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In November, the Productivity Commission released its final report on the National Mental Health and Suicide Prevention Agreement (the National Agreement). It found that while some good work is being done, the National Agreement hasn’t provided the vision and direction we need to build the mental health system that we all want.
In our joint response to the review in March, we called for the establishment of a national strategic direction that prioritises mental health and suicide prevention. This requires articulating a shared vision, focus areas and priority actions based on contemporary evidence and demonstrated need.
We must move the needle on the prevalence of mental ill-health and suicidal thoughts and behaviours and ensure government investment in mental health is translating to improved outcomes for Australians.
Setting a future vision
We want to see a National Agreement that clearly articulates cross-sectoral and cross-jurisdictional reform towards a shared vision of improving mental health outcomes for all people living in Australia. This vision should be underpinned by learnings from people with lived and living experience of mental health challenges and suicide.
To affect real change, a future agreement should work towards a clear set of objectives, and:
- be clear on how funded activities are expected to meet those objectives;
- drive a cross-portfolio approach to focus on both prevention and mental health care for those who need it; and
- ensure collective effort is focused on improving system enablers like workforce and integration.
Beyond this, it is crucial that the agreement is supported by investment in outcomes focused data and embeds transparent monitoring and reporting, so we can assess if activity under the agreement is translating to better outcomes for people.
Activity under the agreement should be underpinned by a nationally agreed service model which includes effective planning tools, such as the National Mental Health Services Planning Framework. This would support parties to the agreement to effectively plan, coordinate, and resource mental health services to meet population demands across jurisdictions and sectors.
Clear lines of responsibility and effective governance matters
We’re pleased to see the Productivity Commission’s recommendation to clarify responsibility, funding and planning for psychosocial supports as part of the next National Agreement.
A future National Agreement should outline how its governance arrangements will interact with other significant national, cross-jurisdictional reform in relevant areas of social policy to ensure alignment where needed.
We welcome the Productivity Commission’s recommendation for future arrangements to explicitly consider the needs of Aboriginal and Torres Strait Islander people, ensure focused effort towards suicide prevention, and effectively integrate services for people experiencing co-occurring problematic use of alcohol and other drugs and mental ill health and/or suicidal distress (Mental Health and Suicide Prevention Agreement Review Inquiry report overview, p. 2).
Partnership with people with lived and living experience
We welcome the call for the current Agreement to be extended until June 2027 to allow sufficient time to co-design changes with people with lived and living experience who hold uniquely valuable knowledge of what’s needed to improve outcomes.
We want to see a new policy architecture that enables the purposeful and effective participation of people with lived experience and for lived expertise to be embedded in governance and decision-making. We recognise that lived experience of suicide and mental health consumer and carer perspectives are distinct and require equitable representation.
The role of the Commission
The National Mental Health Commission holds a crucial role in ensuring accountability in the way the mental health system supports all Australians.
We welcome the Productivity Commission’s call for the National Mental Health Commission’s role to be formalised as an independent entity. More than ever, we are keen to see our Independence formalised, and for us to have a clear and defined role in the governance of the National Agreement.
We want to see a mental health system that meets the needs of all Australians. A system that prioritises prevention, and delivers care that is effective, equitable, accessible and easy to navigate. The National Agreement is an important way to ensure governments are working together towards the same aims and that the system works together for the people it serves.
David McGrath is the Chief Executive Officer of the National Mental Health Commission.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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