The Western Australian Ten Year Mental Health Services Plan:

Development update

WAAMH Forum30 October 2013

Dr Aaron Groves Principal Clinical Lead

I acknowledge the traditional owners of the land on which we meet today the Wajuk people of the Noonygar nation, their ancestors and people who have walked the lands before them. I am proud to work, walk and live on their lands

Government requires a Services Plan for mental health services by December 2013 to guide investment decisions that:

Responds to the needs of the growing populationEmbeds the key mental health reform directionsMeets best practice standards and resourcing

benchmarksUses evidence based approachReflects the unique needs of the StateInforms funding model development

WA Mental Health Services PlanMandate

Alcohol and Other Drugs Working Group

Mr Neil Guard

Minister for Mental Health

Project Sponsors

Commissioner, Mental Health Commission

Director General, WA Health

Steering Committee

Project Management Group

Community Clinical Consultation Group

Dr Elizabeth Moore

Promotion and Prevention

Consultation Group Professor Mike Daube

Bed-Based Consultation Group

Mr Patrick Marwick

Consumers , Families and Carers Reference

Group

Project Sponsor

Executive Director Drug and Alcohol Office

AOD Steering Committee

Principal Clinical Planners

Community Support Consultation Group

Mr Joe Calleja

WA Mental Health Services Plan – Project Governance

WA Mental Health Services PlanWA levers for changeMental Health 2020The Plan will support implementation of the directions

outlined in ‘Mental Health 2020: making it personal and everybody’s business’ which include a greater focus on individualised supports for people, improved coordination and more balanced investment across the mental health sector

Stokes The Plan is being developed as part of the WA

Government’s response to recommendations from the ‘Review of the Admission or referral to and the discharge and transfer practices of public mental health facilities /services in Western Australia’ (Stokes 2012)

Western Australian Drug and Alcohol PlanningIn line with recommendations from the Stokes

Review regarding the need for improved collaboration between mental health and alcohol and other drug services and the government’s announcement to amalgamate the MHC & DAO the plan will incorporate alcohol and other drug services planning concurrently being undertaken by the Drug and Alcohol Office.

WA Mental Health Services Plan

National Mental Health Strategy • In part an acknowledgement of the broader national health reform agenda, including:

Mental Health Reform agenda and commitment to National Mental Health Services planning

National Mental Health Policy 1992

National Mental Health Plan, 1992–98• Medicare Agreements 1993-98

Second National Mental Health Plan,1998–03• Australian Health Care Agreements 1998-03

National Mental Health Plan 2003–08• Australian Health Care Agreements 2003-08

COAG National Action Plan for Mental Health 2006-11

National Mental Health Policy 2008

Fourth National Mental Health Plan 2009-14

States and Territory mental health policies, plans and strategiesCurrent State plans exist in Victoria, NSW, SA, Queensland, ACT and Tasmania.

The last endorsed WA MH Plan was in 1996.

Fourth National Mental Health Plan

Action 16 in the Fourth National Mental Health Plan: An agenda for collaborative government action in mental health 2009-14• Action 16: Develop a National Mental Service Planning

Framework that establishes targets for the mix and level of the full range of mental health services, backed by innovative funding models.

This action is considered one of the foundation actions of the• 4th plan and the Commonwealth provided $2 million to

NSW and Qld Governments to develop the framework in collaboration with all jurisdictions

The project is known as the National Mental Health Service Planning Framework (NMHSPF)

National Mental Health Service Planning FrameworkKey objectives • Nationally consistent - an ‘Australian Average’ estimate

of need, demand and resources• Flexible and Portable - to suit jurisdictional priorities and

other variations in a user friendly format• Not all, but many - will not account for every

circumstance or service possibly required• Not who, but what - will capture the types of care

required, but will not define who is to deliver• Includes intersectoral linkages with housing,

employment and education• Evidence & Expertise - identify what services ‘should be’

provided underpinned by evidence

NMHSPF adapts MH-CCP (“muck up”)POPULATION AND EPIDEMIOLOGY

DEMAND

SERVICE MAPPING

CARE RATE

CARE PACKAGES

RESOURCE PREDICTIONS

OUPUT PREDICTIONS

STAFF PREDICTIONS AND COSTSF

POPULATION EPIDEMIOLOGY

PREVENTION CARE

NMHSPF

Concept of prevention

Concept of mild illness

Concept of moderate

illnessConcept of

severe illness

• Standard reference epidemiology, Australian Burden of Disease 2007

• Stratified by Severity MILD/ MODERATE/ SEVERE

NMHSPFPrevalence WELL MILD MODERATE SEVERE ILL TOTAL

Age 0-17 84.6% 8.8% 4.4% 2.3% 15.4% 100%Age 18-64 81.6% 9.9% 5.0% 3.5% 18.4% 100%Age 65+ 85.2% 7.9% 4.1% 2.8% 14.8% 100%All Ages 82.8% 9.4% 4.8% 3.1% 17.2% 100.0%

AUS Pop 2011 WELL MILD MODERATE SEVERE ILL TOTALAge 0-17 4,302,811 446,133 224,704 115,348 786,186 5,088,997 Age 18-64 11,551,923 1,405,930 710,775 489,770 2,606,475 14,158,397 Age 65+ 2,621,864 242,769 126,443 85,463 454,675 3,076,539 All Ages 18,476,597 2,094,832 1,061,922 690,581 3,847,336 22,323,933

• Standard reference epidemiology, Australian Burden of Disease 2007

• (Detailed prevalence of demand by Dx and severity for each age group, eg 18-64)

Dx=PRIMARY Diagnosis (MI) Dx (N) Tx-MI(N) Tx-MILD(N) Tx-MOD(N) Tx-SEV(N)J02 Schizophrenia 85,200 85,200 - - 85,200 J04 Bipolar Disorder 91,288 91,288 - - 91,288 J03 Anxiety/Depression 1,670,300 1,097,625 477,228 381,783 238,614 J05 Personality Disorder, isolated 401,466 245,697 129,807 103,846 12,044 J06 Anorexia Nervosa 10,929 10,164 - 3,060 7,104 J06 Bulimia Nervosa 10,673 9,926 - 2,988 6,937 J07a ADHD 14,966 9,835 4,276 3,421 2,138 SMHWB(C&A) - Balance - - - - - Subtotal (Dx of Primary MI) 2,284,822 1,549,736 611,312 495,098 443,326 Dx=PRIMARY Diagnosis (non-MI) Dx (N) Tx-MI(N) Tx-MILD(N) Tx-MOD(N) Tx-SEV(N)J07b Autism - Excess over K09 44,498 7,594 3,302 2,641 1,651 J07b Asperger’s Syndrome + PDD (nos) 17,392 - - - - K01 Dementia - BPSD 10,140 4,315 1,521 1,416 1,378 K09 Intellectual Disability-MI 303,714 63,950 27,804 22,243 13,902 J01a Alcohol-MI 898,997 82,708 35,960 28,768 17,980 J01b Heroin-MI 49,924 13,451 5,848 4,679 2,924 J01c Benzodiazepines-MI 52,625 9,683 4,210 3,368 2,105 J01d Cannabis-MI 252,434 23,224 10,097 8,078 5,049 J01e Stimulants-MI 72,773 6,695 2,911 2,329 1,455 Subtotal (Dx with MI Concurrent) 1,702,498 211,619 91,653 73,522 46,444 TOTAL MI TREATMENT DEMAND for NMHSPF 1,761,355 702,965 568,620 489,770

NMHSPF AGES 18-64 (Demand, Numbers, AUS, 2011)

The National MH planning framework methodology can give us a WA Framework that does the following:

Enables us to do State-wide population based planning to determine the evidence based ‘blue print’ for Mental Health services into the future including:

The detail for the mix and level of services including taxonomies and facilities guidelines

The detail for the mix and level of services including standards, care packages & pathways

Informing costing for example cost benchmarking; cost weights; activity based funding models

WA Mental Health Service Plan WEEK 8 this week and counting down … Service Mapping completed and modelling work commenced Steering Committee & Consultation groups(CG) have met regularly

since August and provided with policy context, rationale for national mental health services planning and scope of the work being undertaken

CG Provided with an overview of the process for development of the National Framework and definitions and endorsed the process

Models of service have been reviewed and recommended Groups have been provided with the key aspects of the methodology for

development of the WA Framework and will be provided with a summary of the current WA estimates produced by the model at the next meeting

A series of targeted forums are underway to ensure consideration of populations with unique needs, including consumers, carers and family members ,Aboriginal communities, people living in rural and remote areas, multicultural and youth

Online feedback survey is available on the MHC website

To Deliver …WA Mental Health Services Framework

Applies National Mental Health Services Planning Framework to inform and determine the type/quantity of services required for WA

Maps existing services Identifies gaps and imbalances Informs and aligns with the WA Health Clinical Services Framework

The WA Mental Health Services Plan Will assist in developing strategic directions and priorities based on demand

modelling and expert opinion, balancing short and long terms goals, and ensuring appropriate resource application

Will describe key demand drivers for future mental health service planning in WA and apply them to the WA context to predict future requirements

Will not seek to specify how services will be delivered at a local level – further consultation and consideration of local issues and services is required to determine how to best deliver services at a local level

QUESTIONS