Living Well Survey · An independent analysis of the survey responses was undertaken by the...

November 2019

Living Well mid-term review survey

analysis

Living Well: Mid-term review survey analysis 1

Contents

1 Introduction ................................................................................................................... 3

Overview of methodology ................................................................................................ 3

Survey participants .......................................................................................................... 4

2 All respondents: Key Findings ..................................................................................... 7

3 All respondents: Key findings by question ................................................................. 8

Overview ......................................................................................................................... 8

Key findings by question .................................................................................................. 9

Question 7: What is working well in mental health reform in your community?........... 9

Question 8: What challenges hinder mental health reform in your region? ............... 11

Question 9: What are your priorities for mental health reform over the next five

years? ............................................................................................................ 13

Question 10: What would you like the updated Living Well strategy to achieve? ...... 15

Question 11: What do you need to live well? ........................................................... 17

4 Key findings by respondent group............................................................................. 19

Overview and comparison ............................................................................................. 19

Key findings by respondent group ................................................................................. 21

People with lived experience of a mental health issue .................................................. 21

Respondents ........................................................................................................... 21

Question 7: What is working well in mental health reform in your community?......... 21



years? ............................................................................................................ 24



Carers ........................................................................................................................... 29

Respondents ........................................................................................................... 29




years? ............................................................................................................ 32



Frontline Workforce ....................................................................................................... 37

Respondents ........................................................................................................... 37

2 Living Well: Mid-term review survey analysis




years? ............................................................................................................ 40



Workforce–Management/Policy/Research ..................................................................... 44

Respondents ........................................................................................................... 44




years? ............................................................................................................ 46



Consumer and Carer Peer Workforce............................................................................ 51

Respondents ........................................................................................................... 51




years? ............................................................................................................ 53



Aboriginal and/or Torres Strait Islander people .............................................................. 58

Respondents ........................................................................................................... 58




years? ............................................................................................................ 61



References .......................................................................................................................... 66

Appendix A: Survey ........................................................................................................... 67


1 Introduction

Living Well: A Strategic Plan for Mental Health in NSW 2014 – 2024 (NSW Mental Health

Commission 2014) set a 10-year vision for reform of the mental health system in NSW. The

Mental Health Commission of NSW (the Commission) is conducting a mid-term review of the

Living Well strategy to assess the progress made thus far and determine the key priorities for

the next five years.

As part of the review, the Commission carried out an online survey about mental health

reform. Survey participants included people with lived experience of a mental health issue

and caring, families, kinship groups and community members, as well as mental health

practitioners/clinicians, consumer peer workers, carer peer workers, support workers,

academics and those in management positions.

An independent analysis of the survey responses was undertaken by the Australian Institute

of Health and Welfare (AIHW) and the results are summarised in this report.

Overview of methodology The Living Well mid-term review online survey contained 12 questions (Appendix A).

Questions 1–6 collected selected participant demographic information, questions 7–11

collected open-ended responses about mental health reform, and question 12 collected

optional further information.

A two-step process was utilised for this qualitative data analysis project. Open-ended survey

responses were manually coded into key themes, and to complement this process the text

was also analysed using Wordstat 8.0.

Wordstat is text analysis software designed to study responses to open-ended questions,

interview transcripts, journal articles and other textual information (Provalis Research 2015).

It can be used for content analysis and text mining, and when combined with manual coding,

Wordstat can assist with the systematic application or review of coding as well as the

detection of differences between subgroups. Wordstat was used to refine the key themes

and subthemes for each question as well as to prepare word clouds.

Qualitative analysis was undertaken for each open-ended question on mental health reform

(questions 7–11). To identify any differences between selected respondent groups,

the qualitative process was repeated for each question across six groups:

• People with lived experience of a mental health issue

• Carers

• frontline workforce (clinicians, support workers, etc.)

• workforce – management / policy / research

• consumer and carer peer workforce

• Aboriginal and Torres Strait Islander people.


Survey participants

The Commission received 1,165 responses to the Living Well mid-term review community

survey of mental health reform. People responding to the survey, could identify themselves

as one or more of the following groups. Of these:

• 55.5% (646) reported having lived experience of a mental health issue (Consumer)

• 40.4% (471) reported caring for a person with lived experience of a mental health issue

(Carer)

• 34.4% (401) reported being a member of the frontline mental health workforce

• 14.2% (166) reported being a member of the management / policy / research workforce

• 5.3% (62) reported being a consumer peer worker

• 1.2% (14) reported being a carer peer worker

• 7.0% (81) identified as Aboriginal and/or Torres Strait Islander (Figure 1).

Table 1 displays the number of responses for each category in question 1. These categories

were used to form the consumer, carer and workforce subgroups explored in section four of

this report. The Aboriginal and/or Torres Strait Islander people group was identified through

responses to question 2. As more than one category could be selected by a single

respondent for question 1, subgroup totals represent the number of respondents in each

subgroup following the removal of duplicates.

Table 1. Q1: ‘Which of the following statements describes you? (please select all that apply)’

Response categories Responses to Q. 1 Respondent subgroup for analysis

Number Per cent

people with lived experience of a mental health issue

646 55.5 Consumers

Carer of a person with lived experience of a mental health issue

321 27.6 Carers

Family or kinship group member who cares for someone with lived experience of a mental health issue

246 21.1 Carers

Mental health practitioner/clinician in public/government service

206 17.7 Frontline Workforce

Mental health practitioner/clinician in a community managed organisation

79 6.8 Frontline Workforce

Health practitioner/clinician 101 8.7 Frontline Workforce

Consumer peer worker 62 5.3 Consumer Peer Workforce

Carer peer worker 14 1.2 Carer Peer Workforce

Support worker 77 6.6 Frontline Workforce

Board member, senior manager, executive 69 5.9 Workforce – Management /

Policy / Research

Policy/project manager/officer 69 5.9 Workforce – Management /

Policy / Research

Researcher/academic 48 4.1 Workforce – Management /

Policy / Research


Member of the public/community 209 17.9 Not applicable

Other (please specify) 117 10.0 Not applicable

Total 1,165 -

Note: More than one category may be selected by a single respondent, therefore totals exceed 1165 (100%).

Figure 1. Responses to Q2: ‘Do you identify as any of the following? (please select all that apply)’

Of the 1,140 participants who reported their age, more than half were aged either 45–54

(31.7%) or 55–64 (26.1%), and just 2.5% were under 25 (Figure 2).


Figure 2. Responses to Q3: ‘What age group are you?’

Most survey participants lived in metropolitan areas (46.7%), followed by regional (33.8%)

and rural (17.7%) areas (Figure 3).

Figure 3. Responses to Q4: ‘Which of the following best describes where you live?’


2 All respondents: Key Findings

When all open-ended survey responses were considered, the most commonly discussed

themes included:

• The quality and suitability of available mental health services and community support

• The size, skill and sustainability of the mental health workforce and peer workforce

• Mental health service accessibility, affordability and locality

• Shortages and misallocation of funding and resources

• Mental health awareness, education and knowledge of services.

The word cloud below displays key words from the responses to open-ended questions 7–

11. Word clouds were produced in Wordstat following an exclusion process to remove

conjunctions, pronouns etc. and a categorisation process to help identify key concepts — for

example youth included children, adolescents, young people and youth as a single concept.

Note that the size of each key word represents the number of times it was mentioned by

respondents.

Figure 4. Word cloud of open-ended responses (questions 7–11)

Source: WordStat 8.0

Note: The word cloud is based on keywords, and the size of each word is indicative of the number of times it is mentioned.

Many themes overlapped and differed between questions or subgroups. The following

section (section three) contains a more detailed breakdown of key themes and subthemes

for each open-ended question. Section four contains a breakdown of themes by question for

consumer, carer, frontline workforce, workforce management/policy/research, consumer and

carer peer workforce and Aboriginal and/or Torres Strait Islander people.


3 All respondents: Key findings by question

The most common response themes for each question are below, followed by a more

detailed breakdown of the key themes and subthemes for each question.

Overview Question 7: What is working well in mental health reform in your community?

• Mental health services, programs and community support

• Mental health awareness and education in the community

• Access to mental health services and availability of mental health services

• Mental health staff, training, and growth of the peer workforce

• Nothing is working well.

Question 8: What challenges hinder mental health reform in your region?

• Lack of mental health services and appropriate support options

• Lack of trained and qualified workers in the mental health workforce

• Lack of funding and resources for mental health services and staff

• Lack of available and accessible mental health care

• Lack of local / rural / regional resources and service options

• Lack of affordable options for mental health care.

Question 9: What are your priorities for mental health reform over the next five years?

• More services and improved service delivery

• Mental health workforce development including recruitment, training and staff support

• Easy and timely access to services

• Long term funding directed to where it’s needed most

• Mental health education and awareness in the community as well as among health

professionals and first responders.

Question 10: What would you like the updated Living Well strategy to achieve?


• Easy and timely access to services that are affordable

• Increased recruitment, training and staff support in the mental health workforce

• Increased funding for services and staffing

• Mental health awareness and education in the community.

Question 11: What do you need to live well?

• Support and services that are available when needed

• Stable employment and income

• Support from family and friends

• Social and community participation

• Healthy lifestyle – balance, diet, exercise

• Good physical and mental wellbeing.


Key findings by question The tables in sections three and four display key themes as well as subthemes. Subthemes

represent the main topics covered by each key theme. Where a subtheme is represented by

a direct quote, this is shown in quotation marks. Key themes are presented in frequency

order, however it is important to note that this order is indicative only, and many themes

overlapped or had little or no difference in usage. As such, comparisons should be made with

caution.

Question 7: What is working well in mental health reform in your community?

Responses

Participants were asked to provide three examples that they have identified in the last five

years. There were 973 responses for example one, 753 responses for example two and 566

responses for example three.

Key themes

The following key themes were distilled from the responses to question 7:





• Nothing is working well

• Engagement of consumers and carers with lived experience of mental illness in service

delivery and co-design processes

• Specialised services and prevention programs for youth

• Access to services and funding through the NDIS.

Table 2 displays key themes and examples of the subthemes covered by each key theme.

Table 2. All respondents: ‘What is working well in mental health reform in your community?’

Key Themes Subthemes

Services and support Specific programs, supports and services Community services and support More services are available (including services for carers and family) Targeted services (e.g. for CALD populations or for a specific diagnosis) Service types (e.g. online or over the phone) Improved service delivery Collaboration between services

Awareness and education

Awareness and understanding of mental health in the community Mental health education programs (e.g. in schools) Awareness of mental health services More open discussion of mental health

Access Ease of access to services and information Increased service availability


Free / affordable / subsidised services Referral pathways

Workforce Growing peer workforce Staff training and education Good mental health staff / teams Aboriginal and/or Torres Strait Islander workers

Nothing “Nothing is working well” “None, a lot of talk but very little action”

Lived experience engagement and co-design

Increased consumer / carer / family input and involvement Co-design Person centred care Lived experience voices are being heard

Youth Specialised child and adolescent mental health services Mental health support in schools Focus on youth prevention and early intervention

NDIS NDIS funding Access to services through the NDIS NDIS including people with psychosocial disability

While the above themes were the most prominent, other themes for this question included

recovery oriented and trauma informed care, diversity, suicide prevention initiatives, reduced

stigma, increased funding, holistic approaches to care and least restrictive practices.

Figure 5. Word cloud All respondents: What is working well in mental health reform in your community?





Responses

Participants were asked to provide three examples that they had identified in the last five

years. There were 1,107 responses for example one, 1,032 responses for example two and

902 responses for example three.

Key themes


• A lack of

o mental health services and appropriate support options

o trained / qualified workers in the mental health workforce, and not enough

support for staff

o funding and resources for mental health services and staff

o available and accessible mental health care

o local / rural / regional resources and service options

o affordable options for mental health care

o mental health education and awareness in the community as well as among

health professionals

• Persistence of mental health stigma.


Table 3. All respondents: ‘What challenges hinder mental health reform in your region?’


Services and support Not enough service providers Lack of community services and resources Poor service quality and delivery Lack of services that are appropriate / suitable Service fragmentation and gaps

Workforce Not enough staff Lack of training for workers Limited support and resources for staff Recruitment and retention of qualified and experienced staff Negative culture and attitudes

Funding and resources

Lack of funding for services and staffing Insufficient resources to meet demand Misdirected resources Short term funding cycles

Access Limited service availability Difficulty accessing services Wait times and long waitlists

Local services and support

Not enough local options Long distances and travel time to reach services Lack of services, support and qualified staff in rural and regional areas


Affordability High cost of treatment Lack of free / affordable options Limited Medicare benefits

Education and awareness

Lack of mental health knowledge and understanding in the community Lack of mental health education / training among health professionals Limited awareness of available services

Mental Health stigma

Ongoing stigma in the community, workplace and health sector

Other themes for this question included NDIS shortcomings, lack of service collaboration and

communication, limited care options for young people, issues with drugs and/or alcohol,

housing and homelessness, the medical model, as well as the importance of prevention,

follow up and culturally safe services.

Figure 6. Word cloud All respondents: What challenges hinder mental health reform in your region?





Responses

Participants were asked to provide three priorities. There were 1,070 responses for example

one, 997 responses for example two and 871 responses for example three.

Key themes







professionals and first responders


• Affordable options for mental health care

• Local services and support options

• Appropriate care that suits the needs of consumers

• Increased focus on prevention and early intervention.


Table 4. All respondents: ‘What are your priorities for mental health reform over the next five years?’


Services and support

Improving service quality More services and options for care Enhancing community services and support Service communication and collaboration

Workforce More mental health workers and qualified professionals Better training for staff Growth and development of the peer workforce Support for staff and retention of experienced staff

Access Easier access and clearer pathways to access services and specialists Timely access Equitable access


Increased funding and resources for services and the mental health workforce Long-term funding and planning Appropriate funding allocation


Greater mental health education and awareness in the community and among health professionals, first responders and emergency staff More accessible information about mental health and available services

Youth School programs and support Specialised services for children and adolescents Focus on prevention


Affordable care More free / affordable mental health care options Increased access to psychologists through Medicare


Increased local, regional and rural service availability Increased services and qualified staff in rural and regional areas

Appropriate care Improved ability of services to respond to the individual needs of consumers and provide the appropriate level of support (e.g. moderate or crisis care) A holistic approach to health (including physical and social wellbeing) Provision of specialised services Trauma informed and recovery oriented care

Prevention Increased focus on prevention and early intervention Encourage help seeking behaviour Suicide prevention Easier access to services before a mental health crisis occurs

Other topics for this question included targeted support for diverse populations, housing or

accommodation support, long term support, mental health stigma, improving the current

systems and models of care, NDIS accessibility, recognition of lived experience, improved

wellbeing outcomes and increased engagement and involvement with the community.

Figure 7. Word cloud All respondents: What are your priorities for mental health reform over the next five years?





Responses

There were 962 responses to question 10.

Key themes





• Increased funding for services and staffing


• Regional and local support


• Increased focus on prevention and early intervention

• Better outcomes and wellbeing for consumers, carers and families

• Real action and change for the mental health sector and for those with lived experience

of mental illness.


Table 5. All respondents: ‘What would you like the updated Living Well strategy to achieve?’



More services and options for support Improved quality of service delivery Greater community mental health resources, services and reach of services Collaboration / integration of services and closure of service gaps

Access Improved access to services and mental health professionals Service affordability Easy referral pathways Service availability

Workforce Staff recruitment and training Staff support and retention Growth of the peer workforce


Increased funding and resources for services and staffing Targeted funding allocation


Greater community mental health awareness and education


More services, mental health workers and specialists in local, regional and rural areas Greater resources and support for regional and rural communities

Appropriate care Mental health support appropriate for different levels of need Holistic approach to health (including physical, social and cultural wellbeing) Provision of specialised services and long term treatment options

Prevention Investment in prevention strategies


Focus on early identification and intervention Easier access to services before a mental health crisis occurs

Outcomes and wellbeing

Improved wellbeing and outcomes for consumers, families and communities Suicide prevention

Real change To achieve real change and meaningful system reform

Other themes for this question included healthy communities, support for young people,

approaches to care, mental health stigma, NDIS access, diversity, research and evidence-

based practice.

Figure 8. Word cloud All respondents: What would you like the updated Living Well strategy to achieve?





Responses

There were 1,016 responses to question 11.

Key themes







• Good physical and mental wellbeing

• Safe and secure housing / accommodation

• Love, understanding and acceptance

• To undertake meaningful activities and have a sense of purpose.


Table 6. All respondents: ‘What do you need to live well?’


Support and services

Quality holistic support (e.g. physical, mental, social) and support networks Easy access to appropriate services and resources when they are needed Community support and services

Employment and income

A secure job / stable paid employment A flexible and supportive work environment Income to cover medical costs and basic needs Financial security and less financial stress Free / affordable access to services

Family and friends

Support from family and friends Strong connections and relationships with family and friends

Social and community participation

Social connections and interactions / activities Community connections and a strong sense of community Participation and involvement in the community

Healthy lifestyle Healthy lifestyle Regular exercise Healthy diet / good food / nutrition Good work-life balance

Good health and wellbeing

Good physical and mental health Holistic wellbeing (spiritual, social, emotional, mental and physical) Less stress

Housing / accommodation

Safe and stable long term housing / accommodation Affordable housing

Love, understanding and acceptance

“Love & support” “Understanding and acceptance” “Respect compassion understanding acceptance”


Purpose and meaning

A sense of purpose in life Meaningful work / activity

Other topics raised in response to this question included the need to feel safe, access to

information resources, more trained staff, ongoing support, medication, education and more

options and opportunities.

Figure 9. Word cloud All respondents: What do you need to live well?




4 Key findings by respondent group

This section contains a breakdown of key themes within the following respondent subgroups:

• person with lived experience of a mental health issue

• carers

• frontline workforce

• workforce – management / policy / research

• consumer and carer peer workforce

• Aboriginal and/or Torres Strait Islander people.

Overview and comparison Question 7: What is working well in mental health reform in your community?

The most frequently discussed themes for question 7 overall were mental health services

and support, mental health awareness, access to services, the workforce and nothing.

All subgroups discussed specific services or programs, mental health awareness, service

accessibility and workforce improvements including growth of the peer workforce as working

well. Compared with other subgroups, consumers and carers more frequently reported that

nothing is working well, followed by the management / policy / research workforce subgroup.

Lived experience involvement was among the most frequently discussed themes for the

consumer and carer peer workforce subgroup and the frontline workforce subgroup, followed

by the carer subgroup.

Higher priority themes for Aboriginal and/or Torres Strait Islander people compared to all

respondents included that nothing was working well and community engagement and

collaboration.


Overall, the challenges most frequently noted for question 8 were the lack of mental health

services and support, lack of staff and training in the mental health workforce, lack of

funding, lack of access to services, and lack of local service options.

Across all subgroups, the most frequently mentioned challenges included mental health

services and support, the workforce, access to services and lack of funding, however the

consumer and carer peer workforce subgroup mentioned stigma and discrimination more

frequently than access to services. While all subgroups highlighted financial barriers and

affordability as a key challenge, this theme was mentioned more frequently by the consumer

and carer subgroups compared with workforce groups — the frontline workforce subgroup for

example noted service locality and access for rural and regional areas more frequently than

affordability. The lack of collaboration between services was noted more frequently by the

workforce subgroups compared with consumer and carer subgroups.

Higher priority themes for Aboriginal and/or Torres Strait Islander people included alcohol

and drug use risk factors and the shortage of related treatment services.



The most frequently noted themes for question 9 overall were mental health services and

support, the mental health workforce, access to services, funding and mental health

education and awareness.

Consumers, carers and the frontline workforce most frequently noted services and support,

the workforce and access to services as priorities for mental health reform, followed by

mental health awareness and funding. While these themes were also noted as priorities for

the management / policy / research workforce subgroup and consumer and carer peer

workforce subgroup, mental health education and awareness was mentioned less frequently.

For the management / policy / research workforce subgroup, diversity and prevention / early

intervention were among the most frequently discussed themes. For the consumer and carer

peer workforce subgroup, peer workers and lived experience voices were among the most

frequently discussed themes.

Higher priority themes for Aboriginal and/or Torres Strait Islander people included culturally

appropriate mental health services, specialised services and prevention programs for

children and adolescents, with a somewhat higher priority given to easy and timely access to

services than all respondents.


The most frequently noted themes for question 10 overall were services and support, access

to services, the workforce, funding and mental health awareness and education.

The most frequently mentioned themes for consumer and carer subgroups reflect the overall

findings. The mental health workforce subgroups discussed mental health awareness and

education less frequently compared to consumers and carers, and better outcomes /

wellbeing was among the most frequently discussed themes for the frontline workforce.

Unsurprisingly, the frontline workforce placed greater emphasis on the mental health

workforce compared with other subgroups, and the consumer and carer peer workforce

placed greater emphasis on peer workers and lived experience compared with other

subgroups.

Higher priority themes for Aboriginal and/or Torres Strait Islander people included a focus on

wellbeing and outcomes, focus on children and youth programs, with a lower priority given to

mental health workforce development than all respondents.


The most frequently noted themes for question 11 overall were suitable support and

services, stable employment and income, family and friends, social and community

participation, a healthy lifestyle, and good health and wellbeing.

These needs were a priority for all the subgroups. The need for support and easy access to

services, and the need for stable employment and income were the most frequently

mentioned themes for all subgroups. Health (both lifestyle and wellbeing) and social

connections (including social connectedness, family and friends) were prioritised by all

subgroups, however the consumer subgroup was the only group which discussed health

themes more frequently than social themes. The frontline workforce subgroup discussed the

need to feel safe more than the other subgroups.

Higher priority themes for Aboriginal and/or Torres Strait Islander people included funding

and resources for culturally safe services and youth programs, awareness and education of

the community and workforce issues, including targets for Aboriginal and/or Torres Strait

Islander mental health workers employment.


Key findings by respondent group Note that while key themes are presented by frequency of usage, many themes overlapped

or had little difference in usage, and for smaller subgroups themes were not as clear or

consistent. As such, comparisons should be made with caution.

People with lived experience of a mental health

issue

Respondents

The consumer’s subgroup included the 646 respondents who identified themselves as a

people with lived experience of a mental health issue in question 1.







• Mental health staff, training, and growth of the peer workforce.


Table 7. Consumers: ‘What is working well in mental health reform in your community?’



Specific programs, supports, services (e.g. headspace) and hospitals Community services, support and engagement (including support groups) Greater GP familiarity with and access to mental health plans More services are available (including services for carers and family) Targeted services (e.g. for CALD populations or for a specific diagnosis) Service types (e.g. online or over the phone) Improved service delivery


Awareness and understanding of mental health in the community GPs seem more aware of mental health issues Greater awareness of mental health in the workplace Awareness of mental health services More open discussion of mental health Reduced stigma Greater awareness and openness in school and universities

Access Ease of access to mental health services and information (including counselling and psychology services) Increased service availability Free / affordable / subsidised services Referral pathways NDIS (and other funding) has improved access to services and support



Workforce Growing peer workforce Staff training and education Good, caring mental health staff / teams Aboriginal and/or Torres Strait Islander workers

Figure 10. Word cloud Consumers: What is working well in mental health reform in your

community?





• Lack of appropriate mental health services and support options

• Lack of mental health practitioners (e.g. psychologists, psychiatrists, counsellors), and

not enough support for staff

• Lack of available and accessible mental health care, including availability of local options


• Lack of affordable options for mental health care

• Lack of community support

• Persistence of mental health stigma

• Lack of mental health education and awareness in the community as well as among

health professionals and first responders.



Table 8. Consumers: ‘What challenges hinder mental health reform in your region?’


Services and support Not enough service providers Lack of community services and resources Poor service quality and delivery Lack of services that are appropriate / suitable Service fragmentation and gaps

Workforce Not enough staff and/or long wait lists (practitioners e.g. psychologists, psychiatrists, counsellors) Lack of training for workers Limited support and resources for staff Recruitment and retention of qualified / experienced staff Negative culture and attitudes

Access Limited service availability Difficulty accessing services Wait times and long waitlists


Lack of funding for services and staffing Insufficient resources to meet demand Misdirected resources Short term funding cycles


Local service options Not enough local options Long distances / travel time to reach services Lack of services, support and qualified staff in rural and regional areas


Ongoing stigma in the community, workplace and health sector


Lack of mental health knowledge and understanding in the community Lack of mental health education / training among health professionals Limited awareness of available services


Figure 11. Word cloud Consumers: What challenges hinder mental health reform in your region?






• Mental health workforce development including more trained professionals, recruitment,

training and staff support

• Easy and timely access to services, including in rural and remote areas





• Specialised services for children and adolescents, and prevention programs



• Mental health care / awareness programs targeting diverse populations.


Table 9. Consumers: ‘What are your priorities for mental health reform over the next five years?’



Improving service quality More services and choice Greater support for community services Targeted / specialised services Service collaboration


Workforce More mental health workers and qualified, trained professionals Better training for staff Growth and development of the peer workforce Support for staff

Access Easier access to services and professionals including rural and remote areas Equitable access Increased service availability Greater awareness of services and information resources


Greater mental health education and awareness in the community and health sector Breaking down stigma

Funding Increased funding for services and the mental health workforce Long-term funding and planning Appropriate funding allocation

Affordable care Remove financial barriers to service access

Youth Programs in schools Specialised services for children and adolescents Focus on prevention

Appropriate Services that are targeted Holistic approach to health Flexible

Prevention Increased focus on prevention and early intervention Suicide prevention Access to services before crisis

Diversity Suitable services for Aboriginal and/or Torres Strait Islander people, CALD populations and LGBTQI Targeted awareness campaigns

Figure 12. Word cloud Consumers: What are your priorities for mental health reform over the next

five years?









• Mental health awareness and education in the community as well as among health






• Better outcomes and wellbeing for consumers, carers and families.


Table 10. Consumers: ‘What would you like the updated Living Well strategy to achieve?’



More services and options for support Improved quality of service delivery Greater community mental health resources, services and reach Collaboration / integration of services and closure of service gaps

Access Improved access to services and mental health professionals, including in regional and remote areas Service affordability Easy referral pathways Service availability


Increased funding and resources for services and staffing Long term funding Targeted funding for successful services and programs


Greater community mental health awareness and education Improving acceptance and reducing stigma

Workforce Staff recruitment and training Staff support and retention Growth of the peer workforce



Appropriate care Mental health support appropriate for different levels of need Holistic approach to health (including physical, social and cultural wellbeing) Provision of specialised services

Prevention Investment in prevention strategies Focus on early identification and intervention Easier access to services before a mental health crisis occurs



Improved wellbeing and outcomes for consumers, families and communities Reduction in suicide rates

Figure 13. Word cloud Consumers: What would you like the updated Living Well strategy to

achieve?















Table 11. Consumers: ‘What do you need to live well?’



Quality holistic support (physical, mental, social) and support networks Easy access to appropriate services and resources when they are needed


Community support and services


A secure job / stable paid employment A flexible and supportive work environment Income to cover medical costs and basic needs Financial security and less financial stress Free / affordable access to services


Family and friends



Good physical and mental health Holistic wellbeing (spiritual, social, emotional, mental and physical) Less stress






“Love & support” “Understanding and acceptance” “Respect compassion understanding acceptance”

Purpose and meaning

A sense of purpose and meaning in life Meaningful work / activity

Figure 14. Word cloud Consumers: What do you need to live well?




Carers

Respondents

The carer’s subgroup included the 471 respondents who identified themselves in question 1

as:

• a carer of a people with lived experience of a mental health issue

• a family or kinship group member who cares for someone with lived experience of a

mental health issue.











Table 12. Carers: ‘What is working well in mental health reform in your community?’



Specific programs, supports and services (including for carers) Community services and support (e.g. respite) More services are available (including services for carers and family) Variety of service types (e.g. online or over the phone) Improved service delivery including in hospitals More support for and collaboration with families and carers Improved support and understanding from GPs (including mental health care plans)


Awareness and understanding of mental health in the community Mental health education programs (e.g. in schools and universities) Awareness of mental health services More open discussion of mental health

Access Ease of access to services and information Increased service availability and access/availability of mental health professionals Free / affordable / subsidised services Referral pathways

Workforce Growing peer workforce Staff training and education Good mental health staff / teams Aboriginal and/or Torres Strait Islander workers



Youth Specialised child and adolescent mental health services Mental health support in schools Focus on youth prevention and early intervention

NDIS NDIS funding Access to services through the NDIS NDIS including people with psychosocial disability

Figure 15. Word cloud Carers: What is working well in mental health reform in your community?





• A lack of

o appropriate mental health services and support options

o trained / qualified workers in the mental health workforce, and not enough

support for staff

o available and accessible mental health care

o funding and resources for mental health services and staff

o affordable options for mental health care

o local / rural / regional resources and service options.


Table 13. Carers: ‘What challenges hinder mental health reform in your region?’


Services and support Not enough service providers


Lack of community services and resources Lack of enough in-hospital care Poor service quality and delivery Lack of services that are appropriate / suitable Service fragmentation and gaps

Workforce Not enough clinicians/professional practitioners Lack of experienced, skilled professionals Limited support and resources for staff Clinician caseloads too high and wait lists too long

Access Limited service availability Difficulty accessing services Wait times and long waitlists Lack of professionals and other mental health services in regional areas (particularly psychiatrists)


Lack of funding for services and staffing Insufficient resources to meet demand Misdirected resources, lack of ‘coal face’ funding. Short term funding cycles



Not enough local options Long distances / travel time to reach services Lack of services, support and qualified professionals in rural and regional areas

Figure 16. Word cloud Carers: What challenges hinder mental health reform in your region?

















Table 14. Carers: ‘What are your priorities for mental health reform over the next five years?’



Improving service quality More services and options for care Enhancing community services and support for families and carers and consumers Service communication and collaboration Affordable housing

Workforce More mental health workers and qualified mental health professionals Better mental health training for other staff including GPs, ED staff, allied health professions; more empathy from staff Growth and development of the peer workforce Support for staff and retention of experienced staff

Access Increased local, regional and rural service availability Easier access and clearer pathways to access services and specialists Timely access Equitable access


Increased funding and resources for services and the mental health workforce More subsidised visits with psychologists and psychiatrists Funding for prevention Long-term funding and planning Appropriate funding allocation (e.g. away from administration to prevention and early intervention, service delivery and recovery)


Greater mental health education and awareness in the community and among health professionals, first responders and emergency staff More accessible information about mental health and available services

Youth School programs and support Specialised services for children and adolescents Focus on prevention More support for children of parents with mental illness


Affordable care More free / subsidised / affordable mental health care options Increased access to treatment through Medicare

Appropriate care Improved ability of services to respond to the individual needs of consumers and provide the appropriate level of support (e.g. holistic services, crisis care) A holistic approach to health (including physical and social wellbeing) Culturally appropriate services Provision of specialised services Trauma informed and recovery oriented care

Prevention Increased focus on prevention and early intervention Encourage help seeking behaviour Suicide prevention Easier access to services before a mental health crisis occurs

Figure 17. Word cloud Carers: What are your priorities for mental health reform over the next five

years?







• Increased and targeted funding for services and staffing





• Better outcomes and wellbeing for consumers, carers and families




Table 15. Carers: ‘What would you like the updated Living Well strategy to achieve?’



More services and options for support Improved quality of service delivery Greater community mental health resources and other holistic support (e.g. housing assistance), services and reach Collaboration / integration of services and closure of service gaps

Access Improved and easier access to services and mental health professionals More affordable and free access to mental health services Easy referral pathways Local service availability, including in rural and remote areas


Increased funding and resources for ‘front line’ services and staffing More subsidised treatment available Targeted funding for successful services / programs

Workforce Staff recruitment and training Staff support and retention Increased rural and remote workforce


Greater community mental health awareness and education Education and awareness programs to reduce stigma Education targeting all ages

Appropriate care Mental health support appropriate for different levels of need Holistic approach to health (including physical, social and cultural wellbeing) Provision of specialised services and long term treatment options




Improved wellbeing and outcomes for consumers, families and communities Reduction in suicide rates

Prevention Investment in prevention strategies Focus on early identification and intervention Easier access to services before a mental health crisis occurs Suicide prevention programmes


Figure 18. Word cloud Carers: What would you like the updated Living Well strategy to achieve?















Table 16. Carers: ‘What do you need to live well?’



Quality holistic support (physical, mental, social) and support networks Easy access to appropriate services and resources when they are needed Community support and services


A secure job / stable paid employment A flexible and supportive work environment Meaningful / fulfilling work Income to cover medical costs and basic needs Financial security and less financial stress Free / affordable access to services


Family and friends

Support from family and friends Strong connections / relationships with family and friends







Good / improved physical and mental health Holistic wellbeing (spiritual, social, emotional, mental and physical) Less stress


“Love, understanding and comfort from everyone” “Support and understanding” “Respect compassion understanding acceptance”

Purpose and meaning

A sense of purpose and meaning in life Meaningful work / activity

Figure 19. Word cloud Carers: What do you need to live well?




Frontline Workforce

Respondents

The frontline workforce subgroup included the 401 respondents who identified themselves in

question 1 as:

• a mental health practitioner/clinician in public/government service

• a mental health practitioner/clinician in a community managed organisation

• a health practitioner/clinician

• a support worker.



• Mental health services and support

• Community mental health awareness

• Workforce growth and training

• Access to services and information

• Involvement of people with lived experience of a mental health issue, carers and

families.


Table 17. Frontline workforce: ‘What is working well in mental health reform in your community?’



Increase in the number of local and community services Integration of services Improved service delivery Introduction of specialised / targeted services

Awareness Community education and awareness of mental health issues Increased awareness of available services

Workforce Growing peer and Aboriginal and/or Torres Strait Islander workforce Staff training and educational opportunities Multidisciplinary teams

Access Improved access to services and information Online services and resources

Consumer and carer involvement

Involving people with lived experience of a mental health issue, carers and families in care planning and service design Person centred care


Figure 20. Word cloud Frontline workforce: What is working well in mental health reform in your

community?





• Workforce shortages, stress and difficulty retaining experienced staff

• Lack of appropriate services and support, and a lack of service integration

• Lack of funding directed to where it’s most needed

• Difficulty accessing services and long wait times

• Lack of resources and support in local, rural and regional areas

• Lack of community and professional mental health education and awareness

• Lack of affordable mental health treatment options

• Persistence of mental health stigma in the community and workplace

• Lack of collaboration and communication between services.


Table 18. Frontline workforce: ‘What challenges hinder mental health reform in your region?’


Workforce Mental health workforce shortages Lack of skilled and experienced staff / clinicians Staff recruitment and retention Increased demand and time pressure on workers Lack of support for staff Staff attitudes

Services and support Lack of mental health services and support Lack of community support


Lack of services that are appropriate, specialised and flexible Service limitations, particularly in rural / regional areas


Not enough funding for services and staffing Lack of funding and resources for community and public mental health Ineffective funding allocation and short term funding cycles

Access Difficulty accessing services, particularly specialised services Limited service and staff availability Wait times and long waitlists Referral processes

Local, rural and regional areas

Lack of services, support and qualified staff in rural and regional areas Not enough local services Long distances and transport difficulties


Lack of mental health education and awareness in the community Lack of mental health education / training for workers Limited awareness of available services

Affordability High cost of treatment Lack of free / affordable options for consumers


Ongoing stigma in the community and discrimination in the workplace

Collaboration Lack of collaboration and communication between services Service gaps

Figure 21. Word cloud Frontline workforce: What challenges hinder mental health reform in your

region?






• More services, improved service delivery and service collaboration

• Mental health workforce development and greater staff support to improve retention

• Easy and timely access to services across Australia

• More funding directed to where it’s needed most

• Increased mental health education and training opportunities in the workforce, and

greater awareness in the community




• Safe and specialised mental health care options for diverse populations.


Table 19. Frontline workforce: ‘What are your priorities for mental health reform over the next five

years?’



Improving service quality and capacity More services and options for specialised care Enhancing community services and support Service communication and collaboration

Workforce Increasing staff numbers More skilled / qualified mental health workers Support for staff and retention of experienced staff Growth and development of the peer workforce

Access Easier access and clearer pathways to access services and specialists Timely access Increased local, rural and regional service availability


Increased funding and resources for services and the mental health workforce Targeted funding allocation


Increased training and educational opportunities for staff Increased mental health awareness in the community

Youth Specialised services for children and adolescents Focus on prevention and early intervention for youth

Appropriate care Appropriate support for consumers, at the right level for as long as needed Provision of specialised services Holistic support Trauma informed, person centred and recovery oriented care

Prevention Greater investment and focus on prevention and early intervention Suicide prevention

Diversity Safe and specialised services for Aboriginal and/or Torres Strait Islander people, CALD populations and LGBTQI More Aboriginal and/or Torres Strait Islander mental health workers


Figure 22. Word cloud Frontline workforce: What are your priorities for mental health reform over

the next five years?





• More services, improved service delivery and collaboration

• Mental health workforce development and greater staff support

• Service accessibility and availability

• Increased and targeted funding for services and staffing

• Better outcomes and wellbeing for consumers, families and staff



• Rural, regional and local support

• Mental health awareness and education in the community.


Table 20. Frontline workforce: ‘What would you like the updated Living Well strategy to achieve?’



More services, and improved service delivery and capacity Greater community mental health resources and services Collaboration / integration of services and closure of service gaps

Workforce More staff Improved support and training for staff Support for staff working in rural and regional areas

Access Improved access to services and mental health professionals Service availability



Increased funding and resources for services and staffing Targeted funding allocation


Improved wellbeing and outcomes for consumers, families and communities Focus on holistic wellbeing

Appropriate care Mental health support which is appropriate and responsive to different needs Holistic approach to health and wellbeing Provision of specialised services and long term treatment options

Prevention Greater investment and focus on prevention and early intervention Easier access to services before a mental health crisis occurs

Rural, regional and local areas

More services, mental health workers and specialists in local, regional and rural areas


Greater community mental health awareness and education Awareness of services

Figure 23. Word cloud Frontline workforce: What would you like the updated Living Well strategy

to achieve?





• Support networks and access to services when needed

• Secure employment and income, and good work-life balance

• Social and community engagement


• A healthy lifestyle including regular exercise and good food

• Safe, stable and affordable housing / accommodation


• The need to feel safe




Table 21. Frontline workforce: ‘What do you need to live well?’



Support networks Easy access to appropriate services and support when needed Support in the workplace and from management


Secure employment A flexible, supportive and safe work environment Good work-life balance Financial security Affordable service access

Social and community connectedness

Social connections, relationships and activities Community connections and participation A sense of belonging and acceptance

Family and friends


Healthy lifestyle Regular exercise Healthy diet / good food / nutrition Good work-life balance


Safe and stable housing Affordable housing / accommodation


Good physical and mental / holistic wellbeing Less stress

Safety The need to feel safe Safe workplaces, safe environments and safe housing

Purpose and meaning

A sense of purpose in life Meaningful work / activity

Figure 24. Word cloud Frontline workforce: What do you need to live well?




Workforce–Management/Policy/Research

Respondents

The management / policy / research workforce subgroup included the 166 respondents who

identified themselves in question 1 as:

• a board member, senior manager, executive

• a policy/project manager/officer

• a researcher/academic.



• Mental health services, programs and support

• Mental health awareness in the community


• Peer workforce growth


• Open conversations and discussions about mental health

• Prevention and early intervention.


Table 22. Workforce–Management/Policy/Research: ‘What is working well in mental health

reform in your community?’


Services and support More services and supports are available Specific programs and services Community support and engagement Collaboration and communication between services

Awareness Community awareness of mental health issues Awareness of services

Access Improved access to services and information Increased service availability

Peer workforce Growing peer / lived experience workforce

Nothing “Nothing”

Open conversations More open conversations about mental health in the community

Prevention Focus on prevention and early intervention


Figure 25. Word cloud Workforce–Management/Policy/Research: What is working well in mental

health reform in your community?





• Lack of mental health services and poor delivery

• Not enough trained / qualified workers in the mental health workforce


• Lack of available and accessible services

• Service fragmentation and a lack of service collaboration

• Persistence of mental health stigma

• Lack of affordable options for mental health care

• Lack of local / rural / regional resources and service options.


Table 23. Workforce–Management/Policy/Research: ‘What challenges hinder mental health

reform in your region?’


Services and support Lack of services Poor quality of services and support Lack of services and resources for community mental health Lack of appropriate care and specialised services Lack of consistency of care between services, and some service duplication

Workforce Not enough staff to meet the increased demand Lack of trained / qualified staff Difficulty recruiting and retaining workers



Lack of funding for services and staffing Insufficient resources to meet the needs of consumers Misdirected resources Competition for funding

Access Limited service access and availability Wait times and long waitlists Limited public knowledge of services and difficulty navigating the system

Collaboration Lack of service collaboration and coordination Service fragmentation and gaps


Persistence of mental health stigma Discrimination in the workplace

Affordability High cost of treatment Lack of free / affordable options

Local, rural and regional areas

Lack of services and qualified staff in rural and regional areas Lack of access to local services

Figure 26. Word cloud Workforce–Management/Policy/Research: What challenges hinder mental

health reform in your region?





• More targeted services and improved service delivery

• Mental health workforce growth, training and support

• Increased funding directed to where it’s needed most

• Better access to services, especially in local, rural and regional areas

• Specialised services to support diverse populations and more Aboriginal and/or Torres

Strait Islander workers



• Enhancing the peer workforce

• Targeted support for youth


• Mental health education and awareness in the community.


Table 24. Workforce–Management/Policy/Research: ‘What are your priorities for mental health

reform over the next five years?’



Increasing service quality and capacity More targeted / specialised support options Enhancing community services and support Service communication and collaboration

Workforce Increased training and educational opportunities More mental health workers and qualified professionals Support for staff


Increased funding and resources for services Targeted funding allocation

Access Greater access to mental health and other services (e.g. social services) Increased access to services in local, rural and regional areas

Diversity Specialised services for Aboriginal and/or Torres Strait Islander people, CALD communities and LGBTQI More Aboriginal and/or Torres Strait Islander workers and organisations Mental health education in CALD and Aboriginal and/or Torres Strait Islander communities

Prevention Increased focus on prevention and early intervention Suicide prevention

Peer workforce Enhancing the peer / lived experience workforce

Youth Targeted support for youth

Affordability More free / affordable care options Increased access to treatment through Medicare


Increased community mental health awareness and education


Figure 27. Word cloud Workforce–Management/Policy/Research: What are your priorities for

mental health reform over the next five years?





• Improved quality and delivery of services

• Increased targeted funding for services

• Growth of the peer workforce, staff support and training

• Improved access to services and mental health professionals

• Increased service availability and resources for rural, regional and remote areas.


Table 25. Workforce–Management/Policy/Research: ‘What would you like the updated Living Well

strategy to achieve?’



Improved quality and delivery of services Appropriate and holistic care: “A system providing the right service, at the right time, in the right place, for as long as it is needed” Meaningful reform Improved community based services Community engagement Better outcomes for individuals and communities


Increased funding and resources for services Targeted funding allocation

Workforce More lived experience workers and peer leadership Support and training for workers

Access Improved access to services and mental health professionals


Rural, regional and remote areas

Increased service availability and resources for rural, regional and remote areas

Figure 28. Word cloud Workforce–Management/Policy/Research: What would you like the

updated Living Well strategy to achieve?





• Support networks and easy access to holistic support


• Social and community connections


• Affordable and secure housing

• A healthy lifestyle, including exercise and good work-life balance

• Good physical, mental, social and emotional wellbeing

• Meaningful work and a sense of purpose.


Table 26. Workforce–Management/Policy/Research: ‘What do you need to live well?’



Support networks Holistic support (including social and emotional) Easy and affordable access to support and services when needed Workplace support


Good work culture and work-life balance Adequate income A stable job


Affordable care and living costs


Social connections and relationships Social interactions and activities Community connections and support Meaningful participation and inclusion in the community

Family and friends

Support and connections to family and friends

Housing Affordable housing Secure housing

Healthy lifestyle Exercise and good food Good work-life balance

Wellbeing Good physical, mental, social and emotional wellbeing

Purpose A sense of purpose in life Meaningful / fulfilling work

Figure 29. Word cloud Workforce–Management/Policy/Research: What do you need to live well?




Consumer and Carer Peer Workforce

Respondents

The consumer and carer peer workforce subgroup included:

• 62 respondents who identified themselves as a consumer peer worker in question 1

• 14 respondents who identified themselves as a carer peer worker in question 1.

Initial analysis indicated that clear, consistent themes could not be extracted for the carer

peer workforce subgroup due to its small size. Responses from carer peer workers have

therefore been combined with the responses from consumer peer workers for this analysis.



• Growth of the peer workforce

• Lived experience involvement and co-design

• Consumer centred practice, including recovery oriented and trauma informed care

• Access to mental health services and programs

• Mental health awareness.


Table 27. Consumer and Carer Peer Workforce: ‘What is working well in mental health reform in

your community?’


Peer workforce Increased employment of peer workers Peer leadership

Lived experience involvement

Lived experience / consumer / carer consultation and input Involving people with lived experience in co-design

Consumer centred practice

Focus on recovery oriented, strengths based and trauma informed care Person centred care Reduced use of seclusion and restraint

Services and programs

Improved access to services More services and options for care Peer support and peer based services / groups Community services and engagement NDIS packages Particular services and programs are working well

Awareness Mental health awareness in the community and workforce


Figure 30. Word cloud Consumer and Carer Peer Workforce: What is working well in mental health

reform in your community?





• Lack of appropriate mental health services, service gaps and poor delivery

• Lack of staff and fulltime paid positions for peer workers

• Lack of funding for services and the peer workforce

• Mental health stigma and discrimination against people with lived experience

• Lack of timely access to appropriate support

• Difficulty accessing the NDIS and a lack of support options outside the NDIS.


Table 28. Consumer and Carer Peer Workforce: ‘What challenges hinder mental health reform in

your region?’


Services and support Lack of services and support Lack of appropriate and recovery oriented support options Service gaps and a lack of collaboration between services Poor service quality Community / public support is limited

Workforce Lack of staff Lack of fulltime paid positions for peer workers Insufficient staff training and education Staff burnout and high turnover Workplace culture and attitudes

Funding Lack of funding for peer workers


Lack of funding for services and service development Funding cuts

Stigma and discrimination

Mental health stigma Discrimination against people with lived experience of mental illness

Access to services Lack of access to appropriate support Financial barriers Long wait lists Difficulty navigating the system

NDIS Difficulty accessing NDIS funding Lack of support options for those unable to access the NDIS Loss of funding for services outside the NDIS

Figure 31. Word cloud Consumer and Carer Peer Workforce: What challenges hinder mental health

reform in your region?





• Appropriate and targeted service delivery, and service collaboration

• Growth and development of the peer workforce

• More qualified staff and staff training

• Lived experience consultation, engagement and co-design

• Focus on recovery oriented and trauma informed care

• Accessible and affordable services

• Increased funding for services and the peer workforce.



Table 29. Consumer and Carer Peer Workforce: ‘What are your priorities for mental health reform

over the next five years?’


Services and support Appropriate, targeted and culturally safe service delivery Service collaboration and communication Enhanced community services and engagement More peer led services Services to address holistic needs (including social services)

Peer workers Growth of the peer workforce More paid fulltime positions for peer workers Peer leadership Support and training opportunities for peer workers

Workforce More mental health workers and qualified professionals Staff training

Lived experience Increased lived experience consultation, engagement and co-design Greater recognition of lived experience voices

Recovery oriented and trauma informed

Focus on recovery oriented care and trauma informed care

Access Ease of access to services Affordable care Accessible information about mental health and available services

Funding Increased funding for mental health services and development of the peer workforce

Figure 32. Word cloud Consumer and Carer Peer Workforce: What are your priorities for mental

health reform over the next five years?






• Growth of the peer workforce and recognition of the value of lived experience

• Improved service delivery and collaboration

• Increased funding and targeted funding

• Wellbeing and improved outcomes for consumers and communities.


Table 30. Consumer and Carer Peer Workforce: ‘What would you like the updated Living Well

strategy to achieve?’


Peer / lived experience

Increased recognition of the importance of lived experience voices More peer workers and peer leadership roles Support for peer workers Consumer input in care planning

Services Suitable services, improved service delivery and greater reach Improved access to services Service collaboration Increased peer support Support and training for staff

Funding Increased funding Targeted funding

Wellbeing Wellbeing and improved outcomes for consumers and communities Suicide prevention


Figure 33. Word cloud Consumer and Carer Peer Workforce: What would you like the updated

Living Well strategy to achieve?





• Support networks and access to quality holistic support and services when needed


• Social and community connections

• A healthy lifestyle and good physical health

• Support and connection to friends and family

• Stable and affordable housing.


Table 31. Consumer and Carer Peer Workforce: ‘What do you need to live well?’


Support and services Support networks Access to quality support and services when needed Holistic support: “Personal, professional, physical, spiritual and emotional support. And chocolate.”


Stable paid employment Financial security


Social interactions and relationships Community support Community connections and participation

Healthy lifestyle Healthy diet Exercise Good physical health

Friends and family Support and connection to friends and family


Housing Stable housing Affordable housing

Figure 34. Word cloud Consumer and Carer Peer Workforce: What do you need to live well?




Aboriginal and/or Torres Strait Islander people

Respondents

The Aboriginal and/or Torres Strait Islander people subgroup included the 81 respondents

who identified themselves in question 2 as Aboriginal and/or Torres Strait Islander.



• Mental health services, programs and support

• Community engagement








Table 32. Aboriginal and/or Torres Strait Islander people: ‘What is working well in mental health

reform in your community?’



Specific programs, supports and services Greater number of services Targeted services (i.e. for Aboriginal and/or Torres Strait Islander people)

Community engagement

Community engagement Specific community programs (e.g. Gamarada Community Healing and Cultural Leadership Program) Community groups and conversations Collaboration with Aboriginal and/or Torres Strait Islander mental health services Agencies trying to make their services more culturally appropriate

Nothing “Nil” “Nothing much”

Access Ease of access to services and information Increased service availability Free / affordable / subsidised services


More awareness across the community and the sector Raising awareness and reducing stigma Wider understanding of complex trauma More education and resources available for consumers

Workforce Growing peer workforce Increased funding for workers Aboriginal and/or Torres Strait Islander workforce


Youth Compassion for young consumers and their carers School engagement and giving young people a say in care plans

NDIS NDIS is providing financial support for some people

Figure 35. Word cloud Aboriginal and/or Torres Strait Islander people: What is working well in

mental health reform in your community?





• Lack of

o Appropriate mental health services and support options

o Trained / qualified workers in the mental health workforce, and not enough

support for staff

o Funding and resources for mental health services and staff

o Access to mental health services and support

o Community engagement

o Alcohol and drug use risk factors and shortage of related treatment services

o Affordable options for mental health care

o Mental health education and awareness in the community as well as among

health professionals and first responders

o Local services and support.



Table 33. Aboriginal and/or Torres Strait Islander people: ‘What challenges hinder mental health

reform in your region?’


Appropriate mental health services

Lack of appropriately targeted services (e.g. substance abuse, drug related psychosis) Inflexible services and service models Lack of appropriate services for Aboriginal and/or Torres Strait Islander people Uncoordinated services Not enough support in community for anxiety and depression and other non-psychotic or suicidal conditions

Mental health workforce

Lack of mental health professionals (psychologists, psychiatrists) Lack of Aboriginal and/or Torres Strait Islander mental health workers / culturally appropriate workforce Not enough staff Not enough training / skilled staff / too much turnover

Funding and resources in the mental health sector

Lack of funding for services and staffing More funding should be directed to Aboriginal and/or Torres Strait Islander people mental health services Lack of affordable services

Access to mental health services and support

No / not enough local services and professionals Lack of access to mental health clinicians and other specialists Lack of accessible services Better mental health training required for local GPS

Community engagement

Lack of community understanding and isolation Local, community driven services Not enough community education around mental health

Drugs and alcohol Availability of alcohol and illicit drug use Not enough drug and alcohol treatment services Lack of integrated mental health and drug and alcohol treatment services

Financial barriers High cost of treatment Lack of or not enough free / affordable options Limited Medicare benefits

Mental health education and awareness

Lack of mental health knowledge and understanding in the community Lack of mental health education / training among health professionals including GPs

Local service options Limited access to psychologists and psychiatrists in regional areas Shortage of services in remote areas


Figure 36. Word cloud Aboriginal and/or Torres Strait Islander people: What challenges hinder

mental health reform in your region?





• Culturally appropriate mental health services




• Specialised services for children and adolescents, and prevention programs

• Funding directed to where it’s needed most



• Affordable options for mental health care.


Table 34. Aboriginal and or Torres Strait Islander people: ‘What are your priorities for mental

health reform over the next five years?’


Culturally appropriate mental health services

Culturally appropriate and safe for Aboriginal and/or Torres Strait Islander clients and families Specialised Aboriginal and/or Torres Strait Islander health care models Aboriginal and/or Torres Strait Islander community engagement and consultation


Aboriginal and/or Torres Strait Islander community controlled health services

Mental health services and support

Holistic support for carers and families (e.g. accommodation etc.) 24/7 support for carers More variety of support groups for consumers (e.g. young, older)

Workforce Increased Aboriginal and/or Torres Strait Islander professional mental health workforce and senior positions More hands on workers and support workers

Access Shorter wait times to access services Greater awareness of services and information resources Local services

Youth Better supports for young people by young people Better help for acutely ill youth Young people at risk of suicide

Funding Equitable distribution of funds to relevant services Reduced duplication of funding More funding


Increased awareness of available culturally safe mental health services Improved awareness in community More education and training for staff including police

Affordable care Remove financial barriers to service access More free and accessible therapeutic mental health services

Figure 37. Word cloud Aboriginal and/or Torres Strait Islander people: What are your priorities for

mental health reform over the next five years?







• Wellbeing and outcomes


• Community support and awareness

• More funding and direction of funding to culturally safe services

• Focus on children and youth programs

• Mental health awareness and education in the community as well as among health


• Workforce, including targets for Aboriginal mental health clinician employment.


Table 35. Aboriginal and/or Torres Strait Islander people: ‘What would you like the updated Living

Well strategy to achieve?’



Less people suffering mental illness falling through services gaps More services More client focused services Holistic support / Services around a range of issues

Wellbeing and outcomes

Better outcomes for Aboriginal and/or Torres Strait Islander communities and services Focus on addressing broader societal issues for Aboriginal and/or Torres Strait Islander people that contribute to poor mental health and wellbeing

Access Improved access for clients in crisis Easy referral pathways to access mental health services

Community More support for people to combat isolation Aboriginal and/or Torres Strait Islander community controlled services preferred Community support and awareness


Commitment to funding culturally safe services More money for services

Youth Maintain funding for Aboriginal and/or Torres Strait Islander children’s programs Attention on the effects of trauma on young people


Education and focus on healing and recovery Information on available community services

Workforce Set Aboriginal and/or Torres Strait Islander mental health clinician employment targets Stronger policies on staff mental health and wellbeing


Figure 38. Word cloud Aboriginal and/or Torres Strait Islander people: What would you like the

updated Living Well strategy to achieve?






• Wellbeing and holistic support

• An inclusive community and social connections

• Access to services and specialised services for varied client groups

• Stable employment and good work-life balance

• Financial security

• The need to feel safe.


Table 36. Aboriginal and/or Torres Strait Islander people: ‘What do you need to live well?’



Inclusion and support as required Security, emotional support Access to afterhours services

Wellbeing and holistic support

Stable accommodation Emergency accommodation with kids Security, emotional support, holistic services Meaningful daily activity


Exercise, nutrition Less stress

Community and social connection

An inclusive / less judgemental community Dignity, hope and community Social life that is not just related to sport Supportive and content inner social network Increased social and emotional wellbeing

Access Access/services for varied client groups (men, youth) Access to services and informed care

Employment A permanent job that pays a fair wage A great place to work The ability to work Good work / life balance

Financial Income to survive in high cost of living community Opportunities for free activities especially that can include children People need money

Safe Feeling safe and secure Cultural connections that underpin identity and safety

Figure 39. Word cloud Aboriginal and/or Torres Strait Islander people: What do you need to live

well?




References

NSW Mental Health Commission 2014. Living Well: A Strategic Plan for Mental Health in

NSW 2014–2024. Sydney: NSW Mental Health Commission.

Provalis Research 2015. Wordstat User’s Guide. Montreal: Provalis Research.


Appendix A: Survey

Living Well Survey · An independent analysis of the survey responses was undertaken by the...

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