Organizational Governance and Performance Management

This report analyzes the mental healthcare reform 2012-2022 developed by the Council Of Australian Government (COAG) to improve the health and wellbeing of patients living with mental health conditions. It discusses the main objectives, principles, role of government, challenges, and recommendations.

Running head: ORGANIZATIONAL GOVERNANCE AND PERFORMANCE
MANAGEMENT
Organizational Governance and Performance Management
Name of the Student
Name of the University
Author Note

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Introduction
Health policies often undergo changes in order to accommodate improvement to
existing policies which allows further improvement in the health and wellbeing of the people.
These changes are called health reforms (Nay et al., 2016). The health reforms can be
addressed to several healthcare priority areas which provide an updated guideline for the
healthcare providers, supporting them to deliver care in a more effective manner and monitor
the outcomes in a more efficient way (Blank et al., 2017). In the last five years, Australian
Government has introduced many reforms to existing healthcare policies with the objective to
make them more comprehensive and effective. One of the most significant reforms has been
in mental healthcare through with the Australian Government and healthcare Delivery
systems have attempted to further improve the delivery and efficacy of mental healthcare
throughout Australia (Contandriopoulos et al., 2018; Griffiths et al., 2015). The aim of this
report is to analyze the mental healthcare reform 2012-2022 developed by the Council Of
Australian Government (COAG) to improve the health and wellbeing of patients living with
mental health conditions (Shin & Kim, 2015). The report also aims to develop an
understanding of the main objectives of the reform, the underlying principles, and the role of
the government in the development and implementation of the reform, the various challenges
associated with the reform and recommendations that can be used to overcome such
challenges.
Objective:
The main objective of the mental health reform is to provide a continuous service for
mental healthcare and ensure transparency of care. With the advent of modern technologies in
healthcare, a significant challenge has been posed to the healthcare providers regarding the
incorporation of these technologies into the existing care framework and improving access to

2ORGANIZATIONAL GOVERNANCE AND PERFORMANCE MANAGEMENT
various types of clinical information (Happell et al., 2017). The mental health reform aims to
involve the modern technologies in order to improve accessibility to a wider range of
information such as the experiences of the patient on the service provided, information
related to service failure and about evidence based methods and approaches that can be used
in mental healthcare (Gillieatt et al., 2018). The mental healthcare reform also aims to bring
about a transformation to the existing mental healthcare system, by developing new standards
and protocols of care which can address the mental health needs of the patients. On the short
term, the reforms aim to provide a plan for care delivery for patients living with mental health
conditions by involving Primary Healthcare Networks (PHNs) (Wakerman et al., 2017).
Through the reform the PHN will have the responsibility of supervising the mental healthcare
facilities in the territories and states by following the Medicine benefit Schedule (MBS) in
order to identify the exact nature of the mental health problem faced by each patient which
can then be used to develop a primary care plan. Through this strategy the reform aims to
improve as well as enhance the care as well as develop the referral to other more relevant
services to ensure better continuity of care (Powell Davies et al., 2017). The long term goal
addressed by the reform is to properly monitor the delivery of mental health services for
patients living with mild to moderate mental health problems. The reform also has another
long term objective of identifying the inadequacies of mental health services and
psychological therapies available for mental health patients mainly in the remote and rural
areas of Australia, therefore helping to understand the existing gaps in the service including
those faced in the mental healthcare delivery system for Aboriginal and Torrest Strait
Islanders (Dawson et al., 2017).
Principle:
The main principles that have been addressed by the mental health reform by the
Australian Government for 2012-2022 includes the provision of specialized care for elderly

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people living with mental health conditions, support early detection of mental health
problems, improving emergency mental health services especially in the rural regions,
increasing funding for mental health services and increasing support given at community
levels (Lewis & Garton, 2017). Apart from these, another important principle of the mental
health reform is to support patients living with mental health problems to better cope with
their conditions and helping them to overcome their mental health problem through mental
healthcare so that they can get back to their normal way of life (Ridley et al., 2017).
Steps of implementation:
Different methods are involved in the implementation of mental health reforms by the
Australian Government. In the context of the given mental healthcare reform the first priority
is given to the function of Primary Health Networks (PHN) (Minas et al., 2013). The PHN
plays a key role in the relay of governmental policies and decisions that are related to the
channeling of funds of healthcare agencies through both local as well as regional sources.
Different mental health programs exist under the PHN management such as programs for the
development of mental health conditions in rural and remote regions, detecting the early
warning signs of mental health problems such as psychosis, prevention of suicide rates
among patients with mental health conditions and improving access to allied healthcare
(Knox et al., 2014). Moreover, the PHN utilizes a regional approach in order to reduce the
rates of suicide among mental health patients and improve access to mental health service for
patients suffering from severe mental health conditions or at high risk of developing severe
mental health problems. In addition of supporting patients living with severe mental health
conditions, PHN also aims to improve access to health for patients with mild to moderate
mental health issues (also known as low intensity service) thereby further increasing the
coverage of mental health services (Griffiths et al., 2015; Happell et al., 2017).

4ORGANIZATIONAL GOVERNANCE AND PERFORMANCE MANAGEMENT
According to the mental health reform 2012-2022, initial services for mental health
can also be provided by the PHN’s for individuals who are experiencing the early signs of
mental health problems. The strategy used by the PHN for the treatment for mental health
conditions is termed as the ‘stepped care’ approach which is the central aspect of the reform.
This strategy can be understood as a client or patient oriented service in which the service for
a wide variety of mental health problems can be provided based on the specific condition and
healthcare need of the patient (Wakerman et al., 2017). The reform also further develops
upon the Fifth National Mental health Plan which aims towards the reduction of a taboo or
stigma associated with mental health problems as well as towards the reduction of suicide
rates among mental health patients. It also improves upon the previous mental health reforms
by adding the agendas of reducing suicide rates among patient who already have received
mental health treatment (Chambers et al., 2017).
Another step in the implementation of the reform is to give focus on the mental health
and wellbeing of the Aboriginal and Torres Strait Islander Communities. The plan
incorporates a provision for taking consultation from the target population, the stakeholders
and respondents from healthcare delivery systems and using the information for the
development of the healthcare plan for mental health problems which forms the basis for the
development of the 5th mental health Plan. Documentation of the price and costs of mental
health services has been implemented by the national Disability Insurance Scheme (NDIS)
who are involved in the documentation of various mental health services for different types of
mental health problems (Crowe, 2017).
The reform can also be used in other mental healthcare sectors such as aged care and
palliative care. A transition program is also implied in this reform that can help the
development of further mental healthcare reformation through the allocation of more funds
for the Partners in Recovery (PIR) program, and helping its transition through the assistance

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of PHN. AN important aspect within is context is to improve the effect of implementing the
healthcare reform and expanding the role of the PHN through their involvement in suicide
prevention strategies among mental health patients and also through more engagement in
mental healthcare in rural areas. The PIR functions towards the extension of support the
transition period in the programs on mental healthcare, supporting the long term recovery of
mental health patients (Hickie, 2017).
In addition to all these aspects, development of a community of Mental health Reform
Stakeholders are also supported that can help to address the various issues faced during the
implementation of the program reform and transferring that knowledge to the PHN as well as
the governing bodies who are involved in the ‘stepped care’ approach as well as planning of
the care delivery strategies (McGorry & Hamilton, 2017). The engagement of the PHN has
been focused more in the case of complex stepped care for patients that allow the providence
of various types of mental health services. The reform focuses on both the rural as well as the
metropolitan regions in order to develop and support different ‘low intensity’ mental health
models as well as stepped care strategies and healthcare packages for patients with serious
mental health issues (Hickie, 2017).
Role of Government:
The role of the Australian government towards the single set aged care quality
reforms in mental health is to provide quality care for the older adults while taking active
consideration of their health and safety. As a part of the aged care reforms the government of
Australia is planning to generate end-to-end, market-based system in order to increase the
consumer’s service quality. The government is also taking initiative towards the better ageing
and mental health support for the older adults in Australia (Australian Government
Department of Health, 2018a). The government has proposed an overall increase in the

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mental health funding by $5 billion for a period of five years. The government is also
planning to invest $102.5 million in order to support the mental needs of the Australian older
adults. Against &102.5 million funding, $20 million is secured to improve the mental health
services for older adults in Australia who are over 75 years of age and whose mental and the
physical health condition is at risk due to social isolation and loneliness. This funding is also
devoted to increase the availability of the mental health nurse in order to assist the older
adults and thereby helping to decrease the detrimental mental health impacts of the social
isolation. Rest $82.5 million will be used for framing new and innovative mental health
services who are living in residential aged care facilities (Australian Government Department
of Health, 2018b). The government of New South Wales (NSW) is approved 495 million for
the mental health reform in aged care. Out of this total funding, $6.4 million funding is used
to support aged people who are in their transition and another $1.6 million will be used to
assist community living of the older adults who are residing in Sydney, Central Cost. People
in Western Sydney this funding is invested in order to assist the mental healthcare provides to
develop standard community support. Additional $38 million is used to increase the
specialized service for the mental needs of the older adults with a special mental to the
aboriginals and the Torres Strait Islanders (NSW Government, 2018). Under the specialized
service availability of the culturally competent community health nurse is increases along
with an improvement in the residential care. This overall approach will help to increase the
healthcare access of the older adults especially among the Aboriginals and the Torres Strait
Islanders who lacks proper healthcare access. This initiative will also provide social support
to the older adults who suffer from extreme depression who to social isolation and reduced
capability of the performing daily living activities (Australian Government Department of
Health, 2018b).
Challenges and Recommendation:

7ORGANIZATIONAL GOVERNANCE AND PERFORMANCE MANAGEMENT
Australia is a multicultural place with cultural and linguistic diversity. Under this diverse
atmosphere there reside culturally and linguistically diverse community (CALD) people who
are Aboriginals or Torres Strait Islander. The member of this community become victim of
social isolation and thereby increasing their mental health complications and the condition
becomes more severe during older age (Johannesen & LoGiudice, 2013). Though the
government is taking active initiatives through funding and heath care support in order to
improve the mental health status of these CLAD communities, the results are not over-
whelming. The aboriginal older adults at times lack proper information and health awareness
which decreases their overall healthcare access and thereby increasing the health-inequality.
It is the duty of the government, to come forward and take active initiative in order to
increase the participation of CLAD people through increase in the recruitment of culturally
competent and linguistically diverse nurse (Johannesen & LoGiudice, 2013).
Conclusion
Thus from the above discussion, it can be concluded that the mental healthcare reform
is an important factor under Australian Healthcare. Though the government is taking active
initiatives through funding in order to revamp the overall mental health care service with a
special focus to the older adults, there is a lack of focus over the CLAD people. Active
initiatives by the associated stakeholder are required to be taken in order to decrease the
mental health inequality.

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