Department of Human Services

RESEARCH IN THE CONTEXT OF MENTAL HEALTH RESEARCH IN THE CONTEXT OF MENTAL HEALTH SERVICE PROVISION – THE CHALLENGESSERVICE PROVISION – THE CHALLENGES

Victorian Transcultural Mental Health Research Conference 2005Dr Ruth Vine

THE COMPETING PRIORITIESTHE COMPETING PRIORITIES

• Steady increase in demand for services• Sustained media interest and criticism• Complicated funding and responsibilities

– commonwealth primary care and specialist, state public health and non-government organisations

• Pressure in other areas such as prisons, child protection, juvenile justice

A LITTLE BIT OF HISTORYA LITTLE BIT OF HISTORY

• NMH Policy and first NMHP 1992• Second NMHP broadened the focus• Current plan 2003 –2008 stated

intention to continue the work of the first plan in re-orienting MH services, as well as progressing a more inclusive and whole of government approach

• Victoria ahead of the pack in many ways

Changes in per capita spending mix - Victoria

$-

$10.00

$20.00

$30.00

$40.00

$50.00

$ p

er

cap

ita

1992-93

1997-98

2001-02

1992-93 $46.85 $11.41 $19.09 $5.50 $2.52

1997-98 $11.86 $21.09 $32.48 $13.60 $8.43

2001-02 $5.93 $30.48 $38.62 $17.26 $9.42

Stand alone Colocated Ambulatory Residential NGO

WHY RESEARCH?WHY RESEARCH?

• What is the problem? – prevalence, diagnosis, service access

• What is the cause of the problem? – personal history, environment, social support

• What can be done? – service configuration, service range, workforce attributes, specific treatments, specialist services

WHAT DO WE ALREADY DO? WHAT DO WE ALREADY DO?

• Research not primary responsibility of MHB• Commonwealth responsibility - NHMRC• Specific research funding by MHB:

- beyondblue/Centre for Excellence in Depression and Related Disorders- MHRI

• Other – mix of funding streams- Neuropsychiatry centre- Orygen Youth Health- range of research oriented units – CPNRP, Alfred, Centre for Rural Mental Health etc

WHAT DO WE ALREADY DO IN WHAT DO WE ALREADY DO IN TRANSCULTURAL MENTAL HEALTH?TRANSCULTURAL MENTAL HEALTH?

• Funding to transcultural/ethnic areas- VTPU- ADEC- VFSTT- Ethnic Mental Health Consultants

• Must recognise the importance of sensitivity to and awareness of transcultural issues in mainstreamed services – use of interpreters etc.

WHAT DO WE KNOW?WHAT DO WE KNOW?

• Population stats, incl. specific communities• Cultural backgrounds of people using MHS• Some knowledge of mental illness prevalence

in ethnic groups• Feedback about access & treatment barriers• Knowledge in some areas about what works,

what is helpful, who should be involved

WHAT SHOULD WE DO?WHAT SHOULD WE DO?

• Be clear about the research role of MHS: should lead to better services for consumers and carers

• Direct attention to how best to use existing funds, as well as seeking more funding

• Disseminate research/share info/coordinate research efforts

• Implement research evidence & evaluate

SO WHAT PLACE RESEARCH?SO WHAT PLACE RESEARCH?

• Needs to be a mix of exploring new areas for service and evaluating those already in place

• Must be consistent with overall directions – community support, integration with other areas in health and community, workforce development; and recognise emerging areas such as specific communities – eg detention centres, ethnic specific growth areas

• Funding should be from a range of Government, corporate and philanthropic sources, linked to other research efforts

CONCLUSIONCONCLUSION

• Research important, has to remain relevant, and able to be acted upon

• VTPU operational for 9 years• Greater effort on putting services in place and

addressing workforce needs• Issues will change with new waves of

immigration – Middle East, Africa etc• Need to address both metro and rural areas