This report contains the findings from my Office’s performance audit of access to Western Australian State-managed adult mental health services.
About half of all people will have mental health problems at some time, and about 3% will have issues that require significant care and support. Each person’s experience of mental health is unique and can change over time, and their mental health issues will affect those who care for and support them. Providing care that best matches each person’s needs and circumstances is complex and difficult.
Through the Mental Health Commission, the State invests about $800 million each year in a range of community and hospital based mental health services that are delivered by Health Service Providers and non-government organisations. These services work alongside and with services provided by the Commonwealth and private practitioners.
This audit looked at how State-managed mental health services are structured and how people move through the WA mental health system. We found a system under significant pressure, which often struggles to meet the demand for mental health care. One of the reasons for this is the mix of services currently available does not match what the State needs. This will come as no great surprise, because the issue was identified almost 5 years ago in the Better Choices. Better Lives: Western Australian Mental Health, Alcohol and Other Drug Services Plan 2015-2025. It is a good plan, but progress in changing the service mix in accordance with the Plan has been very limited.
Efficient and effective mental health services should help people access the least intensive care appropriate for them for as long as possible and then provide accessible pathways to more intensive care when they need it. Unfortunately for many people, accessing mental health services is not always effective or efficient. They frequently have to access care in emergency departments and hospital beds when non-hospital alternatives would be better for them and more cost effective for the State. The lack of available suitable care settings hinders the work of dedicated clinicians, care-givers and front-line administrators in this very challenging sector.
The State has expressed its commitment to delivering person-centred mental health care, so this audit used a new person-centred approach to analysing performance information held by WA Health. It provides, for the first time, a systematic analysis of people’s journeys through State mental health services. We have provided the data model to the Department of Health which has committed to developing enduring data repositories available to the Commission and Health Service Providers. Used together with people’s lived experience, expert advice and existing activity data, this approach could make a profound difference to the way the State understands, prioritises and delivers care for people with mental illness.