Mental Health Care Victoria

1. Introduction

The report is intended to focus on the working of four basic human factors in the health care department in Victoria. For simplicity mental health care plan department in Victoria has been selected and will be analyzed with the factors such as

  • Leadership and support to practitioners, clinicians and other health professionals.
  • Transparent and clear role for practitioners in service and patient safety and quality.
  • Effective communication between practitioners and patients.
  • Effective communication within the organization or sector.

Working in a mental health Australia care centers are complex, the environments and patients of these service centers usually have critical illness that requires considered treatment attention and support (Dianne, McGowan, & Downie, 2000). This report has been developed to provide assistance to all the clinical staff entering or working in the clinical mental health services in Victoria.

The document is divided into three main sections: in first section a brief introduction and overview of the organization is given, in the second part four human factors listed above will be discussed and analyzed and in the last part recommendations and conclusion will be provided for maintenance and improvement of the department (Bedirhan & Sartorius, 2005).

1.1 Overview of the Mental Health Department Australia

The reform of mental health care services Australia is recognized internationally as the leader. Australia’s mental health strategy involves the national mental health policy, related publications and subsequent plans. It is the duty of all states and territories to work continuously towards the national priorities and deliver a regular feedback on achievements (Graham, 2005).

To improve the wellbeing of all Victorians the Government of Victoria on 1st of January 2015 created the Department of Health and Human Services (DHHS) to incorporate the human and health services programs and policies. DHHS covers the problems related with planning, funding, policy development and regulation of health activities and services that protect and promote Victorians health. This contains providing services of aged care and mental health services.

1.1.1 Mental Health Department Victoria

Victorian mental health foundation is one of the oldest mental health organizations in Australia, which was established back in 1930. It is an association of sufferers, professionals, families of the sufferers or caretakers (Sweeney & Hazell, 2006). Victoria’s mental health foundation is a part of the national and also the international mental health movement.

“Vision that Victoria will have a high quality, sustainable and competent specialist mental health workforce”

1.1.2 Victorian Mental Health reforms

The Government of Victoria has undertaken a program of reform for the human and health service sectors in particular with the relation to mental health care and treatment, since 2010. Development and workforce planning for Victoria’s professional mental health issues sector will bring into line and support all these significant reform agendas (Maggy, Baghurst, Baghurst, Kosky, & Nurcombe, 2000).

1.1.3 Health Policies and Strategies

To date, three national mental health policies and plans have been there:

  • The first plan was introduced in 1992-93 to 1997–98 the prime focus was on deinstitutionalization and bringing up a community based mental health system. The mental health services were incorporated in general hospitals and some other health sectors (Harvey, Jack, & White, 2005). The basic motive behind was to make an easy access of mental health services for the patients and decrease the huge stigma that is linked with mental illness.
  • Second plan was introduced in 1997-98 to 2002-03. In this plan the agenda of first plan was continued and its focus was broadened to address increasingly high prevalence of disorders such as anxiety and depression. The plan prioritized the promotion of mental health, relapse prevention, early intervention and illness prevention. The plan emphasized the need to reinforce the services for specific patients such as
  • People with mental illness and coexisting substance.
  • Intellectual disability and coexisting mental illness.
  • Coordinating other support and health services with mental health to meet the multiple needs of consumers.
  • 2003-08 third plan was introduced with a commitment to continue the refining services and sketches four priorities: preventing mental health problems and promoting mental health, strengthening quality of service, increasing service responsiveness, fostering innovation, research and sustainability (Dianne, McGowan, & Downie, 2000).

Source: (Maggy, Baghurst, Baghurst, Kosky, & Nurcombe, 2000)

2. Victorian Mental Health Service System

The figure given below depicts the working of the victoria’s mental health service system. The approach is to make sure that all the consumers receive a similar range and type of services from their entry to discharge (Derrick, Steel, & Watters, 2013).

Source: (Derrick, Steel, & Watters, 2013)

·         Leadership and support to practitioners, clinicians and other health professionals

One of the basic goals of the mental health care department of Victoria is to foster positive working and learning environment with strong and solid leadership and support to practitioners. According to Ritsuko, et al(2011) effective leadership and support are the fundamentals of any organization. Victorian mental health care department has a very well organized system of leadership they work by setting the agendas for the clinicians and practitioners, departmental priorities are influenced, motivate the staff by giving them incentives and keeping them engaged, assign and define their responsibilities or roles, allocate proper resources and set clear and define targets to achieve success.

Mental health services with effective and active leadership have better and smooth organizational performance says, Sarah(2005). As the staff engagement is increased the probability of errors are reduced with lower mortality rates and infections, staff morale is greater, financial management is strong and reduces absenteeism.

The leadership strategy of Victorians mental health care services is based on the leadership capability framework of the ‘UK National Health Service’ leadership qualities framework. The strategy provides departmental activities for the improvement of health service centers. A four year plan is set by Johnston, Teesson, & Burgess(2009), acording to that  the strategy which identifies five major priority areas such as developing capabilities of leadership of individuals and groups, organizational approach to leadership, resources and tools, strategic partnership, and tools and resources. A range of programs and approaches are used under this strategy to support the leadership development of Victoria’s publicly funded health services.

The strategy:

  • Foster a culture of innovation
  • Supports leadership development and skills
  • Inspires all leaders to share knowledge and support each other
  • Develops professional networks

This strategy aims at developing a shared view of the capabilities and skills of leaders at varied levels and roles in health care services in Victoria.

Source: (Bedirhan & Sartorius, 2005)

·         Transparent and clear role for practitioners in service and patient safety and quality.

Mental health is not an area that depends on high and modern technology equipment, as compared to some other departments of health care. Working in any mental health center is only about people. According to Graham(2005) the most advanced and up to date technology is their staff. The primary tools are the knowledge, attitudes, personal qualities and skills that the practitioners and clinicians bring to the job.  Thus it is very necessary to have cleared and define goals in order to provide their customers with the best possible services and technology they have.

Victorian mental health service provides the workforce with the essential abilities and support to provide recovery oriented best practice care. They aim at defining transparent and clear roles for practitioners in order to maintain patient safety and quality. The roles of individuals are more strongly align and they are expected to work with agreed capabilities and carer outcomes said by, Ian, Groom, McGorry, Davenport, & Luscombe(2005). Clinical responsibilities of all the practitioners and clinicians are clearly defined to prevent any uncertainty and role confusion.

For the practitioners and clinicians of Victoria’s mental health service, quality and safety is the integral part. Clinicians and services are continuously seeking ways to maintain safe working environment and improve practice. The principle they are working on is that safe and better quality service with effective and active practice leads to an improved carer outcomes and consumers, along with the improved well-being of the staff. The basic concept of safety and quality is simply having defined and transparent roles and wanting to do positive and effective job (Bedirhan & Sartorius, 2005).

According to the Evaluation and Quality Improvement Program Survey, there are eleven standards that covers all aspects of the national standards for mental health services, these are: safety, rights, promoting community acceptance, consumer and carer participation, confidentiality and privacy, carer and consumer participation, promotion and prevention of mental health, integration of services, cultural awareness, documentation, service development, delivery of from the point of entry to exit.

·         Victoria’s strategy for safety and quality

The safety and quality strategy of Victorian mental health services provides a plan and framework for the development of high quality, safe mental health system. Practicing and working safely is a very critical feature of maintaining quality (Sarah, 2005). As people are mentally not stable so they can respond in any unpredictable way. The clinicians, practitioners and the environments of mental health service needs to be prepared to respond and predict appropriately to violence, aggression and risk. A quick and timely response to any risk and maintaining the high standards of workplace safety are the mutual responsibilities of clinicians and services. All the services are likely to have activities and structures in place in order to promote quality and safety of practice, and the improvement of system and accountability said by Rrnoald(2000). In Victoria public mental health services have certain processes and a safety and quality coordinator who examine service and practice delivery to determine that what areas are working properly and what areas might need some improvement.

·         Effective communication between practitioners and patients

By the research conducted by Scott, Andrews, & Hall(2000)     mental health services are largely required to involve their patients and practitioners in effective communication with each other. In that way a shared and mutual understanding between practitioners and patients can be developed about the major issues that need to be addressed and administered from the mental health services. The effective communication can result in more reactive management and decision making practices and improving the quality of care thus increasing the confidence of community in services.

Victorian mental health services make sure that they keep an informal and easy process of communication between their practitioners and patients. According to Anthony, Korten, & Rodgers(2006) some of the basic points that is the part of their effective communication process are: Support patients perspectives to be counted in and valued in all parts of mental health cares, and communicating the broad opinions of the patients with mental health departments and some other relevant departments.

The process of communication starts from the time patient is taken in Victorian mental health cares. The aim of effective communication is to obtain as much information that is necessary to assess the level and type of service response and treatment is required. Communication during the intake process is a clinical function and usually involves a face to face assessment either at the mental health services, patient’s own environment, or in another environment. The process of communication may vary between adolescent, child, adult or aged group services, and between rural and metropolitan services says Graham(2005). Intake communication is considered to be the starting point of delivering services and it is the stage where patients are registered with the hospital.

Under the treatment and recovery planning of Victorian mental health services, effective communication plays a vital role. For mentally unstable and ill patients proper means of communication is considered to be very significant. Patients’ needs are assessed and valued in a number of active, brief and regular communications. Other family members and the care providers of the patients are also a part of this communication process (Johnston, Teesson, & Burgess, 2009).

Patients with mental illness also have same rights that any other normal member of the community. As mostly they are unable to understand a lot of things, their rights are sometimes curtailed. So according to the mental health  Act of 1986 those patients who are mentally ill must also be given a verbal clarification of any piece of information that is related to them, in a language or method of communication that is easily understandable for such patients.

·         Effective communication within the organization or sector

Collaboration and communication within the organization and sector are essential in managing and assessing the patients with mental illness. The core principle of collaborative treatment is an effective means of communication said by Maggy, Baghurst, Kosky, & Nurcombe(2000).

According to Sarah(2005) Most of the Victorians with mental health problems generally try to access mental health services from their primary care provider or general practitioner; however those patients who are seriously pretentious by their ailment are then referred to the mental health service’s specialist. So the collaboration and effective communication between mental health care and general practitioner has made mandatory in Victoria’s mental health organizations in order to provide their patients who are suffering from mental health issues, with good quality health care treatments.

‘We are in it together’

An effective communication among all the members of the healthcare department have positive influence on job satisfaction, the quality of working relationships and profound impacts on patients safety said by Graham(2005). Whenever a communication about responsibilities and tasks are effective and done well, evidences has shown notable decline in nurse turnover and enable a culture of joint support.

All the clinicians and practitioners of the organization share each other’s expression of weaknesses, strengths and suggestions are warmly welcome for continuous improvement in the working of the system and in turn providing their patients with best possible services they can. Communication and collaboration within the organization takes a lot of effort and time but it is necessary for the patients of mental illness.

A research study conducted for a period of 10 years (1995-05) has reflected that ineffective communication among the team members is the major cause for approximately 67 percent of all medical errors during that time period.

3. Recommendations

First step towards the comprehensive and well considered meantal health care services is the drafting of a plan and policy that will guide the system of mental health and services development. Mental health policy is a statement by health authority or government that provides directions for mental health by defining the values, vision, objectives and principles and establishes a model for action to achieve that vision says Dianne, McGowan, & Downie(2000). A policy to be effective must be accompanied with a more specific and detailed action plan that is implemented in a well-coordinated and systematic way.

An “optimal mix of services pyramid” is recommended by The World Health Organization (WHO) in this pyramid such mental health care services that are most frequently needed and cost the lest, form the base of the pyramid, whereas those services which are more expensive are placed at the top of the pyramid said by Ritsuko et al(2011). For those countries who are willing to create this mix of services, WHO recommends that:

  • Build community mental health services
  • Limit the number of mental hospitals
  • Development of mental health care services in general hospitals
  • Build informal community mental health services
  • Integrate mental health services into primary health care
  • Promote self-care

In the mental health global action program multiple strategies has been proposed to improve mental health care services and delivery. The four main strategies are listed as under:

  • Raising awareness on mental illness and disorders through education and support such patients to reduce stigma associated with mental illness.
  • Improving and increasing information for technology transfer and decision making to increase country capacity
  • Building local ability for mental health research in poor areas
  • Assisting countries in developing and designing comprehensive policies and effective mental health services.

For implementation of strategies that can bring improvement in the mental health care services, a huge amount of investment will be required by the global health community including donors, governments, consumer groups and multilateral agencies says Alison & Elaine(2008).

As there is a huge stigma associated with the mental illness Scott & Hall(2000) suggest that integrating mental health services into primary health care can reduce stigma to a noticeable level for people with mental illness and their families. Since primary health care services are not linked with any specific mental disorders or health conditions stigma is reduced and making this level of care far more acceptable. These integrated care centers will improve an access to mental health services as well.

A range of research on mental health care centers has produced tools, programs and methods that can help in the improvement of quality of mental health services. The partners in care program (PIC) have allowed people who were the victims of depression to collaborate and communicate with their service provider and have shown positive outcomes.

Sweeney & Hazell(2006) emphasized on the careful selection of mental health indicators that can monitor the scaling up process. He offered a set of 11 indicators to make sure that countries can evaluate their progress and equate their mental health care status with other countries. The four recommended mental health care goals are:

  • Sufficient workforce that can provide mental health services
  • Sufficient investment and planning for mental health care
  • Better outcomes for people with mental disorders
  • Consistency of mental health care processes and inputs with human rights protection and best practice.

Conclusion

The Victorian mental health service system is undergoing significant reform. The aim of this reform is a commitment to provide improved, more targeted treatment and care for individuals who are going through mental illness. Mental health care service are complex in nature the working environment and patients of these service centers usually have critical illness that demand considered treatment, attention and support. As there is a huge stigma associated with the mental illness it is observed that integration of mental healthcare with primary healthcare can reduce this stigma to a recognized level (Dianne, McGowan, & Downie, 2000). The reform of mental health care services Victoria is recognized internationally as the leader. Australia’s mental health strategy involves the national mental health policy, related publications and subsequent plans. It is the duty of all states and territories to work continuously towards the national priorities and deliver a regular feedback on achievements.

 For the smooth working of the mental health care center it is seen that four human factors that are discussed above plays an important role, this not only makes sure that the department is working properly it also helps a lot in the treatment of mentally disorder people (Rrnoald, 2000). According to the literature discussed above a huge amount of investment is required for the implementation of improved strategies.