Section 2 – Department Outcomes – 11 Mental Health
Outcome 11
MENTAL HEALTH
Improved mental health and suicide prevention, including through targeted
prevention, identification, early intervention and health care services
Outcome Strategy
The Australian Government, through Outcome 11, aims to improve services and
support for people with mental illness, their families and carers.
The Australian Government is committed to ensuring Australia has a sustainable
and effective mental health system. To demonstrate this commitment, the
Government has made mental health reform a priority of its second term.
The Australian Government will invest $1.5 billion in this Budget to reform the
nation’s mental health services over the next five years. This funding will help
people who have a mental illness get the care they need, when they need it.
When combined with the 2010 Budget and election commitments, which delivers
$624 million in funding for new services over the same five year period, the
Government will provide more than $2.2 billion in funding over five years for
mental health services. In addition, the Government will be providing around
$209 million over the next five years, delivering more mental-health focused
subacute beds as well as mental health infrastructure funded through the Health
and Hospitals Fund.
1
Australian Institute of Health and Welfare, 2007. The burden of disease and injury in Australia, 2003, AIHW,
Canberra.
2
Australian Bureau of Statistics, 2008. 2007 National Survey of Mental Health and Wellbeing: Summary of Results
(cat. No. 4326.0), ABS, Canberra.
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Outcome | 11
Mental disorders account for 13.1 per cent of Australia’s total burden of disease
and injury1 and are estimated to cost the Australian economy $20 billion annually,
including through lost productivity and labour participation. In a 2007 survey,
45.5 per cent of Australians 16-85 years of age reported experiencing at least one,
or a combination of, mental illnesses, including anxiety, mood or substance-abuse
disorders, at some point in their lifetime, and 20 per cent of Australians reported
experiencing one or a combination of these disorders in the 12 months prior to
interview.2
Budget Statements – Department of Health and Ageing
These reforms will be focused on delivering the services that have the best chance
of improving the lives of thousands of Australians suffering from mental illnesses,
now and into the future, by:



providing more intensive support services, and better coordinating those
services, for people with severe and persistent mental illness;
targeting support to areas and groups that need it most, such as Indigenous
communities and socioeconomically disadvantaged areas that are
underserviced by the current system; and
helping to detect potential mental health problems in the early years and
supporting young people who struggle with mental illness.
Furthermore, the Australian Government will work with the states and territories
to address notable gaps in the mental health system through the Council of
Australian Governments.
In 2011-12, the department will also continue to implement program activities
associated with the Government’s commitment to prevent the tragedy of suicide
and reduce its toll on individuals, families and communities.
Outcome 11 is the responsibility of the Mental Health and Chronic Disease
Division and the Health Workforce Division.
Program Contributing to Outcome 11
Program 11.1: Mental health
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Section 2 – Department Outcomes – 11 Mental Health
Outcome 11 Budgeted Expenses and Resources
Table 11.1 provides an overview of the total expenses for Outcome 11 by Program.
Table 11.1: Budgeted Expenses and Resources for Outcome 11
Program 11.1: Mental health 2
Administered expenses
Ordinary annual services (Appropriation Bill No. 1)
Departmental expenses
Departmental appropriation3
Expenses not requiring appropriation in the budget year 4
Total for Program 11.1
Outcom e 11 totals by appropriation type
Administered expenses
Ordinary annual services (Appropriation Bill No. 1)
Departmental expenses
Departmental appropriation3
Expenses not requiring appropriation in the budget year 4
Total expenses for Outcom e 11
Average staffing level (num ber)
1
2
3
4
187,732
292,920
14,485
340
17,084
423
202,557
310,427
187,732
292,920
14,485
340
17,084
423
202,557
310,427
2010-11
101
2011-12
127
The 2010-11 estimated actual and the 2011-12 estimated expenses are based on the new program structure to be
implemented 1 July 2011 by the department as part of the Health and Ageing Portfolio - administrative efficiencies
measure.
This program includes National Partnerships paid to state and territory governments by the Treasury as part of
the Federal Financial Relations (FFR) Framework. National partnerships are listed in this chapter under each
program. For budget estimates relating to the National Partnership component of the program, please refer to
Budget Paper 3 or Program 1.10 of the Treasury Portfolio Budget Statements.
Departmental appropriation combines ‘Ordinary annual services (Appropriation Bill No 1)’ and ‘Revenue from
independent sources (s31)’.
‘Expenses not requiring appropriation in the budget year’ is made up of depreciation expense, amortisation
expense, make good expense and audit fees.
311
Outcome | 11
2010-11
2011-12
Estim ated Estim ated
actual1 expenses 1
$'000
$'000
Budget Statements – Department of Health and Ageing
Program 11.1: Mental health
Program Objectives
Through Program 11.1, the Australian Government aims to:






improve the capacity of the mental health system to provide better coordinated
and integrated care across the spectrum of severity of mental illness;
strengthen primary mental health care;
strengthen mental health services for children and young people;
improve the transparency and accountability of mental health services
nationally;
provide mental health services through KidsMatter; and
develop strategies to reduce rates of suicide.
Major Activities
Investment in more and better coordinated services for people with severe
mental illness
Over the next five years, the Government will invest in more services for people
with severe mental illness and introduce structural reforms to better coordinate
and integrate those services to ensure they are targeted to each individuals needs.
These changes will allow more Australians managing a severe and persistent
mental illness with complex needs – and the families and carers who support
them – to access properly coordinated and more comprehensive care and support
through one point of contact.
The Australian Government will fund dedicated care facilitators in Medicare
Locals, or other suitably experienced non-government organisations, to develop
multidisciplinary care plans for individuals and help them access the services they
need. In 2011-12, the department will develop a nationally consistent assessment
framework and select the first round of regions where these services will be
offered.
As part of this investment, the Government will continue and expand the
successful Support for Day to Day Living in the Community program. This program
aims to improve the quality of life for individuals with severe and persistent
mental illness through structured social activity programs and is delivered through
non-government organisations. This expansion will assist an additional 18,250
people over five years.
Strengthening primary mental health care
To help ensure mental health services are targeted to people who need them most,
in 2011-12, the Government will undertake a substantial expansion of the Access to
Allied Psychological Services (ATAPS) program. ATAPS funds Divisions of
General Practice (transitioning to Medicare Locals as they become available) to
broker allied mental health professionals to provide psychological treatment to
people with a diagnosed mental disorder. The expansion will target hard to reach
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Section 2 – Department Outcomes – 11 Mental Health
areas and communities that are currently underserviced, such as children,
Indigenous communities and socioeconomically disadvantaged communities.
Informed by the outcomes of this evaluation and other evidence, in 2011-12 the
Government will increase the cost-effectiveness of the Better Access initiative to
ensure Better Access is targeted at those for whom the program was designed –
people with common disorders of mild to moderate severity. This will allow
funding to be redirected into the ATAPS program (which is more effective at
meeting the needs of vulnerable and hard-to-reach groups) and other measures in
the mental health reform package that will benefit more Australians with mental
illness.
In 2011-12, the Government will also establish a single portal for web based mental
health services, continuing Australia’s international leadership in this area.
Building on the successful outcomes of the recent evaluation on the Telephone
Counselling and Web Based Support measure, this portal will provide easy, ‘one
stop’ access to evidence-based online psychological therapy. This portal will aim to
assist individuals currently not accessing traditional face-to-face services,
particularly those living in rural and remote communities, those isolated due to
other causes, those for whom anonymity is a priority or those who prefer a
non-clinical setting.
Boosting services for children and young people
In 2011-12, the Government will undertake a significant expansion of mental health
services for teenagers and young adults through providing significantly more
funding to the headspace and Early Psychosis Prevention and Intervention Centres
(EPPIC) models.
The Government will provide funding, and seek matching contributions from the
states and territories, to make available a total of 16 EPPIC centres. The EPPIC
model promotes early detection and management of psychosis, and holistic
support – resulting in better mental health and social outcomes for young people
experiencing early psychosis and their families.
The Australian Government will also provide funding to establish an additional
30 headspace centres, bringing the total number of headspace centres around
Australia to 90. The Government will also provide additional support to existing
headspace centres to ensure their sustainability and to help them to better service
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Outcome | 11
The Better Access to Psychiatrists, Psychologists and General Practitioners through
the Medicare Benefits Scheme (Better Access) initiative has been instrumental in
improving the proportion of people with mental illness who use mental health
services, by encouraging general practitioners (GPs) to work collaboratively with
psychiatrists, psychologists and other allied mental health providers. In late 2010,
the department completed a comprehensive program evaluation of the services
provided under the initiative. The evaluation found that Better Access has been a
positive addition to the mental health service offer, reaching many new people
with common mental disorders such as anxiety and depression, but that many of
the most disadvantaged Australians continue to miss out on these Medicare
delivered services.
Budget Statements – Department of Health and Ageing
existing demand. In 2011-12, the process of expanding centres will commence and
a further 15 sites will be announced.
In 2011-12, the Government will also fund the commencement of additional allied
health service delivery to children with mental health and behavioural issues and
their families through the ATAPS initiative. This measure includes funding to
develop linkages and support networks between mental health service providers
and community workers, including school counsellors. As part of the ATAPS
initiative, the department will develop education and training resources for allied
health professionals involved in this level of service delivery, and services to
children will commence.
Strengthening transparency and accountability
The Government is strongly committed to planning more effectively for the future
mental health needs of the community, giving mental health prominence at a
national level with the establishment of Australia’s first National Mental Health
Commission. The commission will be established within the Prime Minister’s
portfolio, with a strong working relationship with the Minister for Mental Health
and Ageing and the department to create greater accountability and transparency
in the mental health system. Amongst other activities, the commission will develop
an annual national report card on mental health and suicide prevention, which will
use the most current data to monitor mental health reform and summarise the
mental health ‘state of the nation’.
In 2011-12, the department will continue to monitor the progress and effectiveness
of mental health reform through a range of existing national mental health reports.
Enhancements made to mental health reporting will inform future policy reform
initiatives aimed at improving the quality, safety and responsiveness of mental
health services.
Existing child and youth mental health programs
The Early Intervention Services for Parents, Children and Young People measure
provides a framework for a number of initiatives promoting good mental health
including the KidsMatter suite of initiatives. The KidsMatter Primary and
KidsMatter Early Childhood initiatives are being conducted in collaboration with
beyondblue, the Australian Psychological Society, Principals Australia (KidsMatter
Primary) and Early Childhood Australia (KidsMatter Early Childhood). The
collaboration across the health, education and early childhood sectors aims to
achieve better mental health outcomes for children from birth to 12 years of age.
In 2011-12, the Australian Government will fund the expansion of the successful
KidsMatter Primary initiative, with around 1,700 additional primary schools
supported to promote good mental health and improve children’s resilience. This
investment will assist schools to tackle issues like bullying by helping children to
develop social and emotional skills, and creating a supportive school environment.
A national dissemination strategy for the implementation of KidsMatter Primary
is continuing in 2011-12 with a target of 600 primary schools by June 2012 and
includes engagement and collaboration with the education and health sectors in
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Section 2 – Department Outcomes – 11 Mental Health
each state and territory. This strategy will focus on areas of disadvantage in the
first instance.
In 2011-12, the department will fund the development and piloting of KidsMatter
Early Childhood in up to 110 preschools and long-day care centres. An evaluation
of this national pilot, funded by beyondblue: the national depression initiative, is due in
2012 and will inform the future implementation of KidsMatter Early Childhood
nationally.
Suicide prevention
Activity under the NSPS supports a combination of universal, population-based
approaches and community-led activity which targets individuals and
communities at risk of suicide.
The NSPP is supported by a formal governance structure, including the Australian
Suicide Prevention Advisory Council (ASPAC) 4, and will be linked to the new
annual report card on mental health and suicide prevention to be delivered by the
new National Mental Health Commission.
In accordance with the Government’s response to the report of the Senate
Community Affairs Reference Committee: The Hidden Toll: Suicide in Australia,
and in recognition of increased Government investment in suicide prevention,
a comprehensive evaluation of the NSPP will commence in mid-2011. This
evaluation will examine how effectively the NSPP has met its aims and objectives
to date, and will set a framework for future evaluation including new activity
under the 2011-12 Budget mental health reform package.
The Government’s commitment to suicide prevention was redoubled through
initiatives announced as part of the Mental Health: Taking Action to Tackle Suicide
package in late 2010.
As part of this package, and in conjunction with the continuing work of the NSPP,
the Government will, in 2011-12, boost frontline services to support those who
have attempted, or are at risk of, suicide by rolling out more community-based
psychological services. The Government will provide services for up to 37,500
people through a national rollout of the successful ATAPS pilot project, which will
3
The current Suicide Prevention Action Framework covers activity to June 2011 and it is anticipated that the
framework will be re-developed to include activity beyond this point.
4
The tenure of ASPAC is due to lapse in June 2011, however, it is anticipated that this formal advisory structure
will continue.
315
Outcome | 11
The National Suicide Prevention Strategy (NSPS) consists of four key interrelated
components: the LIFE Framework, which sets an overarching evidence-based
strategic policy framework for suicide prevention in Australia; the National
Suicide Prevention Action Framework, which provides a plan of activity and
priorities for the NSPS3; the National Suicide Prevention Program (NSPP), an
Australian Government funding program dedicated to suicide prevention
activities; and mechanisms to promote alignment with state and territory suicide
prevention activities. The overall objective of the strategy is to reduce the incidence
of suicide and self harm, and to promote mental health and resilience across the
Australian population.
Budget Statements – Department of Health and Ageing
be delivered through Medicare Locals as they become available. This initiative
facilitates access to immediate and intensive support from allied health providers
for people in the high risk period following a self harm event or suicide attempt or
who have suicidal ideation over a period of acute suicide risk.
In 2011-12, the department will also implement the remaining elements of the
election commitment suicide package. To achieve this, the department will work
closely with ASPAC, local government and states and territories through the
National Suicide Prevention Working Group to develop an approach to prevent
suicides by improving safety and infrastructure at notable suicide ‘hotspots’. In
addition, the department will make Indigenous communities the first priority
under the $22.6 million Supporting Communities to Reduce Risk of Suicide
component of the package and develop education and training resources,
including online resources, to help Indigenous health and other workers to
respond more effectively to Indigenous people at risk of suicide and to help local
communities experiencing grief as a result of suicide.
Program 11.1 is linked as follows:


This program includes National Partnerships payments for:
- National Health and Hospitals Network - Mental Health - Expansion of the Early
Psychosis Prevention and Intervention Centre model initiative; and
- The National Perinatal Depression Initiative.
These Partnerships payments are paid to state and territory governments by
The Treasury as part of the Federal Financial Relations (FFR) Framework.
For budget estimates relating to the National Partnership component of the
program, please refer to Budget Paper 3 or Program 1.10 of the Treasury
Portfolio Budget Statements.
Department of Human Services (Medicare Australia) to administer the Mental
Health Nurse Incentive Program, through its Services to the Community
(Program 1.1).
316
Section 2 – Department Outcomes – 11 Mental Health
Program 11.1 Expenses
Table 11.2: Program Expenses
2010-11
Estim ated
actual
$'000
2011-12
Budget
Annual administered expenses
Ordinary annual services
Program support
Total Program 11.1 expenses
$'000
2012-13
Forw ard
year 1
$'000
2013-14
Forw ard
year 2
$'000
2014-15
Forw ard
year 3
$'000
187,732
292,920
385,856
449,371
514,460
14,825
17,507
14,316
13,052
12,083
202,557
310,427
400,172
462,423
526,543
Program 11.1: Deliverables
The department will produce the following ‘deliverables’ to achieve the objectives
of Program 11.1.
Table 11.3: Qualitative Deliverables for Program 11.1
2011-12 Reference Point or Target
Produce relevant and timely evidence-based
policy research
Relevant evidence-based policy research
produced in a timely manner
Stakeholders participate in program/policy
development
Stakeholders participate in program
development through avenues such as
regular consultative committees,
conferences, stakeholder engagement
forums, surveys, submissions on
departmental discussion papers and
meetings
Investment in more and better coordinated services for people with severe mental
illness
Extend the availability of services to people
living with a severe and persistent mental
illness
New funding arrangements to be
implemented
Strengthening primary mental health care
Increase primary mental health care services
Additional ATAPS packages and e-mental
health portal available to the public
Boosting services for children and young people
Deliver new services for children with
mental health and behavioral issues
Increase in services provided for children
with mental health and behavioural issues
and their families
317
Outcome | 11
Qualitative Deliverables
Budget Statements – Department of Health and Ageing
Qualitative Deliverables
2011-12 Reference Point or Target
Suicide prevention
Projects under the National Suicide
Prevention Action Framework implemented
Projects implemented in a timely manner
Table 11.4: Quantitative Deliverables for Program 11.1
Quantitative
Deliverables
Percentage of variance
between actual and
budgeted expenses
2010-11
Revised
Budget
2011-12
Budget
2012-13
Forward
Year 1
2013-14
Forward
Year 2
2014-15
Forward
Year 3
≤0.5%
≤0.5%
≤0.5%
≤0.5%
≤0.5%
Investment in more and better coordinated services for people with severe mental
illness
Number of people
accessing Day To Day
Living services
11,000
12,825
14,650
14,650
14,650
27,850
39,150
48,100
Strengthening primary mental health care
Number of additional
people assisted under
the expansion of the
Access to Allied
Psychological Services
program
N/A
14,400
Boosting services for children and young people
Number of headspace
youth-friendly service
sites funded
40
55
70
85
90
55
76
77
80
83
Suicide prevention
Number of funded
initiatives focusing on
suicide prevention in
identified high risk
groups5
5
Increase in suicide prevention initiatives focusing on high risk groups in forward years due to increased funding
of $22.6 million through the Mental Health: Taking Action to Tackle Suicide package.
318
Section 2 – Department Outcomes – 11 Mental Health
Program 11.1: Key Performance Indicators
The following ‘key performance indicators’ measure the effectiveness of
Program 11.1 in meeting its objectives thereby contributing to the outcome.
Table 11.5: Qualitative Key Performance Indicators for Program 11.1
Qualitative Indicator
2011-12 Reference Point or Target
Investment in more and better coordinated services for people with severe mental
illness
Improved uptake of structured activities by
people with severe mental illness
Structured activity programs are
increasingly accessed by people with severe
and persistent mental illness
Strengthening primary mental health care
Primary mental health care services are
increasingly used by groups with lower
uptake, such as young people, men and
people living in rural and remote areas
Boosting services for children and young people
Improved access for young people with
general mental health concerns and common
mild to moderate mental illness
headspace sites are more accessible and
utilised by young people
Table 11.6: Quantitative Key Performance Indicators for Program 11.1
Quantitative
Indicators
2010-11
Revised
Budget
2011-12
Budget
Target
2012-13
Forward
Year 1
2013-14
Forward
Year 2
2014-15
Forward
Year 3
100%
100%
100%
Strengthening primary mental health care
Percentage of
Divisions of
General
Practice/Medicare
Locals with the
capacity to provide
perinatal
depression services
through the Access
to Allied
Psychological
Services initiative
100%
100%
319
Outcome | 11
Improved uptake of primary mental health
care by groups with lower usage such as
young people, men and people living in
rural and remote areas
Budget Statements – Department of Health and Ageing
Quantitative
Indicators
2010-11
Revised
Budget
2011-12
Budget
Target
2012-13
Forward
Year 1
2013-14
Forward
Year 2
2014-15
Forward
Year 3
100%
100%
100%
1,200
2,000
2,600
Boosting services for children and young people
Percentage of
Medicare Locals
providing
specialised services
for children
provided by trained
allied health
professionals
0%
50%
Existing child and youth mental health programs
Number of schools
participating in the
KidsMatter Primary
Initiative 6
6
400
600
The forward year targets for this key performance indicator have increased for years 2012-13 and 2013-14 as the
government has allocated additional funding to this initiative through the Mental Health: Taking Action to Tackle
Suicide package.
320