At a time when there is a surge in mental health disorders in young Australians of 47 per cent over 15 years and the health system is struggling to cope with the growing complexity and demand, multidisciplinary solutions are being proposed between the Royal Australian and New Zealand College of Psychiatrists, the Australian College of Mental Health Nurses and other consumer and health professional groups.
At this same time, the report on the Royal Commission into Defence and Veteran Suicide showed that, over the course of the inquiry, the certified numbers of people who died by suicide rose from around 300 to around 1,700. This was because a forensic focus was applied to the statistics. These do not include deaths that may be suicide but have not been recorded as such, like single car accidents, for example. Ex serving veteran suicide is 26% higher than the national average for men and 107 per cent higher for women, identifying a significant need for ongoing mental health (MH) support.
The final report of the Royal Commission into Aged Care Quality and Safety highlighted that as of 30 June 2019, 49 per cent of older people in permanent aged care had a diagnosis of depression, however, the sector has inadequate treatment for conditions, staff lacked skills to care for residents with mental health issues, and there was a lack of access to support systems for people in aged care.
Clearly these problems cannot be solved by carrying on as usual, and the Scope of Practice Review Paper II highlights the fact that “there is no MBS-funded pathway for Registered Nurses to conduct attendances for patients (including for the purposes of assessing mental health care needs and instigating a mental health care plan). This would impact their scope of practice in delivering mental health-related care” (p.53).
Nurses must be part of the solution, and the Australian College of Mental Health Nurses (ACMHN) has welcomed the introduction of school nurses to address MH issues in adolescents in ACT, who will be credentialed mental health nurses, nurse practitioners and allied health workers to deliver more mental health services in the community. There is also to be more accessible mental health support, introducing advanced practice credentialed mental health nurses and mental health nurse practitioners in Walk-in Centres
The ACMHN has also supported the recommendations of the Royal Commission into Defence and Veteran Suicide, in relation to access to a range of mental health practitioners including credentialed mental health nurses, to provide ongoing support for veterans.
ACMHN also launched into the Northern Territory election recently with a partnership campaign calling for changes in government to focus on improving the appalling condition of mental health care in the NT. On most measurements NT performed the worst of all States and Territories with some of the highest levels of need. The use of nurse lead clinics in primary care community locations is an absolute necessity and we hope the newly empowered parliament in NT will take our recommendations seriously.
The ACMHN article is found at: NT Mental Health Patients and Families stand side-by-side with Mental Health Nurses, Peak Bodies.
In addition, the Mental Health Alliance, a multidisciplinary group of health professionals and consumers have provided the joint response mentioned at the beginning of this blog to the August meeting of the nation’s state and federal Health and Mental Health Ministers for meeting and aligning on a number of the sector’s key recommendations, while emphasising that continued, coordinated action is crucial to ensure these reforms make a real difference in the lives of Australians. The following outcomes from that meeting were commended by the Alliance:
- Commitment to progressing the National Health Reform Agreement Addendum (NHRA) negotiations alongside disability reform. We look forward to ongoing collaboration to support government to finalise the agreement as soon as possible, with the NHRA Addendum to commence from 1 July 2025.
- Reaffirmed commitment to deliver the National Mental Health and Suicide Prevention Agreement. We expect governments to work in partnership to improve ongoing coordination of care across the mental health sector.
- Twice-yearly meeting schedule to improve access to mental health services across Australia. We commend the Health and Mental Health Ministers for committing to meet and to include lived and living experience in these discussions as well as in the design and implementation of mental health and suicide prevention initiatives.
- Commitment to develop a plan for future psychosocial support arrangements following the public release of the Analysis of unmet need for psychosocial supports outside of the National Disability Insurance Scheme.
- Undertake national data project to inform how to grow and retain the mental health and suicide prevention workforce. This is of particular importance to NSW as the state is experiencing a crisis in its mental health workforce and both short- and long-term strategies are needed to build and diversify the workforce.
- National framework to improve inter jurisdictional information sharing. We welcome the commitment to develop a new national framework for the mutual recognition of mental health orders and improve access to care across state and territory border.
Whilst there is no doubt that the crisis in mental health is real and alarming, what is heartening about this response is the commitment across all professional groups to address this very real problem together, rather than fighting about turf or payments. In mental health, as in all health in Australia, there is more than enough need to go around, and this combined commitment to solutions is exactly what is required.