A new "well-being service" where people can be referred to and a six-level, re-imagined mental health system are among the recommendations of Victoria's Royal Commission.
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The Royal Commission, called in 2019, identified new referral points - for both children and adults - could fill a gap between intervention and emergency mental health care.
"Area Mental Health and Wellbeing Services will be delivered in a partnership between a public health service (or public hospital) and a non-government organisation that provides well-being supports," Commissioners stated.
"These services will operate with extended hours and respond to crisis calls from anyone in the community 24 hours a day, seven days a week.
"The present system is not designed or equipped to support the diverse needs of people living with mental illness or psychological distress, families, carers and supporters, let alone to cope with unforeseen pressures that may arise."
"The 2019-20 severe bushfire season and the COVID-19 pandemic shone further light on the pressures."
At least 80 new services of this kind would be established and it has been recommended to government that "by mid 2021, eight interim regional bodies to provide advice to the Mental Health and Wellbeing Division in the Department of Health" be established.
"Ensure people can access Local Mental Health and Wellbeing Services through a referral from a general practitioner or any other service provider," Commissioners said.
With there being a major gap in acute inpatient mental health services for young people in Albury-Wodonga - the options are Box Hill in Melbourne or Orange in NSW - the aim to ensure "every region has a Youth Prevention and Recovery Centre for young people aged 16 to 25" could see change locally.
Eastern Health, the facility in Box Hill which has 12 beds for 13-18 year olds, submitted to the Royal Commission that it "often accommodates" adolescents from regional areas including Albury-Wodonga and Wangaratta.
"The number of admissions is high and admissions are typically brief," Eastern Health stated.
"Significant refurbishment, or the development of purpose built child and family mental health community facilities is required."
Neil Coventry, Victoria's Chief Psychiatrist, raised in his submission that there was "some complexity" between NSW and Victoria's differing frameworks affecting Albury Wodonga Health.
"In response to these concerns, my office initiated a process to clarify the arrangements that would underpin safety and quality for AWH's mental health services," he said.
"This included extensive consultation with AWH, the NSW Chief Psychiatrist and NSW Health and culminated in January 2019 in the signing of a memorandum of understanding.
"The MOU clarifies a number of issues related to safety and quality at AWH, including the legislative requirements for AWH mental health services, applicable policies and guidelines, my oversight of AWH and complaints handling policies.
"The MOU defines AWH as a Victorian-governed entity responsive to the Victorian Chief Psychiatrist.
"My office holds oversight of the safety and quality of care of all AWH mental health services and may conduct clinical reviews if warranted."
There were nine initial recommendations to commence change and 65 all up.
Commissioners found that emergency departments were being used "as entry points" due to a lack of services.
"Lack of appropriate community-based mental health services may have led to far greater growth in mental health-related presentations to emergency departments than in non-mental health related presentations," they said.
On regional areas, the report found issues accessing treatment and "stigma".
"Although the prevalence of mental illness is generally the same as in metropolitan Melbourne, suicide rates are higher in rural and regional Victoria than in the city.
"In addition, while the whole system experiences workforce shortages, these are often pronounced in rural and regional areas.
"The Royal Commission recommends that the Victorian Government address mental health and well-being workforce supply needs in rural and regional areas and establish an incentive scheme."
In 2019, there were 718 deaths by suicide in Victoria.
- If you are not in immediate danger but you need help, call NURSE-ON-CALL on 1300 60 60 24.
- For crisis support, contact Lifeline on 13 11 14.
- For phone-based support contact Beyond Blue on 1300 224 636
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