Mental Health Commissioner’s Awardfor mental health and wellbeing

Name of mental health project or program

……………………………………………………………………………………..

Is this project a joint submission with an organisation or organisations external to WA Health?

Yes………….

No…………...

Name of nominee

Please note: only projects or teams (not individuals) can be nominated for the project awards.

Primary contact in WA Health

Name……………………………………………………………………………………

Title……………………………………………………………………………………..

Employing entity (Please give full details - health service, division, directorate, unit/branch, etc.)

………………………………………………………………………………………….

Address………………………………………………………………………………...

Telephone……………………………………………………………………………..

Primary contact email address……………………………………………………...

External partner organisation(s) contact details

If this project is a joint submission with an organisation or organisations external to WA Health, the lead organisation will be considered to be WA Health. Please list the other organisation(s) below.

Organisation name…………………………………………………………………..

Contact person……………………………………………………………………….

Title……………………………………………………………………………………..

Telephone………………………………………………………………………………

Email address………………………………………………………………………….

Organisation name…………………………………………………………………..

Contact person……………………………………………………………………….

Title……………………………………………………………………………………..

Telephone………………………………………………………………………………

Email address………………………………………………………………………….

Organisation name…………………………………………………………………..

Contact person……………………………………………………………………….

Title……………………………………………………………………………………..

Telephone………………………………………………………………………………

Email address………………………………………………………………………….

Sign off (Tier 2 or above)

Name:…………………………………………………………………………………….

Organisation:……………………………………………………………………………

Date:………………………………………………………………………………………

250 word summaryPlease provide a brief overview of the project for promotional purposes. You might follow the SAO format – situation, action, outcome, to tell the story of your project in a succinct format.

This does not form part of judging, but is needed to give judges context for application and will be used in all promotional materials.

General questionsIn a maximum of four (4) pages please address the following criteria.

1. How does this project/program contribute to the mental health and wellbeing of people in Western Australia(10 points)

Describe how this program/project came about? Was it in response to a need? How does it align to the Mental Health, Alcohol and Other Drug Services Plan 2015-2025? Outline the steps you undertook to successfully implement the program.

2. Research and consultation (20 points)

Describe the research and/or consultation undertaken before developing and implementing the project. Describe how you involved key stakeholders, including consumers, carers and family members impacted by the project.

3. KPIs and objectives (10 points)

What KPIs, targets or objectives were set for the project?

4. Implementation (30 points)

Describe the implementation process – including approvals, timelines, resources used, budget, change management, co-design, involvement of consumers, carers and family, and challenges faced.

5. Monitoring and evaluation (30 points)

How was the project monitored and evaluated against objectives, and what were the findings and lessons learnt and how they were measured against your KPIs.

Explain in your response how the evaluation has changed work practices, resource allocation or processes and if the project is ongoing?

How to submit your nominationDeadline for submissions: 22 August 2018

Once you have completed your nomination form, please email it to:

wahealthawards@health.wa.gov.au

A confirmation receipt will be emailed to the primary WA Health contact.

More information:

Event Manager Communications Directorate Department of HealthPO Box 8172Perth Business Centre WA 6849

189 Royal Street, East Perth 6004Phone: 9222 6425Email: wahealthawards@health.wa.gov.au