Regional Planning for Mental Health and Suicide Prevention – a Guide for

Primary Health Networks (PHNs)

Department of Health

August 2017

Version 1.01

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Contents

Introduction............................................................................................................5

1. The Department’s expectations in relation to regional planning................6

1.1 Overview........................................................................................................6

1.2 What should be the scope of the Regional Plan?...........................................7

1.3 What timeframe should the Regional Plan encompass?................................8

1.4 What flexibilities will PHNs have in developing an innovative Regional Plan?8

1.5 How is the Regional Plan different from annual activity work plans developed by PHNs, or by broader planning for commissioning?..................9

1.6 What should the Regional Plan look like? What should it try to achieve?.....9

How does the Plan relate to the joint regional plans foreshadowed in the draft Fifth National Mental Health Plan?..............................................................10

2 Guidance on how PHNs might approach development of the Regional Plan11

2.1 The process of developing the Regional Plan...............................................112.1.1 Setting local parameters for the Regional Plan - refining and agreeing

local scope, assumptions, timeframe and focus..........................................11

2.1.2 Allocating resources to the planning process..............................................12

2.1.3 Establishing governance and consultation arrangements for the RegionalPlan.............................................................................................................12

2.1.4 Compiling the local evidence base..............................................................14

2.1.5 Use of the National Mental Health Service Framework (NMHSPF) and other tools and resources to identify service needs and targets................15

2.1.6 Identifying priorities for change and service development.........................16

2.1.7 Identifying duplication and inefficiencies, including ambiguity in roles and responsibility...............................................................................................17

2.1.8 Considering opportunities for integrated service delivery and supporting providers to work together.......................................................18

2.1.9 Consideration of implementation issues.....................................................20

2.1.10 Measuring progress in implementation of the Regional Plan.....................20

2.1.11 Seeking agreement to the Regional Plan from LHNs and other stakeholders................................................................................................20

2.2 The content of the Regional Plan.................................................................222.2.1 The local context.........................................................................................22

2.2.2 Embedding a stepped care framework within the Regional Plan................22

2.2.3 Suicide prevention......................................................................................22

2.2.4 Aboriginal and Torres Strait Islander mental health and suicide prevention...................................................................................................23

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2.2.5 Other special population groups.................................................................24

2.2.6 Workforce planning....................................................................................25

2.2.7 Drug and alcohol services...........................................................................25

2.2.8 Cross sectoral planning...............................................................................26

3 Resources available to support PHNs in development of the Regional Plan.27

3.1 PHN Mental Health Tools and Resources.....................................................27

3.2 State/Territory mental health plans and frameworks..................................27

3.3 State/Territory Suicide prevention strategy.................................................28

3.4 Local, state and national data sources to support planning........................28

3.5 Resources to support planning for suicide prevention..................................29

3.6 Resources to support planning for Aboriginal and Torres Strait Islander Mental Health and Suicide Prevention.........................................................30

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Version Release date Details1.0 11 July 2016 Version released to all PHNs

1.01 23 August 2017

Minor editorial corrections to remove typos and formatting errors. Updated 1.1 Overview.

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Introduction

This document provides guidance to Primary Health Networks (PHNs) on the requirements and opportunities associated with their requirement to develop a Regional Mental Health and Suicide Prevention Plan. It should be read in conjunction with other guidance documents, circulars and within the context of the funding Schedule for the PHN Program: Primary Mental Health Care Activity (the Funding Schedule).1

PHN development of the Regional Mental Health and Suicide Prevention Plan (Regional Plan) is a pivotal element of broader mental health reform. A comprehensive, evidence based Regional Plan, developed in partnership with Local Health Networks (LHNs) and other regional stakeholders, has the capacity to support future service delivery pathways which are integrated, targeted to need across the spectrum of stepped care, and which address local priorities. It can offer the opportunity to embed partnerships needed to make optimal use of resources and ultimately deliver improved outcomes and experiences of care for consumers and carers. The importance of a Regional Plan to support service integration and clarity of responsibilities at a regional level has been highlighted in the Government’s response to the Review of Mental Health Programs and Services2 and as a priority area in the draft Fifth National Mental Health and Suicide Prevention Plan (the draft Fifth) Plan.3 The need for regional planning and integration is also supported through several recent state and territory mental health plans and frameworks as well as bilateral agreements to support coordinated care currently being negotiated between the Commonwealth and states and territories. PHNs are ideally placed to undertake regional planning in partnership with LHNs and other stakeholders.

The parallel development over this period of the National Mental Health Service Planning Framework, and regionally targeted resources to support PHNs, provides opportunity to give some precision to planning processes to ensure that Regional Plans become a valued resource which genuinely inform planning and resource allocation by Commonwealth, state government and NGO service providers.

This guidance is broken into three parts.

Part 1 provides advice on the Department’s requirements and expectations, and the parameters within which PHNs can work in developing a Regional Plan.

Part 2 offers advice on how PHNs may wish to implement this area of activity, and considerations they may wish to take into account.

Part 3 identifies resources which may be of further assistance to PHNs in development of the Regional Plan.

This guide does not override the requirements set out in the Funding Schedule.

1 PHN Program: Primary Mental Health Care Activity Funding Schedule, Department of Health, 20162 Australian Government, Response to Contributing Lives, Thriving Communities – Review of Mental Health Programmes and Services, Commonwealth of Australia, 20153 Fifth National Mental Health Plan, Draft for Consultation, October 2016

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1. The Department’s expectations in relation to regional planning

1.1 Overview

The Department’s formal requirements for the development of a Regional Plan are set forth in the Funding Schedule and in related circulars. The Department’s expectations of, and parameters for, the contents of the Regional Plan are also linked to broader guidance and requirements of the Department for PHN mental health activity.

The Funding Schedule indicates that PHNs are required to

“develop, in partnership with LHNs and other stakeholders, a comprehensive Regional Mental Health and Suicide Prevention Plan, which is in addition to annual activity plans and is likely to span a number of years. It must be evidence based and be developed through comprehensive Needs Assessments and service mapping to identify gaps and opportunities for the efficient commissioning and targeting of services, including those related to the Key Objectives of this Activity. Once completed, this Plan should provide a vital resource to Australian Government, state government, non-government and services in the region to support the integrated delivery of mental health and suicide prevention services within the community. Agreement to the Plan must be sought from regional stakeholders including LHNs, who should also be encouraged to be co-signatories to the Plan” (2.1 (iv) PHN Primary Mental Health Care Activity Funding Schedule)

Although the requirement for PHN’s to submit the completed Regional Plan to the Department has been removed as a contractual milestone, regional planning remains a very important component of PHN activity.

PHNs should seek agreement from LHNs and other regional stakeholders to the Regional Plan and to collaboratively develop the Regional Plan to the maximum extent possible. The Department recognises that the nature of this agreement may vary from endorsement of the Plan to acknowledgement to work together on specific priorities.

Local Hospital Networks (LHNs)

LHNs vary across states and territories. Local Hospital Networks (LHNs) entities established by state and territory governments to manage single or small groups of public hospital services, including managing budgets and being directly responsible for performance. Most, but not all, LHNs are responsible for managing public hospital services in a defined geographical area. At the discretion of states and territories, LHNs may also manage other health services such as community based health services. LHNs may have different names in some jurisdictions. For example, they are referred to as Local Health Districts in New South Wales, Health and Hospital Services in Queensland, Local Health Services in South Australia, and the Tasmanian Health Service in Tasmania.

The Department will not itself seek to assess, endorse or approve the Regional Plan, and there is no specific template or pro-forma with which PHNs need to comply. The Regional Plan will not in any way supersede or obviate other mental health obligations and objectives PHNs have in association with the Funding Schedule. For example, the existing commissioning priorities for mental health and suicide prevention funding under the

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Schedule will remain for the duration of the Schedule, regardless of whether other priorities at a regional level are identified for the longer term or for the broader government and non-government service sector.

Figure 1: Summary of Department of Health expectations set out in PHN Mental Health Circular No. 2 and related documents 4,5

The Department’s expectations of the Plan as set forth in Mental Health Circular 2, March 2016 and in the Schedule and other documents and guidance materials can be summarised as follows. The Plan should be developed with, and desirably be agreed by, the Local Hospital

Networks and other stakeholders as appropriate, including consumers and carers.

It should be underpinned by evidence and data, including information obtained through needs assessments, and local population and service data.

It should support an integrated, coordinated approach to service delivery and joined up pathways to care.

The Plan’s development should take into consideration existing service arrangements provided in the region by ACCHS, LHNs and other organisations.

It should aim to identify and address duplication, inefficiencies and gaps in the system and provide solutions to address them.

It should seek to facilitate clear delineation of roles and responsibilities at a local level.

It should identify key priorities for system and service development within the life of the plan.

It should address a multi-year timeframe – potentially identifying longer term priorities for growth beyond the life of the plan.

It must embed a stepped care approach to mental health service delivery to ensure that a broad range of service types are available.

It must promote a joined-up approach to preventing suicide.

It should consider cross sectoral links required particularly to promote mental health, support early intervention and prevent suicide.

1.2 What should be the scope of the Regional Plan?

In previous advice, the Department has suggested that the Regional Plan should encompass primary mental health care services and their interface with mental health services provided by state governments, private providers, the National Disability Insurance Scheme (NDIS), and non-government and Indigenous health sectors. It is not anticipated that the Regional Plan will cover admitted patient services delivered by hospitals, except to the extent that PHNs acknowledge referral pathways and the level and type of services available.

There is also an opportunity for the Regional Plan to engage with human services operating outside the health sector, particularly disability, education, employment and social services 4 Mental Health Reform Implementation, Circular 2/2016, Department of Health, March 20165 See suite of documents PHN Primary Mental Health Care Flexible Funding Pool Implementation Guidance, Department of Health, 2016 at the Department of Health website.

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in providing support and services to people with mental illness, particularly in the context of suicide prevention activity. In summary, the Department expects the Regional Plan to position primary mental health care within a broader context, but acknowledges that PHNs will vary in the extent to which they are able to engage other sectors and services in the development of the Regional Plan. Further guidance later in this document elaborates on opportunities for extending the reach and scope of the Regional Plan.

1.3 What timeframe should the Regional Plan encompass?

The Regional Plan should be a detailed multi-year document, however the exact timeframe for the Regional Plan should be subject to local agreement and consideration, and alignment with other local planning processes or with LHN planning timeframes. Others may wish to have a longer-term Regional Plan which potentially could be subject to review.

In general, The Department suggests that a period of three to five years is regarded by the Department as the timeframe that should be covered by regional plans. Should PHNs consider the Regional Plan should cover less than three years, it is requested that the rationale for this be provided when submitting the Plan to the Department.

1.4 What flexibilities will PHNs have in developing an innovative Regional Plan?

The Department recognises that the Regional Plan is likely to vary significantly from one PHN to another, and that local priorities, aspirations and the extent of integration will vary. The Regional Plan provides opportunity for local innovation, and this may be reflected in a range of ways.

Significant flexibility, variation and innovation is anticipated in relation to:

the format, structure and length of Regional Plan; the extent to which PHNs are able to agree a shared Regional Plan for service delivery

into the future with LHNs and other stakeholders; priority issues and/or population groups; sub-regional issues requiring particular focus; aspirations for growth and change; innovative approaches to workforce, particularly in areas of workforce shortage; the depth and nature of partnerships with LHNs and other organisations in planning and

commissioning of services; and the approach to engagement of other stakeholders.

While PHNs will have this flexibility, the Regional Plan does not amend contractual obligations associated with the current funding agreement with the Department for mental health activity. For example, the approach to planning youth mental health services would need to accommodate existing commitments regarding maintenance of headspace centres, and the six priorities of the funding agreement would remain in place.

1.5 How is the Regional Plan different from annual activity work plans developed by PHNs, or by broader planning for commissioning?

Planning is a core activity which underpins most of the work PHNs undertake. The commissioning role undertaken by PHNs requires extensive structured planning

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arrangements, and has been subject to previous detailed advice and guidance from the Department.6,7 Similarly, PHNs have been required to provide specific work plans for their annual mental health activity for which specific templates have been provided.

Many general principles associated with planning may apply to the development of a Regional Plan, and in this respect detailed guidance previously provided by the Department on undertaking needs assessments, and on planning in a commissioning environment may be helpful and relevant. These resources are summarised in Section 3 of this guidance document.

There are, however, some fundamental differences between these PHN specific planning activities and the planning associated with a Regional Plan.

The Regional Plan may go beyond a focus on the PHN’s activities to consider broader mental health services and needs within the community, including services provided by LHNs and through non-health sectors.

The Regional Plan is intended to span a multi-year period rather than an annual plan for action. The PHN’s role is to develop the Regional Plan in collaboration with other regional stakeholders.

Agreement to and, if possible, endorsement of the Regional Plan should be sought from local government, LHNs and local stakeholders.

1.6 What should the Regional Plan look like? What should it try to achieve?

Various national, state and local mental health plans have been prepared previously which have served a broad range of purposes. Some simply articulate a vision, while others attempt to put together existing mental health commitments in a way which documents collaboration and ways of working together. Other more recent plans at a jurisdiction level have attempted to undertake evidence-based service planning to support a shared view of what services will be needed and by whom into the future.

The Regional Plan should provide a platform for regional service integration and planning by capturing a vision for improving services, documenting partnerships and existing commitments, and identifying strategies to improve service delivery. However, they need to do more than simply encapsulate principles, vision and existing arrangements. They should also endeavour to scope a plan for moving towards the vision, through an integrated service system, and articulate the changes in service delivery, service pathways and use of regional resources and workforce needed to address the identified priorities. Noting earlier guidance on engaging all relevant local stakeholders, it will important to clarify and agree on the roles and responsibilities in implementing these changes.

The Regional Plan will be limited by a range of factors, including the available resources, length of funding agreements and the capacity of LHNs and other stakeholders to engage and commit. Where possible PHNs should seek to mitigate identified risks to maximise the success of the Regional Plan. Having agreed aspirations and well developed service targets that perhaps go beyond the life of the Regional Plan ensures all parties are armed with evidence and agreed priorities in the event should additional resources become available.

6 Planning in a Commissioning Environment – A Guide, PricewaterhouseCoopers and the Department of Health, June 2016.7 PHN Needs Assessment Guide, Department of Health, 2015.

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Ultimately the value or success of the Regional Plan will be determined by whether it is embraced as a valued regional resource which articulates agreed service priorities and the partnerships, pathways, and local system changes which are needed to achieve them.

How does the Plan relate to the joint regional plans foreshadowed in the draft Fifth National Mental Health Plan?

Priority Area 1 of the draft Fifth Plan specifically focuses on regional planning and service delivery and commits governments to a range of actions to support the roles of PHNs and LHNs. Actions 1 and 2 of the draft Plan explicitly require the development of joint regional and suicide prevention plans by PHNs and LHNs. These actions also require governments to provide a range of support materials, including planning tools based on the NMHSPF, region-level data and guidance about the development of joint plans.

The Department anticipates that the regional plans developed by PHNs will provide a strong foundation for joint plans developed with LHNs in the future. Although the requirement for PHN’s to submit the completed Regional Plan to the Department has been removed as a contractual milestone, regional planning remains a very important component of PHN activity. Regional Plans should be developed with stakeholder engagement and possible endorsement by LHNs wherever possible however, the extent to which this is achieved will vary across regions.

The first stage of implementation toward regional planning of mental health services may not cover the full range of services and may not extend into areas traditionally the responsibility of state and territory funded services. By contrast, joint regional and suicide prevention plans developed by PHNs and LHNs under the terms of the draft Fifth Plan will be expected to be comprehensive as well as be fully endorsed by the LHN(s) with service responsibilities within the PHN’s regional boundaries. It is also expected that state and territory central health departments will contribute to Regional Plans and may choose to set this as a requirement for any LHN endorsement. Implementation arrangements and guidance to support the development of joint plans, as committed in the draft Fifth Plan, will clarify this and other requirements.

PHNs are therefore encouraged to proceed with development of the regional plans for which they are responsible and regard these as providing a strong foundation towards integrated service delivery and joint planning that they will be undertaking more formally once the Fifth Plan is endorsed.

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2 Guidance on how PHNs might approach development of the Regional Plan

2.1 The process of developing the Regional Plan

This section outlines issues and opportunities PHNs may consider in developing and negotiating a Regional Plan and provides some questions which may help to guide PHNs in negotiating the Regional Plan with other stakeholders. It is structured against the broad steps PHNs may take, noting that many PHNs will already have progressed through some of these steps and may have already established good working relationships with stakeholders within their region (Figure 2).

Figure 2: The process of developing a Regional Plan

2.1.1 Setting local parameters for the Regional Plan - refining and agreeing local scope, assumptions, timeframe and focus

The scope, reach and duration of the Regional Plan will depend in part on the partnerships and engagement the PHN is able to negotiate to develop the Regional Plan, and should be agreed through these partnerships early in the planning process. The following summary advice may assist with the scoping process.

As noted earlier, a three to five year period is suggested as a reasonable timeframe over which to achieve meaningful change. The duration or timeframe should be informed by the timing of other plans or frameworks in the region. Discussion with LHNs can help to inform how best to dovetail with these, and work within the restraints and opportunities they present. Another consideration is whether there is a need for significant growth or change, which will require longer term targets. Some PHNs may wish to articulate interim service or system changes which could mark progress towards the longer term vision.

Implementation

Seeking agreement to the Plan

Measuring progress using data from the Primary Mental Health MDS

Implementation issues and how they are proposed to be mitigated

Embedding integration into the Plan

Agreeing on service needs, and priorities for growth over the life of the Plan - what needs to change and when and how

Identify system problems - duplication and inefficiencies

Identify population needs, service targets and gaps - with assistance of NMHSPF

Getting the local evidence base

Establish clear governance and consultation arrangements (that includes carers and consumers and people with lived experience)

Agree parameters - scope, timeframe, focus of Plan, vision for the region

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PHNs should also identify the key assumptions which underpin the Regional Plan. For example, what is a reasonable expectation of growth in available resources for mental health over the life of the Regional Plan? Is there an assumption of increased flexibility in use of some types of funding? Are there key assumptions about transitional arrangements for other services? Is there an assumption that some parts of the workforce might grow? (e.g., low intensity workforce, or mental health nurses)?

The scope should include, as a minimum, a focus on primary mental health care and its interface with other community-based mental health services. However, PHNs may achieve a Regional Plan which might engage at a whole of region health system level and with other sectors beyond health. Similarly, clarity about the focus and aims of the Regional Plan will be vital. It needs to be clear to stakeholders that the Regional Plan is intended to be a regional resource for service planning – not just a statement of vision and aspiration. Agreeing the parameters for the reach of the Regional Plan at the outset is important. Is it likely the Regional Plan will seek to identify areas for shared action and even shared resourcing? This is an area where some PHNs may wish to reach further than others, depending on the engagement of LHNs, and the risks to be managed in local partnerships.

2.1.2 Allocating resources to the planning process

Developing the Regional Plan is a significant task. PHNs will need to use mental health activity funding to support this level of activity. Local stakeholders, such as LHNs, may also need to contribute resources to aid development of the Regional Plan, particularly in connection with data collection and analysis. Aspects of developing the Regional Plan which may need resourcing as part of the PHN leadership role include:

coordination of the planning process – this is likely to require significant time from PHN mental health staff;

liaison with LHNs and other stakeholders – senior PHN staff may need to allocate significant time to this;

supporting governance arrangements – venues, communication with members, supporting consumer and carer members to attend;

consultation costs; data collection and analysis, noting some technical support may be needed; preparation of the Regional Plan itself; and implementation arrangements – the PHN is likely to play a role in ongoing arrangements

to support and measure progress of the Regional Plan.

2.1.3 Establishing governance and consultation arrangements for the Regional Plan

Effective governance is vital to development and ultimately ownership of the end product. In general, PHNs already have established governance arrangements to support mental health activity, on which arrangements for the Regional Plan would build.

The Department has an expectation that LHNs, GPs, Community Health Services, Aboriginal Community Controlled Health Organisations, and consumers, carers and people with lived experience should be engaged from the outset in all stages of the development of the

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Regional Plan. Psychiatrists, being the medical specialists for mental health, including substance abuse and suicide prevention, would have much to offer in the development of the plan. Other important partners could include but are not limited to private mental health service providers (e.g. psychologists and private allied health providers), drug and alcohol services, NDIS providers and coordinators, NGOs involved in delivery of primary care and other community-based mental health and suicide prevention services and various cross sectoral agencies.

Which stakeholders might be appropriate to include on governance bodies and which would be more appropriately engaged through broader stakeholder consultation or even through expert panel arrangements? Governance bodies will need agility in order to provide timely and expert advice to PHNs, but they also need to include representation at the right level from LHNs and other agencies expected to endorse the Regional Plan.

How can stakeholder expectations for the Regional Plan be managed? Is there an appropriate point in time when broad priorities have started to emerge when consultation would help to refine and inform plans for change? Consultation which is too early or too late can impede ownership and development processes. Agreed underlying assumptions about resource availability can also help to manage overall expectations.

PHNs may wish to target consultation on the parameters and scope of the Regional Plan. Can previous consultation on needs assessment help to guide the development of the Regional Plan? Can specific consultation be targeted to issues emerging from analysis of data and evidence to ensure focus?

Engagement of consumers, carers and people with lived experience in both governance and broader consultation is very important, and PHNs may benefit from seeking different types of consumer experience. This could include seeking input through consultation from people with lived experience of suicide, and consumers who have different levels of need from low intensity to high intensity, as well as consumers and carers from particular population groups, and if appropriate, sub-regions. The Consumer and Carer Engagement and Participation Paper included in the PHN Primary Mental Health Care Flexible Funding Pool Implementation Guidance will guide PHNs on ways to engage consumers in a participatory process when developing the Regional Plan. The paper is available at the Department of Health website.

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Consumers and carers

Improving the Mental Health System and outcomes for people with mental illness can only be done in partnerships with consumers, carers, mental health stakeholders and state and territory governments.

The Australian Government is committed to continued consultation and engagement with consumers and carers. Consumers and carers are people with lived experience of mental illness and /or suicide and are at the heart of the mental health system.

Ensuring strong consumer participation in the development of the Regional Plan will help ensure their development as mental health leaders and advocates.

2.1.4 Compiling the local evidence base

Evidence-informed planning will be a key element of the Regional Plan, and will help to avert the risk of advocacy for priorities which do not genuinely align with regional need. PHNs should be informed by the characteristics of the local population, available services and any gaps in service provision. They also need evidence of special needs particularly relevant to the PHN priorities and its sub-regions.

The PHN’s needs analysis and the associated consultation processes will help to inform the evidence base and shape questions to be asked. The Department’s PHN Needs Assessment Guide is an important resource to inform this step of the process, as outlined in Section 3.

There is a range of data sources which can provide information on the demographics of the local population, many of which are already available to PHNs – these are summarised in Section 3 and include information on anticipated rates of mental illness against age groups, use of disability services and special needs within the population.

Getting a good understanding of local service capacity will require strong partnerships with LHNs and local providers. LHNs may have access to local service data not available to the PHN. Tips on engaging with other sectors are also provided in Section 3.

Consideration also needs to be given to nationally and state funded services and programs available locally – for example, population level digital mental health services, national school mental health programs or state-wide initiatives.

Use of service mapping or ‘snapshot surveys’ to provide a one-off audit of services available to people across a stepped care spectrum may be useful in the event that there is not easy access to information about available services. This might also help to map existing pathways and problems in accessing these from a consumer or carer perspective.

Evidence of special needs will ensure the need is understood and quantified. How many people are in a particular group? What level of service is being received? What evidence is there this is inadequate?

Finally, evidence of the efficacy of services is vital. Where the National Mental Health Service Planning Framework (see below) is not able to provide direction on best practice

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services to meet a need, local experts or clinical councils may be engaged to provide advice on approaches for which there is evidence of efficacy and efficiency.

2.1.5 Use of the National Mental Health Service Framework (NMHSPF) and other tools and resources to identify service needs and targets

The Department, through the University of Queensland, will be assisting PHNs to use the decision support tools available through the NMHSPF to customise service needs and workforce requirements associated with meeting the service needs of the region. A report will be provided to all PHNs in the first half of 2017 outlining the key outputs from the National Mental Health Service Planning Framework (NMHSPF) model. This report will be a standardised report for all PHNs, to be used as a starting point for understanding the NMHSPF and engaging in further work and training to apply its estimates, if desired, to support regional planning within PHNs. The report will include an overview of the NMHSPF model, its key concepts, modelling assumptions and limitations.

The report will also include standardised national benchmarks for the full spectrum of mental health services in a ‘should be’, optimally functioning mental health system, in the form of the suite of standard output reports produced by the NMHSPF (Table 1).

Table 1: NMHSPF standard reportsReport number Description of reportEpidemiology Provides an overview of the population prevalence and demand for treatment

identified in the model. Information is included on the total population analysed by level of severity and age group.

Summary of resources

Provides a summary of selected outputs from the database. The report focuses on key populations, resources (e.g. workforce FTEs and mental health beds) and costs, arranged by level of severity and funding source.

Workforce FTEs Shows workforce FTE data, focusing on staff types (e.g. consumer peer worker, nurse practitioner, GP, psychologist and psychiatrist) and level of severity for each funder group (e.g. state or Commonwealth funding).

Beds Shows bed program types for acute, sub-acute and non-acute hospital and community-based beds, arranged by target age group.

State ambulatory programs

Shows levels of activity and costs predicted for state-funded ambulatory clinical services such as adult continuing care, acute care services and consultation liaison.

Commonwealth clinical programs

Shows expected levels of activity, providers (e.g. GP or psychologist) and costs predicted for Commonwealth-funded clinical programs. Focuses on the following resources and outputs: occasions of service by staff, hours of client demand, workforce FTE and workforce FTE prices ($million).

Community support sector programs

Shows expected levels of activity and costs for programs provided by the mental health community support sector such as family support services, respite services and individual or consumer peer work.

High intensity adult community support services

Shows the level of support provided to those populations with the highest level of modelled community support sector resource demand, a significant proportion of whom would be eligible for the National Disability Insurance Scheme.

Youth resources Shows youth resources modelled for the 12-24 years age range such as population, workforce FTE, mental health beds and workforce FTE prices ($ million) by severity level.

Each report will be accompanied by detailed information on how the numbers should be interpreted. PHNs will be provided with attachments containing the selected NMHSPF

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standard reports of most relevance to PHNs, for each PHN population. These reports can be used to provide an indication of evidence-based, nationally agreed reform directions for mental health services and are best used in conjunction with data on available services within each PHN. The focus of a gap analysis should be on new service models and areas of relative underinvestment which might be relevant priorities in future planning.

As a new tool, the NMHSPF has limitations which will be the focus of its further development in future years. It is not easily adapted to support planning for remote areas or to address the service needs of particular populations. It identifies optimal service requirements and the associated workforce requirements to meet the needs for the population – it does not undertake a gap analysis, or inform roles and responsibilities in addressing service needs. Most importantly, the NMHSPF does not produce a Regional Plan, but rather provides critical information that can be taken into account in the Regional Plan’s development. Additional work will be required by PHNs and other stakeholders to review the evidence produced and determine regional priorities in terms of what they consider feasible with current or anticipated resources and workforce, and what can be achieved within the local context.

There are a range of other tools, most of which have been developed internationally, available for mapping current service provision in the region. Use of these tools may help to supplement the reports from the NMHSPF, and assist with gap analysis. However, caution does need to be exercised to ensure consideration of Commonwealth funded mental health primary care services as well as specialised services are included in the mapping and gap analysis process. The NMHSPF is the only mental health specific planning tool developed in Australia through a process of developing evidence-based benchmarks against a broad stepped care framework, with the assistance of a range of experts, and suited to the Australian health system environment.

It is essential to engage local stakeholders, in particular LHNs, when developing and considering the reports generated through the NMHSPF. This will ensure stakeholders can actively participate in the design and planning process within the local region. Stakeholder engagement will also support the use of the NMHSPF in anchoring stepped care in the identification of the gaps in existing services and the priority needs of the community.

2.1.6 Identifying priorities for change and service development

The NMHSPF outputs will need to be subject to analysis and discussion to secure agreement on which service gaps require priority action, and what other changes may be needed. The NMHSPF will not itself identify key priorities, though it will help to provide the evidence base for informing them.

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Considerations in identifying priorities may include:

What service areas need to grow? Which might need to grow selectively in sub-regions – and how could this be managed and communicated?

What system changes are needed over time to deliver services in line with the service targets identified through the NMHSPF?

What national or state policy priorities for people with mental illness are particularly relevant to the region? For example, how can a stronger focus on better managing the physical health care needs of people with severe mental illness be built into service development?

Identifying barriers to achieving priorities will also be critical to enable clarity of the changes in services and pathways needed.

The priority areas for PHN commissioning identified by the Commonwealth in the Funding Schedule will need to be considered and will help to inform the planning process.

Figure 3: Summary of steps involved in compiling the evidence for the Regional Plan

2.1.7 Identifying duplication and inefficiencies, including ambiguity in roles and responsibility

The current service system contains ambiguities in responsibility for service delivery which is best identified and resolved at a regional level. For example, responsibility for follow-up care after discharge following a suicide attempt in some places may be assigned to primary care or in other locations, to post-discharge outreach services from the hospital or state funded community mental health teams.

Clarification of roles and responsibilities in addressing regional priorities will be vital to ensure best use of available resources.

Analysis of pathways and available services should not only identify gaps but also where there are multiple providers delivering similar services.

Needs assessment for

the region

Identify projected need

for the population

(with help of NMHSPF)

Map current service levels

and workforce

Identify priorities for

changeImplementation

planning

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Rigorous service planning may identify some service delivery models which are not efficient or which do not make the best use of the available workforce or resources. The planning process will need to articulate the evidence for this and clearly communicate the need for change to providers and stakeholders. Guidance previously provided by the Department on decommissioning may be useful in this respect.8

Sometimes services which are funded for one purpose have transformed over time into a different service type to address a service vacuum, or because of lack of information about other parallel services. It may be important to identify the nature of the workforce and service delivery being undertaken within services to find duplication and to plan collaboratively to more optimally use the available workforce.

2.1.8 Considering opportunities for integrated service delivery and supporting providers to work together

Regional planning should identify ways in which better joined up services can be achieved to deliver a single, connected system that facilitates the consumer’s transition between service platforms when required, including health and broader services.

Joint development of Regional Plans and coordinated arrangements for commissioning services guided by the Regional Plan was seen as a vital element of achieving integration in national consultations on the draft Fifth Plan, and an area which was strongly supported by all stakeholders.

Where there are priority areas for growth or redevelopment, a key question will be how to deliver these services in an integrated way, through which providers communicate and work together. This is an area where some PHNs may be able to stretch further to achieve more integration including with service providers such as psychiatrists. It will depend on local relationships and agility of services, and the need for change. Key considerations include the following:

What are the specific local problems in relation to lack of integrated care? What problems are consumers experiencing? This needs to be clear before opportunities for change can be identified and agreed. Is there fragmentation and problems in transition and pathways, particularly for vulnerable individuals with high intensity needs?

A strong consumer and carer focus will be vital to identify both the problems in existing pathways and integrated solutions. Similarly, representatives from other service sectors may be able to identify shortfalls in integrated services for their clients.

Consideration of vertical and horizontal integration is important – transitions and links up and down the spectrum of stepped care as the intensity of care needs increases – but also integration horizontally across sectors and across service platforms.

Building relationships will be vital to integration. Genuine integration will require high level authority from agencies and service providers involved in pathways. Their ownership in development of the Regional Plan will be essential and arrangements for integration may need to be embedded in Memorandums of Understanding (MOUs), service level agreements or through protocols for transition.

8 Planning in a Commissioning Environment – A Guide, PricewaterhouseCoopers and the Department of Health, June 2016

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Is there a need to plan for resourcing care coordination or service connection? Or will creation of better pathways reduce this need?

Synchronisation of commissioning and funding periods and arrangements will be one vital way in which integrated service delivery can be achieved.

Finally, and very importantly, arrangements for smooth transitions between services should be subject to commitment in the Regional Plan.

PHN Health Pathways are important tools when considering approaches to linking up services.

Youth mental health is an example of how the Regional Plan may help to get a local mandate for joined up service arrangements which involve partnerships between education, employment, drug and alcohol services, as well as primary and specialist mental health care. Other sectors have much to gain from embedding connections and integrated pathways which will enable early intervention and better outcomes for young people, and make better use of their own resources.

Different levels of integration are possible with any of these service arrangements adding value to regional processes for promoting organisations to work together. These range from simple information sharing to pooled funding at the other end of the spectrum (Figure 4).

Where integration extends to consideration of pooled funding arrangements, PHNs will need to consider how broader contractual obligations will continue to be delivered, particularly relating to the delivery of a balanced stepped care approach to service delivery, and performance indicators relating to access to services.

Figure 4: Different levels of integration9

2.1.9 Consideration of implementation issues

A comprehensive and effective Regional Plan should outline the approach to implementation. This could include the following considerations:

What ongoing monitoring and governance arrangements will be needed to support its implementation?

What are the resource requirements associated with proposed growth? What workforce planning is involved to support these requirements?

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What information and data sharing infrastructure will be needed to support the level of agile communication and records management to support smooth pathways to care for individuals?

Are specific MOUs or service agreements needed to support effective transitions? When and with whom will these be developed?

What arrangements will be in place for monitoring the Regional Plan?

2.1.10 Measuring progress in implementation of the Regional Plan

The Regional Plan should identify indicators of system reform for monitoring implementation progress. Similarly, there should be arrangements built in for a review process which could, if required, enable adjustments to the Regional Plan in the future. Considerations may include:

Who should be involved in the monitoring and review process? What specific outcomes and targets could be articulated against which monitoring and

evaluation of the Regional Plan could take place? Is there time to achieve these outcomes within the life of the Regional Plan – or is there

a need to articulate process indicators which might represent stepping stones to achieving the vision for change that the Regional Plan presents?

2.1.11 Seeking agreement to the Regional Plan from LHNs and other stakeholders

Most PHNs will be in a good position to engage LHNs and other stakeholders in the process of development and as co-signatories to the Regional Plan, and are well on the way to laying the groundwork for this. Others may encounter difficulties because of particular policy or other imperatives at a local or state level, or because of a mismatch in the timing of planning activities. In some cases the agreement of LHNs may be subject to unrealistic expectations about the role of PHNs in the Regional Plan, or agreement on priorities cannot be reached. To facilitate opportunity for agreement, PHNs may wish to consider the following:

Is there any jurisdictional mandate to support regional planning which might be of assistance to negotiating the LHN’s support and cooperation? A number of states and territories have made commitments in their own mental health plans to regional integration and planning and have noted the role of PHNs. These commitments will be documented through the draft Fifth Plan and the bilateral agreements currently being negotiated to support the Council of Australian Government’s commitment to enhanced coordinated care.10

Have LHNs been engaged in the process of using the NMHSPF decision tools in the planning process, and have any sensitivities arising from the gap analysis been identified in consultation with the LHN and managed early in the Regional Plan’s development?

If agreement cannot be reached, could there be some other form of commitment or backing such as a letter of support or partnership developed in relation to the Regional Plan?

10 As articulated in the Addendum to the National Health Reform Agreement (NHRA) for 2017-18 to 2019-20.

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Has adequate time been allowed to support the agreement process in relation to both LHNs and other local stakeholders, who may need to obtain approval from their boards or executives?

Figure 5: Inputs and enablers to the planning process

Inputs and enablersStepped care frameworksuicide prevention system approachcross sectoral supportMOUs and service agreements

Inputs and enablersgovernanceMOUs/service agreementsshared information and datalocal data sourcescommunication protocols

Inputs and enablersNMHSPF decision tools and resourcesLocal service mappingconsumer/carer experience

Inputs and enablers-needs assessment-existing PHN prioritieslocal dataLHN policies/prioritesgovernanceconsultation

Groundwork and scopingneeds

evidence local context

service mapping

Identifying gaps and service targets

Indigenousother special needs subregional needs system problems

Preparing the Planareas for change and

system reform areas for growth integration issues

stepped care suicide prevention

drug and alcohol services

Implementation issues

getting agreement to plan timeframe for review

monitoring Potential amendments or

review of the Plan

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2.2 The content of the Regional Plan

This section of guidance focuses on the content areas which may be addressed by PHNs through the Regional Plan. It is not intended to provide a contents page or checklist but rather, to suggest the range of considerations which may guide local planning around these issues. PHNs may address some of the issues covered by this section through seeking agreement to key principles or assumptions underlying the Regional Plan.

2.2.1 The local context

The Regional Plan needs to be framed within the policy and circumstance of the local areas covered by the PHN and should be contextualised by:

existing LHN mental health plans or policy imperatives; the timeframe of existing local mental health planning or funding activity; issues facing other sectors within the area which may impact their capacity to engage in

mental health issues; and other local factors of concern to the local community, or consumers and carers, such as

the status of rollout of the NDIS, or key defining local characteristics such as size, rurality or high profile needs such as known high suicide rates or spikes in illicit drug use.

2.2.2 Embedding a stepped care framework within the Regional Plan

PHNs have been working towards establishment of stepped care service delivery through their own commissioning arrangements under the Funding Schedule, and will provide a spectrum of services targeting a range of needs. Embedding this early in the Regional Plan will be vital in order to achieve a balanced approach to service planning, and provide a disciplined approach to considering the spectrum of need from population level prevention through to the need for services of the highest intensity. A stepped care lens can also help PHNs to maintain a focus on early intervention, and avoid a disproportionate focus on high acuity needs and high intensity services. PHNs may wish to:

Consider seeking agreement to a stepped care approach as a foundation principle for the Regional Plan;

Consider embedding the principle of early intervention into the Regional Plan to secure commitment to providing access to services early in the trajectory of disease and for low intensity presentations;

Articulate a local stepped care framework as the basis for service planning, and for identifying service targets and gaps supported by the NMHSPF planning support tools.

2.2.3 Suicide prevention

A Regional Plan is potentially the best way to underscore the imperative to have in place integrated services, well developed pathways for care and follow-up, and communication required to support a coordinated, systems-based approach to suicide prevention. It also offers the potential to identify and address key local factors in suicide prevention which require high level, cross sectoral agreement. Whilst the resources identified in Section 3 provide more detail on the elements of a systems approach to planning for suicide prevention, the Regional Plan may include:

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local protocols identifying who is responsible to provide follow-up to individuals after presentation to health services associated with a suicide attempt, and the minimum level of service which should be provided;

clear and well communicated arrangements for crisis support including phone-based support and acute interventions;

a shared approach to addressing particular regional risk factors for suicide – such as local suicide ‘hot spots’ or other ways of reducing means of suicide, or particular local population groups at heightened risk of suicide including Indigenous groups or individuals with drug and alcohol problems;

cross-sectoral support arrangements in the event of a high profile event or suicide cluster – such as the support which health services should locally provide schools, local employers and others in the event of heightened suicide risk;

commitment to supporting key workforce including GPs and local first responders to identify and be able to support individuals at high risk of suicide; and

arrangements for agile cross service and cross sectoral communication and networking to ensure information sharing, early awareness and action at a community and individual level.

PHNs should develop a suicide prevention plan to articulate in greater detail commitments and local needs and/or may already have such a plan or framework under development. This plan or framework should be cross-referenced in the broader Regional Plan, and ideally should complement it, given the interdependence between mental health service delivery and suicide prevention.

Input from people with lived experience of suicide should be central in the development of the Regional Plan.

The comprehensive resource document commissioned by the Department and prepared by the NHMRC Centre of Research Excellence in Suicide Prevention at the Black Dog Institute, covering suicide prevention planning and commissioning, provides a critical resource for PHNs.11

2.2.4 Aboriginal and Torres Strait Islander mental health and suicide prevention.

A Regional Plan is an opportunity to plan for collaborative action to build protective factors within Indigenous populations and prevent the onset and exacerbation of mental health problems, substance misuse and other problems. The approach to planning Aboriginal and Torres Strait Islander mental health and suicide prevention services through the Regional Plan will be likely to vary enormously across regions.

PHNs will have established relationships with local Aboriginal Community Controlled Health Organisations on which to build the planning process and will have underway new commissioning arrangements for Indigenous mental health and substance misuse as well as suicide prevention. Additionally, PHNs should acknowledge the role of, and engage with jurisdictional Aboriginal Health partnership forums when developing the plan.

11 Black Dog Institute, An evidence-based systems approach to suicide prevention: guidance on planning, commissioning and monitoring. Commonwealth of Australia 2016. Available at http://www.health.gov.au/internet/main/publishing.nsf/content/phn-mental_tools

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Previous guidance from the Department has identified the imperative to better integrate and link drug and alcohol services, suicide prevention, mental health and broader social and emotional wellbeing and mainstream services for Aboriginal and Torres Strait Islander people. PHNs are expected to use the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP) Report as a guide to planning, commissioning and evaluation of suicide prevention initiatives for Aboriginal and Torres Strait Islander people.

Key considerations in development of the Indigenous mental health elements of the Regional Plan also include;

How best can local Indigenous communities and services be engaged in the development and implementation of the Regional Plan?

Are there state or regional Indigenous health or mental health plans or frameworks which should inform priorities?

Are there opportunities to plan for genuinely holistic services which consider a range of needs including the connection to culture, community and country as well as issues such as physical health, substance misuse, social emotional wellbeing and suicide prevention?

Can this be a priority for cross sectoral partnerships to support whole of government solutions, through linking up efforts in areas such as health, education, justice and other mainstream services?

And finally, is there a case for Indigenous suicide prevention to be a key priority in relation to the Regional Plan, and/or an area for system change?

2.2.5 Other special population groups

Other specific population groups may be identified in the process of developing the Regional Plan for whom there is an imperative to design for better service provision. This may include populations at a sub-regional level where, because of remoteness or other reasons, there is a significant service shortfall. It may involve groups which have particular needs that are not met by mainstream mental health services for cultural or other reasons. The Department has not articulated expectations about particular groups in recognition that each PHN is in the best position to know its own populations and their needs. PHNs may wish to consider the following factors in identifying special needs groups:

Is there an evidence base indicating that there is a service gap for this particular group and articulating the nature of the gap?

Are there data on the number of individuals within the group for whom services are needed?

Is there a need for specific services to meet their needs, or can existing services be adapted to meet their needs?

Are there particular groups at greater risk of suicide for whom there is a need to plan mental health and other service delivery?

If the population group involves a particular sub-region, which has significantly different needs and issues to the rest of the region, is there a case for the Regional Plan to be broken down at a sub-regional level?

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2.2.6 Workforce planning

Use of the NMHSPF planning tools will support calculation of robust estimates of the nature and size of the workforce needed to deliver services to the region. Where workforce shortages exist, PHNs may need to seek innovative solutions. Workforce planning offers a significant opportunity for innovative use of the available public and private workforce – and for supporting shared efforts between primary care settings and LHNs to grow particular elements of the workforce through recruitment, training and sometimes reallocation of resources.

In addressing workforce issues in the Regional Plan, PHNs may consider:

Innovative approaches to making the best use of workforce in remote locations or areas of service shortage – for example shared arrangements between mental health nurses and remote health care professionals or, use of Telehealth and digital technologies to enable clinician facilitated treatment to people in isolated areas.

Joined up approaches to training and skill development for regional workforce – for example in areas such as responding to individuals in crisis, or in delivering culturally appropriate services to Indigenous people.

Planning ahead to recruit and retain staff needed for service growth identified in the Regional Plan.

Using evidence and tools from the Regional Plan development process to both identify and communicate the need to reallocate scarce workforce resources from one area to another, where this is necessary.

Ways to optimally use the private mental health workforce – how can services provided through Medicare and private hospitals fit into the overall service plan, and how best might they be complemented.

Whether there are established state-wide referral networks that can support subpopulations identified as being at risk where specialist services are not available in the region.

2.2.7 Drug and alcohol services

The Plan offers an opportunity to address the disconnection between specialist drug and alcohol services, primary care and state mental health services which has presented a problem to people with comorbid mental illness and substance misuse problems, or who are at risk of substance misuse because of mental health problems. There may be opportunities through regional planning to:

Address issues identified in the drug and alcohol needs assessments undertaken by PHNs;

Promote integration between the drug and alcohol and mental health sectors – particularly between primary care and specialist drug services;

Consider provision of integrated services in a single location for people with comorbidity or for other forms of integrated service delivery; and

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Consider provision of integrated local preventive activity associated with reducing the impact of mental illness and substance misuse, given the shared protective factors and the importance to both of early intervention.

2.2.8 Cross sectoral planning

As previously acknowledged, the extent to which PHNs may be able to engage non-health sectors in the development of the Regional Plan will vary. There may be also opportunity through the Regional Plan’s development to:

Support a joined-up approach across sectors to promoting protective factors which prevent and reduce the impact of mental illness and suicide – for example shared strategies for implementing parenting programs or engaging with family support services to plan jointly for service pathways which better support a healthy start to life for children at risk;

Embed links between education, mental health services and related social support, particularly connecting school based mental health professionals with broader networks for purpose of referral, communication and even shared professional development;

Promote and authorise pathways for linking individuals with severe mental illness to psychosocial support and other social services including housing, and embed recognition of the interconnectedness of these needs;

Provide a platform for joint planning arrangements which ensure that the NDIS has appropriate links with mainstream mental health services;

Plan for evidence-based integrated approaches to supporting people with mental illness to gain employment and/or broader vocational support; and

Gain cross sectoral commitment to work together to reduce the risk of suicide.

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3 Resources available to support PHNs in development of the Regional Plan.

3.1 PHN Mental Health Tools and Resources

Resources which can assist PHNs in regional planning are available on the PHN website portal. These include:

The PHN Needs Assessment guide; PHN Commissioning resources – particularly PHN Planning in a Commissioning

Environment – Guide and Resources; PHN Mental Health Circulars, particularly Circular 2 which focuses on planning issues; PHN Mental Health Guidance materials; An evidence-based systems approach to suicide prevention: guidance on planning,

commissioning and monitoring as produced by the Black Dog Institute; PHN mental health data; and The draft Fifth National Mental Health and Suicide Prevention Plan as at 21 October

2016.

In addition to these Department resources, the department has funded the National Centre of Excellence in Mental Health (Orygen) to provide expert, specialist advice and support and guidance to PHNs in their planning and commissioning services for young people with, or at risk of, severe mental illness, in line with evidence-based practice. Tools and Resources are available at Orygen’s website.

3.2 State/Territory mental health plans and frameworks.

PHNs will be aware of their relevant state/territory mental health and suicide prevention plans or frameworks. A summary of these plans is below, although it should be noted that a number of these plans and frameworks are currently being redeveloped or reviewed.

Jurisdiction Mental health plan or strategyNew South Wales Living well – a strategic plan for mental health in NSW 2014–2024,

October 2014Northern Territory Northern Territory mental health service strategic plan 2015–2021, August

2015Queensland Connecting care to recovery 2016–2021: A plan for Queensland’s State-

funded mental health, alcohol and other drug services, October 2016; Queensland mental health, drug and alcohol strategic plan 2014–2019, September 2014

South Australia South Australia’s mental health and wellbeing policy 2010–2015, February 2010; (Mental Health Plan currently under development)

Tasmania Rethink mental health. Better mental health and wellbeing. A long-term plan for mental health in Tasmania 2015–2025, October 2015

Victoria Victoria’s 10-year mental health plan, November 2015Western Australia Western Australian mental health, alcohol and other drug services plan

2015–2025, December 2015Australian Capital Territory

ACT Mental Health and Wellbeing Framework 2015-2025. Mental Health Act 2015, March 2016

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3.3 State/Territory Suicide prevention strategy

Jurisdiction Suicide Prevention Strategy

Australian CapitalTerritory

Let’s talk for suicide prevention, 2016 initiative

Northern Territory NT suicide prevention strategic action plan 2015-2018

New South Wales Proposed suicide prevention framework for NSW 2015-2020

Queensland Queensland suicide prevention action plan 2015-2017

South Australia South Australian suicide prevention strategy 2012-2016

Tasmania Tasmanian suicide prevention strategy 2016-2020;Youth suicide prevention plan for Tasmania 2016-2020; andSuicide Prevention Workforce Development and Training Plan (SPWDTP) for Tasmania 2016-2020

Victoria Victorian suicide prevention framework 2016-2025

Western Australia Suicide prevention 2020 strategy

3.4 Local, state and national data sources to support planning

The following table provides a high level summary of the type of data that can be useful, and where this could be sourced. PHNs will also have collated significant population level and local data as part of their needs assessments.

Data content Description of data How to access this dataSociodemographic data Data on population, cultural

diversity, employment, disability and education status

Demographic data is available on PHN portal

Population health level information

Psychological distress, community connection; social capital measures

State level population health surveys

Prevalence of mental illness

Recent mental health population surveys for adults and children/adolescents

Child/adolescent regional rates are available to PHNs on closed portal.

PHNs will soon receiveregional estimates of prevalence for adults, broken down on same basis as child/adolescent rates.

Suicide and self-harm. suicides. suicide attempts. self-harm data

Suicide ratesSuicide attemptsPresentations to ambulance/hospital after suicide.

ABS Causes of Death \(noting suicide rates for small regions are not available).National Coronial Information System data on intentional self-harm.Regional data on rates of presentation/discharge after suicide attempt or self-harm

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Data content Description of data How to access this datashould be sought from LHNs if not available.Australian Institute of Health and Welfare: Suicide and hospitalised self-harm in Australia; Trends and Analysis

Current service use – mental health services(health sector)

Medicare, PBS, state data PHN NMHDS (MHS)MBS and PBS data is available on the PHN portal.

And Youth mental health services Headspace database.

And Regionally delivered state/territory mental health services

State funded regional service data will generally need to be requested through Local Hospital Networks

And Local private hospital services Private hospitals listed on PHN website

And NGO services provided by Commonwealth and State

Relevant agency or local information

and Indigenous mental health and drug and alcohol services

Also relevant agency or local information

Drug and alcohol services Alcohol and other drug treatment services

NGO Treatment Grants (Commonwealth data)State service data.

and Indigenous drug and alcohol services(Commonwealth and state)

Relevant agency or local information

Service use – other sectors

Disability support/NDISSchool based mental health servicesEmployment services

DSP data (PHN website)NDIS data sourcesDSS/PIR data

Workforce GPsPsychiatristsPsychologistsMental health nursesPeer support workers

Health Workforce Data

3.5 Resources to support planning for suicide prevention

Planning for a regionally appropriate approach to structuring a system for reducing the impact of suicide on the community must be locally driven, but there are a number of national resources to draw upon.

Resource DescriptionRegional approach to suicide prevention, Department of Health

Part of suite of guidance materials Departmental resources supporting planning activity

An evidence-based systems approach to suicide prevention: guidance on planning, commissioning and monitoring,

Guidance for PHNs on evidence based strategies that have been found to prevent suicide. Available on PHN Mental Health Tools and Resources page.

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Resource Descriptionproduced by the Black Dog Institute https://www.blackdoginstitute.org.au/.../evidence.../an-

evidence-based-systems-approach.LIFE Framework A framework for prevention of suicide in Australia

available at the Hunter Institute of Mental Health website.

Communities MatterToolkit developed in partnership between the Mental Health Commission of NSW and Suicide Prevention Australia

Toolkit: Suicide prevention for small towns and local communitieswww.communitiesmatter.com.au

See also reference above to suicide prevention strategies in states/territories at 3.3

3.6 Resources to support planning for Aboriginal and Torres Strait Islander Mental Health and Suicide Prevention

In addition to state and territory frameworks and plans for Indigenous health, the following resources may be of assistance to planning for integrated Indigenous mental health and suicide prevention activity.

Resource Description/ReferenceAboriginal and Torres Strait Islander Mental Health Services

Part of suite of guidance materials provided by Department – see PHN Mental Health Tools and Resources

PHN and ACCHOs – guiding principles Departmental guidance to PHNs on best practice in working with local Aboriginal Controlled Community Health Organisations.

National Aboriginal and Torres Strait Islander Leadership in Mental Health Gayaa Dhuwi (Proud Spirit) Declaration.

Renewed call by Aboriginal and Torres Strait Islander people for linking mental health, social and emotional wellbeing, suicide prevention and substance misuse services Launched August 2015.

Document 3 – Indigenous specific guidance: Drug and alcohol treatment.

Departmental guidance on drug and alcohol treatment for Aboriginal and Torres Strait Islander peoples for all services. Provided to PHNs, Feb 2016

Solutions that work - What the evidence and our people tell us:Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP) Report

The Report summarises the evidence-base for what works in Indigenous community-led suicide prevention, including responses to the social determinants of health that are ‘upstream’ risk factors for suicide. It also presents tools to support Indigenous suicide Prevention activity developed by ATSISPEP.

National Aboriginal and Torres Strait Islander Suicide Prevention Strategy

The National Aboriginal and Torres Strait Islander Suicide Prevention Strategy encompasses the Aboriginal and Torres Strait Islander peoples' holistic view of mental health, physical, cultural and spiritual health and has an early intervention focus that works to build strong communities through more community-focused and integrated approaches to suicide prevention.

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Activities under DevelopmentAboriginal and Torres Strait Islander Social and Emotional Wellbeing FrameworkThe work leading to the renewal of the Aboriginal and Torres Strait Islander Social and Emotional Wellbeing Framework is nearing completion. Links to the resource will be provided following final release.

Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide PreventionThe Australian Government is committed to efforts to prevent suicide in Aboriginal and Torres Strait Islander communities. Through the National Suicide Prevention Leadership and Support Program, the department recently sought applications for the establishment of a Centre of Best Practice in Aboriginal and Torres Strait Suicide Prevention. The Centre will seek to build support and build the capacities of PHNs, Aboriginal and Torres Strait Islander organisations and Aboriginal and Torres Strait Islander communities to take action in response to suicide and self-harm in their immediate region. Details of the selected entity will be provided.

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