Govt to build digital mental health gateway, PHNs to plan regional services
The federal government will develop an integrated web-based portal with a single phone line as part of a digital gateway program to help people navigate mental health services, with work to begin this financial year and the gateway progressively rolled out from 2016-17.
As part of its response to the 'Contributing Lives, Thriving Communities' review of mental health programs by the National Mental Health Commission, delivered a year ago, the government will also redirect $350 million per annum in funding for various programs coordinated by the Department of Health to Primary Health Networks (PHNs), which will now be in charge of planning and commissioning mental health services on a regional basis.
The funding will be redirected into a 'flexible primary health care funding pool' and will include programs such as Access to Allied Psychological Services (ATAPS), Early Psychosis Prevention and Intervention Centres (EPPIC), Headspace service delivery, the mental health nurse incentive program, mental health services in rural and remote areas, and various fragmented suicide prevention programs.
The government wants to take a regional approach to mental health care delivery, with better integration with primary and secondary health services through a stepped care model. A specific priority for regional service integration and delivery led by PHNs will include better sharing of consumer history and information between service providers and consumers through the My Health Record, formerly known as the PCEHR.
The government's response to the commission's review says the new digital mental health gateway will be aimed at providing a first point of call for mental health needs and will include an online triage element. It will include links to existing online forms of self-help for mild to moderate mental health needs.
Health Minister Sussan Ley said the idea of a single national mental health phone line was not to replace existing phone lines but to help direct callers to the appropriate phone or online mental health service they need.
Ms Ley said there were currently over 30 individual federal government-supported phone and online mental health services available to the public, which have been described as fragmented, confusing and difficult to access for people needing quick access to a specific support service.
“There are many fantastic phone counselling and advice services in Australia, but with so many different numbers available, it can be difficult for people to navigate themselves to the right service in their time of need,” Ms Ley said in a statement.
She said a direct help phone service would also help reduce the number of people ringing a service which may not be able to provide the best assistance for their specific needs, which, in turn, could prevent other people getting through.
“Evidence shows that for some phone counselling services, over 300 people each month cannot get through. Other services have answering rates of about 60 per cent.”
The web portal part of the gateway would provide links to digital mental health services offering a range of products from mobile applications that can help to detect the onset of anxiety to professional online counselling and psychological services where people can chat with mental health professionals in a discrete setting.
Ms Ley said the government wanted to harness these digital innovations and provide the easiest possible access to people who may be seeking help.
“These are evidence-based services that deliver real help to people at a low cost,” she said. “They are easily accessible and allow people who might not otherwise access services to get help in a private, discrete setting.
“Whether people are accessing peer-to-peer forums, self-help information or accessing professional services online, we want to make sure we can direct people to the right service as easily as possible.”
Digital service delivery
The government describes digital mental health as the delivery of services targeting common mental health problems through online and mobile phone interactive websites, apps, sensor-based monitoring devices and computers. The term also extends to telephone crisis lines and online crisis support services.
The plan is for the gateway to also provide links to online mental health services and information offered by portfolios such as the departments of Veterans’ Affairs, Social Services, Defence and Education.
According to the government's response, enhancements to the gateway will be explored “to more comprehensively reflect the potential for digital service delivery in mental health over time, to support fully integrated information and service pathways becoming available for both consumers and service providers”.
While the gateway will be directed at people with or at risk of mild to moderate mental illness, the government is planning to introduce integrated, 'stepped care' packages tailored to individual needs for people with severe or complex mental health needs.
Ms Ley said the government plans to identify demonstration sites for these new packages this financial year, with arrangements phased in over three years from early 2016-17.
The government's response to the review says it will give priority to resolving the fragmentation of service delivery for people with severe and complex mental illness who are being managed in primary care, and address their need for coordinated clinical and social supports, by promoting the use of a single eHealth record.
It also plans to provide better, joined up support for child mental health through a new networked system to help reduce the effect of mental illness on children. This will include a single, integrated, end-to-end, school-based mental health program and new pathways to services including online-based support.
Ms Ley said work would begin on the digital gateway this financial year (2015-16), with it being progressively rolled out from 2016-17 as part of the government’s broader three-year reform plan.
Shadow health minister Catherine King said Labor was pleased the government had finally responded to the commission's review, and in broad terms supports the general direction of devolving mental health service delivery to a regional level through PHNs.
However, Ms King said the government’s response was light on detail and provided very little information of funding allocations and the timeframes for implementation.
“It is very difficult to see how many of these reforms can be implemented without additional funding,” she said.
The Australian Medical Association (AMA) also said questions remained about new funding, on-the-ground service delivery, and the ongoing role of the federal government in the mental health sector.
AMA president Brian Owler said the success of the new direction in mental health service delivery will depend very much on the capacity and capability of PHNs and it would be important to ensure that the system did not lock people into a package of care decided upon by a PHN based on the services it has chosen to organise.
Professor Owler also insisted that GPs must remain at the centre of care, citing BEACH data that estimates that around 13 per cent of GP encounters are mental health-related.
He said an underlying concern of the new framework was the withdrawal of the federal government from funding and program delivery to assume a ‘strategic leadership’ role.
“The AMA will be closely watching the government’s reviews of primary care and private health insurance to see if this approach is going to be replicated, with greater responsibilities going to the states and territories and the private sector,” he said.
Posted in Australian eHealth