Comprehensive Report: NSW Mental Health Reform 2014-2024

This report provides an executive summary and detailed discussion of the NSW Mental Health Reform 2014-2024. It examines the prevalence of mental illness in Australia and the government's efforts to address it. The report evaluates the reform's objectives, including strengthening early intervention, shifting to community-based care, and delivering person-centered care. It critically assesses the strategies employed, such as the focus on vulnerable groups like young people and children, and the transition from hospitals to community-based residential options. The report highlights the values guiding the reform, such as recovery, respect, and community, and analyzes the allocation of resources for specialist services and workforce training. The report emphasizes the importance of dignity, equity, and the therapeutic relationship in mental healthcare, and concludes with recommendations for future directions. The report uses the provided data to analyze and evaluate the NSW Mental Health Reform 2014-2024, which is a ten-year roadmap for the reform of the existing mental health system in NSW.

Running head: HEALTH CARE REFORM
Executive summary
Mental illness is widely prevalent in Australia and 1 in 3 people have experienced some form
of mental disorders in their lifetime. While major efforts have been taken by the government
to reduce stigma related to mental illness, the NSW Government had taken initiatives for the
enforcement of a mental health reform “NSW Mental Health Reform 2014-2024”, for the
enhancement of health and wellbeing of the sufferers. The report found that the NSW Mental
Health Reform 2014-2024 has acted in the form of a framework that puts the affected people
at the core of all mental healthcare system. The government is working hard for creating a
balance between the mental health services and has also taken steps to shift the people from
hospitals to community-based care centres, while upholding their respect, dignity and
opinion.

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Table of Contents
Introduction................................................................................................................................2
Discussion..................................................................................................................................2
Objectives...............................................................................................................................2
Critical evaluation of strategy................................................................................................5
Conclusion and recommendation...............................................................................................8
References................................................................................................................................10

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Introduction
Health care reforms refer to the recent changes and modifications that are made in
health policies, particularly government policies. These reforms are found to affect the
delivery of health care services at a particular location. The primary aim of health care
reforms are to broaden the population that is receiving the health coverage, either via
insurance programs in public sector or private sectors (Katon & Unützer, 2013). Kidd,
McKenzie and Virdee (2014) state that the reforms also attempt to enlarge the range of the
health care consumers, augment the quality of care, and reduce the associated costs. The
principles of Catholic Social Teaching delivers the indispensable framework for thoughtful
reasoning of the societal problems. With an increase in the aging population and associated
costs of healthcare services, the Australian government has proposed several health reforms
that have or will create an impact on the quality of life and health status of most Australians
in future.
Reports from the government suggests that almost 1 in 3 people living in Australia,
above the age of 45 live with a chronic health condition. Statistical reports suggested that
more than 39% of potentially avoidable hospitalisations in the nation were due to chronic
diseases during 2013-2014. Furthermore, more than 11 million Australians, which accounts
for an estimated 50% of the entire population reported presence of at least one chronic
conditions in 2014-2015 (Australian Government, 2018). The eight identified chronic
diseases are arthritis, mental health conditions asthma, cancer, back pain, cardiovascular
disease, diabetes, and chronic obstructive pulmonary disease. This report will elaborate on
the NSW Mental Health Reform 2014-2024 and will explore its strategies and recommend
future directions.

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Discussion
Objectives
Mental health refers to the psychological, emotional, and social well-being and controls
the way by which an individual acts, feels and thinks. Mental health is also responsible for
assisting people in handling stress, relating to others, and making informed choices. Thus,
mental health is utmost imperative to all stages of human life, beginning from childhood till
old age. The NSW Mental Health Reform 2014-2024 was formulated by the Mental Health
Commission, the primary role of which is to monitor, review and improve the status of
mental health and wellbeing for all people residing in NSW (NSW Government, 2015). The
Mental Health Commission of NSW referred to different sources for the development of a
strategic plan that focused on mental health care in the NSW.
This led to the adoption of the Living Well: A Strategic Plan for Mental Health, a ten year
road map 2014-2024 in 2014, by the government. The chief objective of the plan was to
frame actions related to reform of the existing mental health system in NSW (Mental Health
Commission, 2014). This also called for the need of effective collaboration between the non-
government agencies, private sectors, and the NSW government, for improving the
consequences for people residing with a mental disorders. The basic objectives of the health
reform are given below:
 Strengthening the early intervention and prevention
 Shifting the emphasis to community based care services
 Emerging an additional responsive system (NSW Government, 2015)
 Working in an organised manner for delivering person-centred care
 Constructing a better system

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The objectives of the health reform place a due reemphasis on the highly vulnerable
group that comprises of young people and children. This can be recognised as a correct
reform approach due to the high prevalence of psychiatric disorders in the target population.
This can be accredited to the fact that 13.3% students belonging to the age group 12-17 years
reported experiencing high psychological distress in the year 2014. While 17.2% of them
were females, males were less likely to experience such mental distress (9.6%). Furthermore,
in the year 2014, 33.3% students reported feelings of sorrow, wretchedness and/or depression
(NSW Government, 2016). 16.5% of the population also stated that their behaviour in the
past few months often landed them in trouble. Hence, it can be stated that the NSW
government was correct in recognising the current state of mental health of the wider
population.
The reform also focused on the transition of patients in psychiatric hospitals and tried to
shift them to residential options that are community based. There is mounting evidence for
the fact that community based health care encompasses a wide range of services and
programs that are designed to meet the needs of the local population (Caplan, 2013). The
community based programs that address mental needs of people include housing services,
treatment options, case management, self-help programs, peer support, mobile crisis services,
employment services, and club houses. Furthermore, efforts taken by the mental health
reform to work towards delivery of person-centred care emphasises on the combination of
mainstream health, human services, justice, mental health services, and commonwealth
funded services (Grob, 2014). Scholarly literature by Yang and Anthony (2015) have focused
on the fact that person centred care refers to the way that involves the people who are using
the health care and social services. The service users are recognised as partners and their
decisions are considered during the health planning, development, and care monitoring
processes.

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Thus, by placing the service users and their family members at the centre of the decisions
that are related to mental health and wellbeing, the best outcomes will be obtained (Oldham,
2016). The fact that the NSW Mental Health Reform 2014-2024 objectives also focus on
Strengthening Specialist Support is another step towards enhancing the mental health of the
target population. Specialised support systems focus on the delivery of multidisciplinary care
that allows people to commence their activities of daily living, as soon as possible
(Mendenhall et al., 2014). Hence, the reform aims to implement specialist services that offer
care options for people with mental needs, which are directed towards upholding their
independence.
Critical evaluation of strategy
The vision of the NSW Mental Health Commission is primarily focused on the people
of NSW and intends to provide them with best opportunities for sound mental health and
wellbeing, which in turn allows them live well in the wider community. This vision forms the
core of the government mental health reform that aims to formulate a stable system of
deterrence and early intervention, civic and infirmary based management and rehabilitation
services (Beronio, Glied & Frank, 2014). In other words, combining the response to different
mental disorders with certain opportunities for employment, housing, learning, and social
interaction is a good approach in assisting people cope with their mental illness (Dennis &
Monahan, 2013). The reform is also guided by a set of central values that commonly
encompass, recovery, respect, community, quality, hope, and citizenship.
Recent trends on a global basis suggest that more number of people having been
diagnosed with mental illnesses are residing in their communities, in place of spending
considerable time in healthcare settings. This in turn is compassionate and steady with the
expectations and aspirations of individuals with mental diseases, and their family members
(Solbjør et al., 2013). In other words, the fact that the reform has recognised the need of

6MENTAL HEALTH REFORM
shifting people from hospitals to their communities elaborates on the fact that it will try to
treat or support people facing mental problems in a domiciliary setting, in place of some
psychiatric hospital. The benefits of mental health services that promote dignity have also
been recognised by the World Health Organization that defines it to be more effective,
accessible, and helpful in eliminating or reducing social exclusion (WHO, 2015). This has
resulted in the reform allocating $6.4 million for supporting an estimated 115 people in their
transition to the larger community, besides an extra $1.6 million. Time and again, scholarly
literature such as the article by Senior et al. (2013) have elaborated on the benefits of
specialist mental health services that are basically designed for individuals suffering from
serious mental disorders. The reform can therefore be stated correct in working towards
providing tertiary level of health care, through the collaboration of highly trained
interdisciplinary psychologists and psychiatrists, who specialise in their particular field.
This approach of the reform will help people of the NSW who suffer from serious
mental disorders, experience acute phases of mental disturbances, and whose behaviour has
been identified to pose danger to others. Some common examples of specialist mental health
services that can be implemented by the NSW government include acute mental health wards,
eating disorder clinics, and suicidal counselling services. The reform has allocated $38
million for increasing the access to specialist mental health services, with $3.6 million for
clinical teams, $2.4 million for older adults, and $2.2 million for adolescent and child mental
health teams. $39 million has also been assigned for the expansion of psychosocial and living
support for individuals who reside in the community (NSW Government, 2018). $2.2 million
has also been apportioned for providing adequate training to the workforce, in addition to an
extra $1 million for mental health first-aid courses.
Respect has often been defined as the identification of the intrinsic worth, dignity, and
exclusivity of every person, irrespective of the socio-economic position, particular attributes

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and the kind of health problem. Hence, the key components of a therapeutic relationship that
needs to be established in a mental health setting are namely, (1) trust, (2) respect, (3)
professional intimacy, (4) partnership, (5) caring, and (6) power (Chambers et al., 2014).
Hence, the components recognised by the reform, are a correct approach that will be able to
facilitate the establishment of a therapeutic milieu, which is essential for mental health
advancement and illness prevention. Unconditional positive regard and respect are often
communicated via attitudes, actions and activities in the mental health setting. Attitude
usually encompasses non-verbal and verbal feelings and communication that help in guiding
the actions towards all patients (Trower, Bryant & Argyle, 2013). Individuals living with
mental illness also expect to be supported correspondingly in their retrieval, notwithstanding
their gender, culture, age, and/or sexual identity.
On the other hand, behavioural health equity is generally achieved by confiscating
biased and avoidable obstacles that negotiate with the mental health and wellbeing. The
vulnerable population that are found to have reduced access to health services are the
Aboriginals and Torres Strait Islanders, the socio-economically disadvantaged, those with
intellectual disabilities, mental disorders, and people affected by abuse, neglect, social
exclusion, and discrimination. Parker and Milroy (2014) opined that the Aboriginals have
also been found to place a great emphasis on their ideas of social, family, emotional, and
community wellbeing, which powerfully resonates when they are subjected to different
stigma and stereotypes due to their existing mental illnesses. Hence, the reform has been
correct in recognising the notion of dignity that is the inalienable and inherent worth of all
beings, regardless of their social status such as, gender, race, and physical or mental state.
Therefore, this focus on mental health equity in the reform is a precise owing to the
fact that it will help in focusing on presence of fair access and chances to healthcare facilities,
and proper resource distribution for alleviating the disadvantages that are experienced by the

8MENTAL HEALTH REFORM
vulnerable groups. The reform has correctly recognised the role of trauma-informed care, the
basic principles of which are trustworthiness, safety, collaboration, choice, and
empowerment, in accordance to the essential doctrines of recovery-informed approaches.
According to Huckshorn and LeBel (2013) trauma-informed care focuses on the importance
of partnership between the service users and the staff, which in turn depends on the
assumption that healing and recovery are triggered by meaningful power sharing and decision
making. Additionally, principles of the reform are also supported by the fact that it intends to
reinforce the clients', staff's, and family members' knowledge and distinguish that every
being's experience is exclusive and necessitates an individualized tactic.
Rutten et al. (2013) stated that mental reforms should comprise of a trust in resilience
and in the aptitude of persons, organizations, and societies to reconcile and promote rescue
from trauma. The reform has also identified certain indicators that will determine if the
mental health and wellbeing of the target population is increasing or decreasing. Promotion of
mental wellbeing can be facilitated by the active participation of the people, presence of a
peer workforce, and increase in amount of mental health funding (Tambuyzer, Pieters & Van
Audenhove, 2014). The reform has also recognised the role that is played by private
psychiatrists, psychologists, general practitioners, nursing staff and allied health
professionals. Evidences by Cameron et al. (2014) have acknowledged the importance of
enhancing and supporting the capacity to maintain wellness of the vulnerable people, residing
in the community, either through the delivery of integrated care enterprises or via the
identification and support to medical funding. This will bring about success of the mental
health reform and help it achieve its objectives.
Conclusion and recommendation
Thus, it can be stated that the NSW Mental Health Reform 2014-2024 is a primary
national coalition that focuses on mental health, and is working towards driving the reform of

9MENTAL HEALTH REFORM
mental health services that are available in the region. The reform has recognised the
demanding agenda that all people suffering from mental illnesses should be providing with
the necessary support and access to care services in the community setting, while maintaining
their dignity and demonstrating a respect towards their preferences and opinions. Thus, the
reform has been found to assert on the principles of social equity. This elaborates on the fact
that at any phase of life, regardless of the demographic features, culture, place of residence,
social difficulties, and mental health status, all individuals are equal citizens who should
presume to discover timely, superior quality mental health support, as and when required.
This made the reform illustrate the need of ensuring that the self-respect, dignity, self-
confidence of individuals with psychosocial and mental disability is well-looked-after.
Although the NSW government has recognised the need of driving change, in relation
to mental health and wellbeing of all citizens, the contemporary economic climate does not
hold promise of noteworthy supplementary venture in mental health care. Furthermore,
owing to the fact that the reform had been formulated when comes at a time when the
governments were taking initiatives for coping with the exponential growth in costs related to
hospital services. Basic recommendations for the same requires harnessing local action in
order to provide enhanced services to the mentally vulnerable people. Thus, all people who
are contributing for the successful implementation of the program must be provided with
reliable benefits. Aligning the mental health services of the primary care organisation with
the local health districts will also allow the population to access relevant information
regarding medical benefit schemes, and pensions. Reinforcing on the use of technology and
building provisions for coordinated responses across different human service will also help in
success of the reform.

10MENTAL HEALTH REFORM

11MENTAL HEALTH REFORM
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