The National Mental Health Commission’s
2 Vision 2030; Key Concept Consultation Paper | National Mental Health Commission | 14 November 2019
Purpose
Vision 2030 is a long-term blueprint for a successful, connected and well-functioning mental health
and suicide prevention system meeting the needs of all Australians.
Vision 2030 will be delivered in two phases. The Commission has committed to completing the initial
work in producing the Vision 2030 report before the end of 2019. This will be followed by a
Roadmap to be completed by mid-2020.
The development of the National Mental Health Commission Vision 2030: Key Concepts Consultation
Paper follows a consultation project, Connections, undertaken by the Commission in July –
September 2019 with a wide range of stakeholders including mental health consumers, carers,
government and non-government service providers across 26 communities and online.
This document is intended to share they key concepts of Vision 2030 with those who participated in
Connections consultation meetings in 2019. It is intended for review only by those who participated
in the Connections consultation process and is not for wider distribution.
This document is not intended to represent the final content of the Vision 2030: Blueprint for Mental
Health and Suicide Prevention. All information is given in good faith and believed to be accurate at
the time of release.
Acknowledgement
The National Mental Health Commission gratefully acknowledges the time, effort and insight
provided by all the consumers, carers and professionals who have been involved in sharing their
experience with the Connections Project to inform Vision 2030.
As Vision 2030 seeks to find themes and commonality, some individuals may feel the details of their
own experience are not reflected in this document. We acknowledge that everyone’s story is unique
and that this has an impact on their needs, goals and strengths. Vision 2030 seeks to establish a
person-centred system of mental wellbeing for Australia which has the capacity to acknowledge,
value and respond to the experience of each individual.
Next Steps
Feedback from this consultation will be considered and incorporated as appropriate. Vision 2030 will
be finalised by the end of 2019. In 2020, the National Mental Health Commission, guided by Vision
2030, will engage with states, territories and other key stakeholders to
develop a Roadmap that considers specific steps and strategies, roles,
methods and oversight requirements to enable implementation.
3 Vision 2030; Key Concept Consultation Paper | National Mental Health Commission | 14 November 2019
Connections – A National Conversation about Mental Health Care.
Everyone experiences mental wellbeing and mental ill-health is common. We know that over 4
million Australians in any one year experience mental ill health and need treatment, and a further 6
million could benefit from support for their mental wellbeing.
There have been challenges to achieving effective mental health care. The split of responsibilities
across governments and sectors does not adequately address community care resulting in programs
and services that are disconnected, reactive and do no cover the essential components of care. Data
and capacity to inform local planning and delivery of services has been lacking and difficult to
develop.
Despite these challenges, mental Health is a priority for the federal government and state and
territory governments. Significant investment has been made in mental health and suicide
prevention in recent years resulting in promising initiatives and change. There is an opportunity to
harness this commitment and ensure all components of the system are working together towards a
commonly held Vision for mental health and suicide prevention.
From July – September 2019 the National Mental Health
Commission conducted a consultation about the future
of mental health care, suicide prevention and wellbeing
in Australia. The Commission held 26 Town Hall
meetings and 17 service provider stakeholder meetings;
connecting with over 1,300 individuals including
representatives from approximately 86 organisations.
This was accompanied by an online consultation which
received 2090 responses.
In reviewing the feedback provided during this consultation it is important to note that participants
self-selected to engage with Connections. Their reasons for choosing to participate may influence
their ability to represent all those with mental health concerns in Australia.
The consultations highlighted the diversity of experience, between communities and among
individuals within communities. Many people discussed positive interactions with individual
supports and gave examples of services they hoped to see implemented or expanded. However,
largely people discussed challenges in their current experience.
Information was analysed to identify key themes and consensus about the barriers experienced,
community needs and opportunities to improve the experience of mental health care. The following
themes were consistently raised across the consultations. These themes were used to inform the
development of Vision 2030 Key Concepts.
4 Vision 2030; Key Concept Consultation Paper | National Mental Health Commission | 14 November 2019
Mental health is not well understood and this results in shame, stigma and
discrimination.
There is significant variability in services’ capacity to deliver appropriate, quality care
across the country.
The system creates barriers to identifying need and providing quality care that is
accessible to all.
Individuals experience self-stigma (shame) that decreases their ability to identify concerns and
seek care.
Individuals experience stigma and its consequences within their community.
Individuals experience structural stigma and its consequences in formal settings e.g. service
providers, government, workplaces.
Services are not providing consistent, quality care.
Services are not providing care which is culturally appropriate.
Consumers do not consistently have a voice in their own care, or the development of service
responses to need.
Individuals are not able to access available services.
Individuals have poor experiences that decrease trust.
Care is not financially, geographically or practically accessible.
Services are not available across the spectrum of care when/where people need them – gaps.
Workforce does not have capacity to deliver suitable quality services.
Services are not well coordinated or easily navigable.
Service system does not focus on community-wide prevention and identification.
Mental health is not treated with equality and parity with physical health.
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A Vision for Mental Wellbeing and Care in 2030.
Vision 2030 imagines an Australia in which:
• Everyone is supported to be mentally well.
• Mental health is well understood and there is no shame in acknowledging mental ill health.
• People with mental health issues are respected and able to live a contributing life; working,
studying and engaging in ways that are meaningful to them, without experiencing stigma or
discrimination.
• People with mental ill health have positive life experiences and reach their own potential.
• People suffer less avoidable harm as a result of mental health concerns.
• Communities are at the centre of identifying their needs, designing responses and delivering
care.
• Services are delivered in a well-functioning, integrated system with consistent, appropriate
quality care available across all steps in the spectrum to every individual; right care, right
time, right place
• People with a lived experience have a voice in their own care, and in the design and delivery
of services that support them.
• Mental Health is prioritised by all levels and sectors of government and receives parity and
respect within the broader health system.
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A System to enable effective care. A person-centred system which implements national mechanisms to deliver regionally operated,
community designed and based services that are sufficiently resourced and properly integrated.
Mechanisms for a National System
National Agreement: The system is clearly
defined and implementable through formal
agreement(s) that outline mental health
funding, delivery and outcome responsibilities
for all levels of government.
Leadership: Coordination and monitoring of
diverse local responses to ensure consistency,
quality and effectiveness.
Investment: The system is able to be
delivered sustainably and develop with future
need. Funding is at a level commensurate
with prevalence and cost of mental ill health
and recognises the value of prevention and
early intervention.
National Standards; Clear benchmarks for the
delivery of consistent, quality care. National
standards identify key elements of best
practice from regional design to individual
care and are accompanied by methods for
measurement and reporting.
Community Design and Delivery: Care is
community led. Services are designed and
delivered at a community level with regional
coordination. System includes capability
building and mechanisms for need analysis,
co-design, implementation and evaluation.
Vehicles to Enable Effective Service
Delivery
Data and Information Management: National
collection and sharing of mental health and
social determinants data, at point in time and
longitudinally, to inform current and future
decision-making.
Integration: Shared responsibilities,
connected information and interoperability of
systems within and across sectors to provide
consistent care and enable the sharing of
information in real time.
Multidisciplinary Workforce: Care is
delivered by a diverse workforce that includes
clinicians, peer workers, allied health, primary
health and community support professionals.
Team approaches are taken, including
multidisciplinary teams, co-location, virtual
teams and tertiary consultation.
The workforce is actively recruited,
appropriately trained, retained and
incentivised to take up regional and rural
work.
Those working in other areas of human
service are considered part of the broader
mental health workforce and provided with
training and support appropriate to their role.
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Research and Evaluation: Interventions and
services are evidence-based, effective and
replicable where appropriate. Research is
translated to practice in a timely way.
Priority Populations: The needs of vulnerable
people are met in ways that are safe and
meaningful to them. Services are delivered by
providers able to demonstrate their capacity
to understand and meet these needs.
These groups include but are not limited to:
Aboriginal and Torres Strait Islanders,
veterans, those from culturally and
linguistically diverse communities, those who
have experienced crisis or natural disaster,
and those who identify as LGBTIQ+.
Age Streams: Services are provided as early as
possible in a developmentally appropriate
way and are streamed to focus on the needs
of children, young people, general adult
populations and older Australians.
Focusing on Outcomes
The mental health system will focus not only
on outputs but on the outcomes delivered for
individuals, families and communities. A cycle
of continuous improvement and integration of
emerging evidence is key to a long term
approach to mental health care.
Measurement and information:
National and/or comparable datasets
on mental health attitudes,
treatment and outcomes as well as
related health and wellbeing
outcomes in physical health,
housing, employment, education,
child protection and justice.
Monitoring and accountability:
Methods for demonstrating
achievement of standards and
agreed outcomes and reporting on
these. Monitoring of implementation
of agreements and community-led
approaches is regularly undertaken.
Evaluation and research: Program
and policy evaluation is an
appropriately resourced
requirement. Research is focused on
innovation and emerging evidence as
well as translation and real world
effectiveness.
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Delivery of the Essential Components of Care
Stepped Care takes a person centred
approach, acknowledging the
interactions between steps and the
services which span individual steps
including:
community/welfare supports
primary healthcare
connection/navigation supports
recovery psychosocial care
care planning/case coordination.
Separate steps prioritise wellbeing,
carer support and crisis intervention
regardless of the intensity of ongoing
care needs.
There are a range of essential components of care to be delivered under these steps.
Prevention; universal programs that promote
mental wellness and address social
determinants and risk factors targeting
community environments including education
and workplace settings. Communication
strategies address stigma and understanding
to decrease distress and promote acceptance
and early help-seeking.
Screening and Assessment; universal
screening at key touchpoints throughout the
lifespan including, early childhood, parenting,
starting primary and secondary school,
retirement, registration of a death, applying
for income benefits. Opportunities for
assessment included in navigation and front
line services.
Psychoeducation/Information and Self-
guided Care; easily accessible and well-
advertised low intensity packages of
information and self-guided interventions to
address mild concerns, enable early help
seeking and entry into other treatments.
Early Intervention; coordinated
multidisciplinary care programs provided early
in onset or period of mental health concerns.
These may be general or diagnosis specific.
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Connection and Coordination; universal
services providing general navigation and
connection to appropriate care for everyone
and care planning and coordination for those
with more complex needs.
General Psychological Interventions; range of
therapies provided or supported by suitably
qualified practitioners to meet mild to
moderate needs.
Specialist Psychological Interventions; range
of therapies provided by suitably qualified
clinicians to meet moderate to high needs.
Occupational Rehabilitation and Recovery;
services which provide supports to enable
recovery and independence with a focus on
individual goals and strengths.
Psychosocial Engagement and Support;
services which engage individuals and connect
them with peers and community in ways that
are meaningful to them, providing positive life
experiences and reducing isolation.
Intensive Team Care; coordinated
multidisciplinary care programs provided to
those with complex and/or high intensity
needs.
In-patient and Residential; 24/7 intensive
care for all who need it. This could be
delivered in a community, home-like setting
or hospital setting.
Crisis Resolution; services based in the
community which respond to mental health
crisis situations. This includes provision of
tertiary suicide prevention, consultation and
support to first responders, delivery of crisis
response services in community hubs and at
home and after care services.
Emergency; mental health presentations
receive timely assessment and response in a
suitable environment, cared for by staff with
training in mental health.
Carer Supports; services that provide
psychological and psychosocial support and
respite specific to the needs of carers.
There are many ways these essential components of care can be delivered to meet each individual
community’s capacities, needs and strengths. The choice of delivery method may relate to
appropriateness, suitability, the needs of individual and communities, geography and availability,
intensity, cost and consistency. Using a multimethod approach at each level of care can ensure the
lowest restrictive setting possible. Methods for delivering care include:
Digital and telehealth; services that utilise technology in their delivery.
Community Hubs; coordinated delivery of mental health care in single service centres
Community integrated; services delivered using organisations, services and spaces that are
already operating in a community for example schools, local government community spaces.
Professional Practices; individual professionals providing care in private and public practices
Home and flexible; care delivered in the home or other flexible locations
Residential; community home-like environments providing 24/7 care and support.
Hospital; emergency, general medical and mental health in-patient care.
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Taking a Balanced Community-based Approach.
While there was a clear plan for the shift away from institutional care for people with mental illness,
there has not been as clear a vision for development of community approaches to meet the needs
that resulted.
Central to Vision 2030 is a revision of the mental health and suicide prevention system towards a
cohesive community-based approach.
Balanced Community-Based Care means that everyone has access to care in their community in the
least restrictive environment possible. This enables safe recovery while supporting a person’s
connections to family, culture, social supports, work, education and community. It puts the person
at the centre of the process.
This approach is not about one type of care, or one type of service, but about the way that we
deliver all aspects of prevention, assessment, treatment and recovery.