RURAL health services might finally get a strong say in what the bush needs to address growing mental health issues, if the recommendations from a recently released review are followed.
"This is the first time in a long time where we might be able to line the ducks up and maybe work to get this right for rural and remote and regional Australia," says James Cook University Dean of Medicine Richard Murray.
Professor Murray, an expert in rural, remote and indigenous health, said broadly the National Mental Health Commission's Review of Mental Health Programs and Services was positive.
The review recommended an overhaul of the system to shift the focus from crisis and acute care to community-based services, prevention and early intervention; and to better focus services on individuals and families, particularly in regional, rural and remote Australia.
Professor Murray said the notion the level of investment in mental health care matched the severity of the problem and that high risk and high care people could access flexible services to meet their needs in the local context was good policy.
"The problem with national strategies for any health condition is they tend to be developed with a metropolitan context assumed," he said.
"This (review) represents a credible effort to say let's wrap the services around the patient rather than align services to the preferences of professional groups or clinical service providers."
He said if the recommendations were adopted, it was important "the meat on the bones" was put on at the regional level.
"The principles for reorganising investment that this provides, along with the regional health and hospital system governance, and the primary health networks, does provide the right ingredients, but the cake may not rise... it's up to all of us to make it work," he said.
"The effectiveness of this is all about local and regional implementation in systems of care that make sense to that region and for its population."
He said Australia had often developed laudable national policy statements that were not matched by resources nor mechanisms for practical implementation.
"The thing about local areas is that you know the high-care needs communities, families and individuals who require mental health resources and how they have fallen in the cracks.
"You can then identify what those cracks are and how we can work together locally between those in the community services and mental health services, both local and visiting services."
Health ministers met at the Council of Australian Governments (COAG) Health Council this week to discuss the report, and Professor Murray said they had unsurprisingly indicated concern at the proposal to shift investments from acute care to community services.
"But beyond that sensitivity, health ministers seem genuinely supportive."
Professor Murray said while some health care professionals could sometimes get frustrated with various governments undertaking a series of reviews, and sometimes with little in the way of practical results, he was more philosophical.
"While nothing in this review is radically different, it does reflect broader learning about how to design effective, joined-up health care and social services aligned to the needs of people."
Health Minister Sussan Ley said the review painted a complex, fragmented and in parts, disturbing picture of the mental health system.
"I see the COAG process as essential to developing a co-ordinated, binding national approach long-term."
The government was setting up a working group to co-ordinate the process and an expert reference group to inform the process.
Kim Chappell
Editor of Farming Small Areas.
Editor of Farming Small Areas.
