
new approach includes two types of elements that are ground up and top down. At the national
level, federal government will seek the support from different states and terrorise in terms of
implementing the arrangements with the help of regional planning and integration. For effective
implementation of this policy, ministry builds the capacity of PHNs to lead these efforts in the
partnerships with the Local Hospital Networks (LHNs) and other important stakeholders
including non-government organisations, Aboriginal and Torres Strait Islander organisations and

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consumers. Following are some figures related to this policy, and all these figures clearly
demonstrate the importance of effective implementation of this policy.
 Each and every year almost 16.8 % population in Australia experience the symptoms of
mental illness which is sufficient to warrant the diagnosis.
 Almost 23.1% have symptoms which fall short of the formal diagnosis but they have
other indicators of need for mental health assistance (Department of Health, 2015).
This government already show their intentions that they does not give their support to the
proposal of the commission to reallocate the minimum funding of $ 1 billion in the
commonwealth funding to the public hospital services in the forward estimates into the services
which are alternative in nature. As disclosures made by the consultation groups, no disadvantage
or harm is caused to the consumers because of the absence of the simple contrast between
services and reducing funding for public hospital services. There is significant proportion of the
commonwealth funding to the public hospital services and also used to support the community-
based clinical mental health services (Department of Health, 2012b).
Evaluation of Findings
Above stated evaluation clearly state that this policy affects the consumers in number of
ways, as response of government in this context ultimately improves the complete mental health
system. It further provides the specific benefits to the consumers who bear the risk of mental
illness. Some of these advantages and findings of the above evaluation are stated below-
 Across the Australia, consumers get the benefit from the local service system of this
policy, as this system is designed and planned as per the needs of the consumers. This
local system will directly support the communication among the providers, and also with
the help of consumers ensures the best use of workforce and available resources.
 Policy focus on giving the better targeted clinical services in the primary care setting, and
this will be available for matching the need of the consumers. As intense nature of the
service enhance with the higher the need of the consumer.
 New digital getaways are used in terms of services for matching the needs of the
individuals. In other words, those services are given to the individuals which best meet
their needs and gives easy access to the information about the mental health services.
Those services which are low cost or anonymous in nature will be easy to access through
the phones or web based services, and this is also supported by the online system.
 Children under this policy get the advantage from gaining the resilience skills, and this
further supported by the better equipment’s and informed parents, teachers, and service
providers (Department of Health, 2016).
 Number of young people in Australia also gets the advantage from the services which
recognize the connection between their mental health issues and also their ability to
participate in the mental health issues.

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 This policy also gives advantage to the aboriginal and Torres Islanders by enhancing the
number of services given to them in terms of mental health (Department of Health, 2013).
 Those people who are at the risk of suicide also get support from the local communities
through the new evidence which is based on the approach of suicide prevention. Those
people who self-harmed themselves or attempt suicide get the critical support in form of
follow up from the service providers.
 Those people who are suffered from the critical and high level mental health illness will
get the advantage from new assessment process and also from the packaging of the
available services. It further coordinates the health and support disability services in
better manner (Department of Health, 2014).
Strength and weakness
This policy addresses the need to move towards the more agile and consumer focused
approach in terms of delivering the services related to mental health. Currently, this policy
structure in the health department cover almost 20 separate areas of funding the activity and all
these activities developed in sedimentary layers over number of years. It must be noted that, this
policy is not well sufficient in terms of joining up the approaches for improving the benefits to
the consumers. These separate programs activities will be mixed up in five core programs, and
following are the key areas on which this policy focus in the commonwealth health department-
• National leadership;
• Promotion, prevention and early intervention;
• Primary mental health care;
• Suicide prevention; and
• Supporting the psychosocial needs of people with severe mental illness.
As all these areas ultimately enhances the strength of this policy as compared to previous
policies developed by the ministry of health.
However, there is some weakness of this policy also such as effectiveness of the services
and programs are negatively impacted because of the poor design of the policy planning, and
ultimately this result in the poor implementation and results. Design of the policy is not guided
by the consistent and consolidated frameworks, and the decisions taken by the policy makers
fails to support the decisions of the government (Department of Health, 2015).
Conclusion
After considering the facts of this paper, it is clear that this policy related to mental health
system is effective in nature and focus on fulfilling the basic requirements of the individuals
required these services. This policy also focuses on the promotion of the recovery from mental
health issues and mental illness. It also deal with one more issue that is assurance of the rights of
people related to the mental health problems, and also enable them in participating in the society

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in meaningful manner. There are number of other people which mainly face the emotional and
mental health issues which directly affect their ability in fulfilling their social obligations and
also require particular services to helping them in overcoming with this issue.
Formulation process of this policy is effective in nature as number of expert groups and
authorities are involved in the formulation process of this policy. Locally planned and
coordinated services related to mental health with the help of primary health networks and also
the establishment of the flexible primary health care funding pool. Formulation of this policy
also considers the easy way to access digital mental health gateway. It refocuses on the primary
health care programmes and services in context of supporting the stepped care model.
Additionally, opting the stepped care approach in the system of mental health develop
opportunities for improving the primary mental health of the patient.
Real and meaningful change in the delivery of the mental health services play important
role in the implementation of this policy. It also promotes the early prevention and improvement
of the system for the benefits of all the Australians. Ministry further established the mental health
expert reference group to give advice on the substantial system issues which is identified by the
review. No real evidence in terms of the policy implementation is found which clearly states that
particular services and programs were not adding the value or they should be defunded because
of the lack of impact. Instead of this, it is found that effectiveness of the services and programs
are negatively impacted because of the poor design of the policy planning.
Therefore, it can be said that there are some loopholes in the process of implementation
of this policy and it is necessary for the government to address these loopholes for effective
implementation.

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References
Department of Health, (2012a). E‐Mental Health Strategy for Australia. Retrieved from
http://www.health.gov.au/internet/main/publishing.nsf/Content/7C7B0BFEB985D0EBC
A257BF0001BB0A6/$File/emstrat.pdf.
Department of Health, (2012b). National mental health policy 2008. Retrieved from
http://www.health.gov.au/internet/main/publishing.nsf/Content/B4A903FB48158BAECA
257BF0001D3AEA/$File/finpol08.pdf.
Department of Health, (2013). National Aboriginal and Torres Strait Islander suicide prevention
strategy. Retrieved from
http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-pub-atsi-suicide-
prevention-strategy.
Department of Health, (2014). Fourth national mental health plan: an agenda for collaborative
government action in mental health 2009-2014. Retrieved from
http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-pubs-f-plan09.
Department of Health, (2015. Australian Government Response to Contributing Lives, Thriving
Communities – Review of Mental Health Programmes and Services. Retrieved from
http://www.health.gov.au/internet/main/publishing.nsf/Content/0DBEF2D78F7CB9E7C
A257F07001ACC6D/$File/response.pdf.
Department of Health, (2016). Mental health policy. Retrieved from
http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-policy#aus.
Department of the Premier and Cabinet, (2015). Developing policy. Retrieved from
https://www.dpc.sa.gov.au/__data/assets/pdf_file/0005/16880/Policy-Development-
Guide-2.pdf.
OECD, (2015. Health policy in Australia. Retrieved from http://www.oecd.org/australia/Health-
Policy-in-Australia-December-2015.pdf.
Press books. 3. Introducing the Key Stakeholders: Patients, Providers, Payors, and Policymakers
(the Four P’s). Retrieved from https://jln1.pressbooks.com/chapter/3-introducing-the-key-
stakeholders-patients-providers-payors-and-policymakers-the-four-ps/.
WHO. Engaging stakeholders. Retrieved from
http://www.who.int/nationalpolicies/processes/stakeholders/en/.