Evaluation of Mental Health Care System in Australia: A Recovery Oriented Approach

The essay evaluates the mental health care system of Australia and assesses whether recovery from serious mental health problem is possible for people using the mental service available or there is a need for reform in the mental health care system infrastructure. The sufficiency of a mental health care system to treat mental disorder can be understood from the review of available resource to treat the disorder. Guided by the National Mental Health Strategy, a collaborative government action in mental health from the year 2009-2014 was planned. This plan overlapped with the Council of Australian Governments (COAG) National Action Plan for the period between 2006 and 2011.

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With the prevalence of mental illness in Australia, the expense associated with the cost of
mental illness and the societal cost of mental disorder has increased in the country. The
widespread prevalence of mental disorder is understood from the fact that 4 million people were
estimated to be living with one common mental disorder in 2015. The impact and burden of the
disease may differ based on severity and episodic or persistent nature of the disorder. According
to the 2015 estimate, about 2-3% of Australian population has severe mental disorder judged by
severity and duration of symptoms (Australian Institute of Welfare, 2018). Considering the
prevalence and burden of the condition, the need for adequate mental health services is essential
to promote quick recovery of patient. The main purpose of the essay is to evaluate the mental
health care system of Australia and assess whether recovery from serious mental health problem
is possible for people using the mental service available or there is a need for reform in the
mental health care system infrastructure. Review of recent developments in existing mental
health programs and services will also help to estimate provision of recovery oriented care for
mentally ill people in Australia.
In case of western countries like Australia, health care system and services are shaped
legislations and budgets set by the government. Responsibilities related to mental health policy
and provision of mental health services is also taken up the Australian government. The positive
aspect is that importance of good mental health has been a focus of the Australian government
since the last three decades. The government has worked towards the development of mental
health care services through the implementation of mental health programs and services that
serves the need of Australian population affected by mental disorder (Australian Institute of
Welfare, 2018). One of the commitment of the Australian government is the National Mental
Health Strategy where the main motive is to improve the lives of people affected with mental

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disorder. The Strategy was endorsed in April 1992 and the main aim is to promote mental health
of the Australian population, prevent mental disorder, reduce the impact of mental disorder and
maintain rights of people with mental illness. In accordance with the aim, the National mental
health policy, the National Mental Health Plan and the National Mental Health Statement of
rights and responsibilities were developed (Department of Health, 2014). The overview of this
plan and policy shows that Australian government developed an appropriate framework to
develop advanced system of care and integrate service across health and social domain to
provide care. However, the success of these plans and policies in assisting people to recover
from mental illness needs to be reviewed.
The sufficiency of a mental health care system to treat mental disorder can be understood
from the review of available resource to treat the disorder. Guided by the National Mental Health
Strategy, a collaborative government action in mental health from the year 2009-2014 was
planned. This plan overlapped with the Council of Australian Governments (COAG) National
Action Plan for the period between 2006 and 2011. The effectiveness of the National mental
health plan was that it guided the government regarding funding priorities for mental health.
Under this arrangement, the Australian government has made services accessible and affordable
to people by funding specialized mental health services through the Medicare Benefit Schedule
and the Pharmaceutical Benefits Scheme (PBS). Apart from specialized mental health care
services, social issues such as employment, housing and environmental stressors also increase
the risk of mental illness (Mahindru, Sharma & Chaturvedi, 2016). Workplace environment
determines self-esteem needs of people. According to the Maslow’s Heirarchy of needs theory,
esteem needs is a form of psychological needs that needs to be fulfilled to promote well-being of
a population (Niemela & Kim, 2014). Hence, to increase other form of support for people, the

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government also funds range of other programmes such as income support services, disability
services and housing assistance. On the whole, it can be said that the National Mental Health
Strategy and the National Suicide Prevention Strategy have provided the vehicle for reform of
mental health services in Australia.
To promote recovery of people affected by severe mental health conditions such as
psychotic disorders, substance use disorders and severe obsessive compulsive disorder,
addressing difficulty in accessing effective primary and preventive service is essential to promote
recovery of people (). Varieties of mental health services are available in Australia such as
hospital based services, community mental health services and consultation with specialist and
general practitioners. However, the uptake and equal utilization of these services among
Australian population is one area of concern. Australia has taken innovative approach to deliver
mental health services and promote a shift from hospital based care to community based care. It
is strongly going in line with the deinstitutionalisation trend. This is evident from the fact that
health care expenditure on psychiatric hospitals has dropped from 46% to 12% and the
expenditure for community mental health services has increased from 24% to 39% in the past 20
years. However, unless high quality community care services are available patients with mental
illness are at risk of worsening symptoms and increase in length of hospital stay. For this reason,
focusing on maintaining a balance between care provision and quality of service is necessary.
One of the issues that have affected the quality and outcome of patients include regional
disparities in access to care. The incidence of mental health issues and inequities in service
access is particularly high for rural communities. For this reason, mental health inequities are
particularly high for indigenous people in Australia compared to non-Indigenous population.
Disparities in access were the reason for poor distribution of mental illness among the group.

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According to survey report in 2010, 26% of Aboriginal and Torres Strait Islander people aged
above 15 years reported problems in accessing mental health services. The reported problems in
accessing services was particularly higher for Aboriginal and Torres Strait Islander adults with
high level if psychological distress, self-assessed health status and those with disability. The
problem was found to be higher for people living in remote areas compared to those living in
other areas (Australian Bureau of Statistics, 2011). This implies that despite availability of funds
and advancement of mental health services, unmet population needs of all sections of population
has not been addressed. Hence, to promote optimal health and recovery from mental illness
among indigenous population, it is essential that health planners obtain population level
information related to how indigenous people are using the services and the extent to which these
services are accessible (McIntyre et al., 2017).
The positive aspect of the mental health care system of Australia is that they have
focused on identifying the above mentioned challenges and addressing them too. The ‘Better
Access’ initiative is ones such program that looks to improve access to mental health services.
The increase in the number of individuals accessing services suggests increase in the volume of
Better Access MBS items. The initiative has addressed accessibility and affordability issues.
However, still more work is needed to achieve equality across geographical areas and population
group. For example, inequalities were reported across people with low income and those living
in low socioeconomic regions. In case of working with indigenous people, the problem was that
problem linkage between the community and other resources were not possible (Department of
Health , 2010). This was the scenario presented in the year 2010. However, the current strategies
seem to be more effective in dealing with the inaccessibility issues. For example, the
Commonwealth Government has expanded Medicare items under the ‘Better access to Mental

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Health’ initiative and it included telehealth items for rural and remote patients. The items were
introduced in November 2017 to support people living in rural areas to access mental health
service via video conference and skype. It was also ensured that the technology was capable of
delivering high quality service in accordance with security and privacy laws (Vines, 2018). To
promote long term use of such services, it is also essential that professional bodies collaborate
with GPS to ensure that the service is available to those most in need of care.
Apart from the attention of government on addressing quality and accessibility
issues in mental health care, the past five years has also seen major emphasis on recovery
oriented practices in mental health plans. The evidence for this is the Fourth National Mental
Health plan, where the number 1 priority area was to promote adoption of recovery-oriented
culture in mental health services. Recovery orientation has been desired by many people with
lived experience of mental illness. In accordance with the Fourth National Mental Health Plan
and the Roadmap for National Mental Health Reform 2012-2022, recovery approach to care has
been embedded in all policy and reforms related to mental health (Brown, 2013). The advantage
of recovery oriented approach is that it considers the social determinant of health factor for
health and well-being. This means recovery has been visualized by connections with individual,
family and community and also by visualizing recovery within the context of age, gender and
developmental stages (Kidd, McKenzie, & Virdee, 2014).
The mental health priority of recovery oriented practice can be regarded as the most
innovative and effective strategy to support Australian population to recover from serious mental
illness. It is guided by six principles of uniqueness of the individual, real choices, attitude and
rights, dignity and respect, and partnership and communication. These principles guides mental
health care professionals and services regarding the approached needed to provide care to diverse

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population group. The principle of uniqueness related to acceptance of the fact that recovery is
unique for each individual and empowering patient is the main goal of care. It also promotes
respecting individual choice of patient and promote and protect basic rights of each patient. It
also acts to address dissatisfaction with care issues by respecting values, beliefs and culture of
each individual. Lastly, achieving individual goals and aspiration of patient was also provided by
proper partnership with clients and tracking progress in key outcomes such as family
relationship, housing, employment and education (health.gov.au, 2017). The uniqueness of the
recovery oriented principle is that the recovery oriented care approach supports mental health
care professionals to develop the behavior, attitude, skills and knowledge needed to engage in
collaborative practice and achieve optimal mental health outcome for the Australian population
(Le Boutillier et al. 2015). In the long run, recovery oriented care would help to promote good
practice and good leadership across mental health service in Australia and it would help in the
development of a mental health care system for the 21st century.
By the discussion on the evaluation of mental health care system of Australia in
promoting recovery of patient, it can be concluded that that the Australia Government focused on
addressing mental health needs of Australian with the implementation of several mental health
plan and policies. The National Mental Health Strategy is one such initiative that guides health
care services to provide adequate support to people with mental illness and make services
affordable to them with the use of MBPS (Medicare and Pharmaceutical Benefits Schedules).
Despite advancement in mental health services, several issues like that of health inequities and
accessibilities was seen. However, the Australian government took innovative steps to overcome
these adversities and prepare a health care system that embraces recovery oriented approach to
care. Appropropriate use of technology and useful collaboration process with key stakeholders

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can help to transform and increase coverage of mental health services for the Australian
population.

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Reference:
Australian Bureau of Statistics (2011). 4704.0 - The Health and Welfare of Australia's
Aboriginal and Torres Strait Islander Peoples, Oct 2010 Retrieved from:
http://www.abs.gov.au/AUSSTATS/abs@.nsf/lookup/4704.0Chapter955Oct+2010
Australian Institute of Welfare (2018). Mental health services in Australia. Retrieved from:
https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-
australia/report-contents/summary/prevalence-and-policies
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australia/report-contents/summary/overview
Brown, P. (2013). A national framework for recovery-oriented mental health services: Policy
and theory Retrieved from http://www.mhima.org.au/pdfs/Recovery%20Framework
%202013_Policy_theory.pdf
Department of Health (2010). Improved access to mental health services. Retrieved from:
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Kidd, S. A., McKenzie, K. J., & Virdee, G. (2014). Mental health reform at a systems level:
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