Assessment 2: Individual Written Report (30%) Due Date: Week 8Students are required to submit a written report on the introduction and effect of one (1) Australian social policy. Word Count: 1000-1200 words▪ Identify and describe one social policy that has been introduced by the Australia government▪ Discuss the history and reasons behind the social policy change as well as examine the effects and impacts of the change within Australian societyYour written journal should include at least 5 (scholarly) journal articles read, in addition to any textbook references. The format of your report will be discussed in greater detail during tutorials.Do NOT utilise sources such as www.tutor2u.com and other such web materials as these in no way constitute academic references for the purpose of your assignments. If you rely on such sources for theoretical support you will be deemed NOT to have met the requirements of the assessment.
Mental health in Australia: a quick guide ISSN 2203-5249 RESEARCH PAPER SERIES, 2018–19 14 FEBRUARY 2019 Mental health in Australia: a quick guide Lauren Cook Social Policy Section Introduction According to the World Health Organization, mental health is ‘a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. ’ When a person has a condition that affects their mental health, they may have a mental illness or mental health disorder. This includes conditions such as depression, anxiety, schizophrenia and bipolar disorder. In Australia, the framework for mental health services is a highly complex mixture of public and private systems, with funding shared between the Australian, state and territory governments, individuals and private health insurers. This quick guide provides an overview of mental health in Australia, including the prevalence of mental health conditions, the cost of mental illness, government responsibilities, and mental health services available in Australia. Prevalence of mental health conditions The Australian Bureau of Statistics (ABS) National Survey of Mental Health and Wellbeing (NSMHWB) provides the most comprehensive (albeit dated) estimates for mental disorders in Australian adults both over their lifetime and in the preceding 12 months. The survey estimated that 45 per cent of Australians had experienced a mental disorder in their lifetime, with 20 per cent experiencing a mental disorder in the previous year. Conducted in 2007, this was the second ABS mental health and wellbeing survey, with the first survey conducted in 1997. The Department of Health has said that there are no plans to fund another survey on mental health by the ABS. In addition to the NSMHWB, the following sources provide an indication of the prevalence and impact of mental health conditions in Australia: • The most recent ABS National Health Survey estimated there were 4.8 million Australians (20.1 per cent) with a mental or behavioural condition in 2017–18. This was an increase of 2.6 percentage points from 2014–15, mainly due to an increase in the number of people reporting anxiety-related conditions, depression, or feelings of depression. While this is the https://www.who.int/features/factfiles/mental_health/en/ https://www.healthdirect.gov.au/mental-health-disorders https://www.healthdirect.gov.au/mental-health-disorders http://www.abs.gov.au/AUSSTATS/
[email protected]/Lookup/4326.0Main+Features32007?OpenDocument https://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;query=Id%3A%22committees%2Festimate%2F85178966-bdae-4a37-982c-5a847f8e63c1%2F0004%22 http://www.abs.gov.au/ausstats/
[email protected]/Lookup/by%20Subject/4364.0.55.001%7E2017-18%7EMain%20Features%7EMental%20and%20behavioural%20conditions%7E70 Mental health in Australia: a quick guide 2 most recent available data for mental health prevalence in Australia, it only provides data on people who currently identify as having mental or behavioural conditions, and does not provide data on lifetime prevalence or incidence of mental illness in the past year. • The Australian Child and Adolescent Survey of Mental Health and Wellbeing, conducted between June 2013 and April 2014 by the Department of Health, estimated that almost 14 per cent of young people aged 4 to 17 years (or 560,000 people) experienced a mental disorder in the 12 months before the survey. • Poor mental health may also be associated with suicidality. According to the ABS, 3,128 people died in Australia from intentional self-harm in 2017, rising from 2,866 in 2016. While suicidality is not confined solely to people with poor mental health, the NSMHWB estimated that 94.2 per cent of persons who attempted suicide in the previous 12 months had experienced a mental disorder in the same time period. • According to the Australian Institute of Health and Welfare’s (AIHW) Burden of Disease Study, in 2011 the Australian population lost a total of 542,554 years of healthy life as a result of mental and substance use disorders. This accounted for 12.1 per cent of the total burden of disease, making mental and substance use abuse disorders the third highest cause of burden in Australia. Cost of mental illness in Australia Economic impact A report commissioned by the Royal Australian & New Zealand College of Psychiatrists (RANZCP) estimated in 2014 that the cost of severe mental illness in Australia was $56.7 billion per year. This includes the direct economic costs of severe mental illness arising from the use of health and other services, as well as indirect costs due to lost productivity because people are unable to work. Similarly, in December 2016, the National Mental Health Commission stated that the cost of mental ill-health in Australia each year was around $4,000 per person, or $60 billion in total. The 2018 KPMG and Mental Health Australia report, Investing to Save, looked at how much mental ill-health in the workplace costs Australian employers. The report found that, mental ill-health in the workplace costs an average of $3,200 per employee with mental illness, and up to $5,600 for employees with severe mental illness. Overall, it was estimated that the cost of workplace mental ill-health in Australia was $12.8 billion in 2015–16. Spending on mental health services The Australian Institute of Health and Welfare (AIHW) estimates that spending on mental health- related services in Australia from all sources (government and non-government) was around $9.0 billion, or $373 per person, in 2015–16. Of the $9.0 billion, $5.4 billion (59.8 per cent) was funded by state and territory governments, $3.1 billion (35.0 per cent) was funded by the Australian Government, and $466 million (5.2 per cent) was funded by private health insurance funds. In 2016–17, the Australian Government spent: • $1.2 billion on Medicare-subsidised mental health-specific services ($49 per person) and • $511 million on mental health-related subsidised prescriptions under the Pharmaceutical Benefits Scheme (PBS) and the Repatriation Pharmaceutical Benefits Scheme (RPBS) ($21 per person). https://www.health.gov.au/internet/main/publishing.nsf/Content/9DA8CA21306FE6EDCA257E2700016945/$File/child2.pdf http://www.abs.gov.au/ausstats/
[email protected]/Lookup/by%20Subject/3303.0%7E2017%7EMain%20Features%7EIntentional%20self-harm,%20key%20characteristics%7E3 http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/6AE6DA447F985FC2CA2574EA00122BD6/$File/National%20Survey%20of%20Mental%20Health%20and%20Wellbeing%20Summary%20of%20Results.pdf https://www.aihw.gov.au/getmedia/d4df9251-c4b6-452f-a877-8370b6124219/19663.pdf.aspx?inline=true https://www.aihw.gov.au/reports/burden-of-disease/abds-impact-and-causes-of-illness-death-2011/contents/summary https://www.aihw.gov.au/reports/burden-of-disease/abds-impact-and-causes-of-illness-death-2011/contents/summary https://www.ranzcp.org/Files/Publications/RANZCP-Serious-Mental-Illness.aspx http://www.mentalhealthcommission.gov.au/media-centre/news/economics-of-mental-health-in-australia.aspx https://mhaustralia.org/publication/investing-save-kpmg-and-mental-health-australia-report-may-2018 https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/report-contents/expenditure-on-mental-health-related-services?request=smoothstate https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/report-contents/expenditure-on-mental-health-related-services/australian-government-expenditure Mental health in Australia: a quick guide 3 Government responsibility for mental health services Responsibility for funding and regulating mental health services in Australia is shared between the Australian and state and territory governments. However, as noted in the Parliamentary Library publication, Health in Australia: a Quick Guide, their respective roles are not always clear. Below is a broad outline of government responsibility for mental health services in Australia. Australian Government • Medicare-subsidised mental health services provided by general practitioners (GPs), psychiatrists, and allied health professionals (for example, through the Better Access initiative) • subsidised mental health prescription medications under the PBS and Repatriation Pharmaceutical Benefits Scheme (RPBS) • veterans’ mental health services through the Department of Veterans’ Affairs • primary care quality and access through Primary Health Networks (PHNS), including funding the PHN Primary Mental Health Care Flexible Funding Pool and • social security payments; for example, the Disability Support Pension. State and territory governments • management and administration of public hospitals and • funding and management of community mental health services. Shared responsibility On 4 August 2017, the Council of Australian Governments (COAG) agreed to the Fifth National Mental Health and Suicide Prevention Plan, which established a national approach for collaborative government effort from 2017 to 2022. Additional shared arrangements are usually detailed in national agreements, such as those agreed to by COAG, and include: • funding of public hospital services based on an agreed national activity-based funding (ABF) formula as outlined in the National Health Reform Agreement • registration and accreditation of mental health professionals through the Australian Health Practitioner Regulation fAgency (AHPRA) • the National Disability Insurance Scheme • homelessness as outlined in the National Housing and Homelessness Agreement and • suicide prevention (a National Partnership Agreement is in development). Mental health services Medicare-subsidised services In Australia, mental health services provided by GPs, psychiatrists, psychologists, occupational therapists and social workers may be subsidised through Medicare. General practitioners According to the Bettering the Evaluation and Care of Health (BEACH) survey of GPs, 12.4 per cent of GP encounters (or 17.7 million separate encounters) in 2015–16 involved the management of psychological problems, such as depression, anxiety and sleep disturbance. This is much higher https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp1819/Quick_Guides/HealthAust https://www.humanservices.gov.au/individuals/medicare http://www.health.gov.au/mentalhealth-betteraccess http://www.pbs.gov.au/pbs/home https://www.pbs.gov.au/browse/rpbs https://www.pbs.gov.au/browse/rpbs https://www.dva.gov.au/health-and-wellbeing/mental-health http://www.health.gov.au/internet/main/publishing.nsf/Content/PHN-Home http://www.health.gov.au/internet/main/publishing.nsf/content/phn-mental_tools https://www.humanservices.gov.au/individuals/services/centrelink/disability-support-pension https://www.healthdirect.gov.au/community-mental-health-services http://www.coaghealthcouncil.gov.au/Portals/0/Fifth%20National%20Mental%20Health%20and%20Suicide%20Prevention%20Plan.pdf http://www.coaghealthcouncil.gov.au/Portals/0/Fifth%20National%20Mental%20Health%20and%20Suicide%20Prevention%20Plan.pdf https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp1819/Quick_Guides/FundingPH https://www.ihpa.gov.au/what-we-do/activity-based-funding http://www.federalfinancialrelations.gov.au/content/npa/health/_archive/national-agreement.pdf http://www.ahpra.gov.au/About-AHPRA/What-We-Do.aspx http://www.ahpra.gov.au/About-AHPRA/What-We-Do.aspx https://www.ndis.gov.au/understanding/how-ndis-works/mental-health-and-ndis http://www.federalfinancialrelations.gov.au/content/housing_homelessness_agreement.aspx http://www.health.gov.au/internet/budget/publishing.nsf/Content/budget2017-factsheet30.htm https://ses.library.usyd.edu.au/bitstream/2123/15514/5/9781743325148_ONLINE.pdf Mental health in Australia: a quick guide 4 than the 3.2 million GP mental health-specific Medicare Benefits Schedule (MBS) items (MBS Group A20) that were billed by GPs in 2015–16, indicating that GPs likely billed many of these encounters as general MBS items. Psychiatrists Under Medicare, rebates are available for consultations with psychiatrists. In 2017–18, there were 2.4 million MBS items billed by psychiatrists (MBS Group A8). According to the AIHW, psychiatrists provide the highest number of services per patient (in 2016–17, 6.2 services per patient) of all mental health-related services. Allied health professionals Under the Better Access initiative, Medicare rebates are available for up to ten individual and ten group allied health services per year to patients with a mental disorder who are referred by a GP, psychiatrist or paediatrician. The table below outlines the number of mental health-related services that were billed under Medicare by allied health professionals in 2017–18. Medicare benefits claimed under the Better Access initiative, 2017–2018. Professional MBS Items Services billed Clinical psychologist 80000, 80001, 80005, 80010, 80011, 80015, 80020, 80021 2,302,682 Registered psychologist 80100, 80101, 80105, 80110, 80111, 80115, 80120, 80121 2,855,039 Occupational therapist 80125, 80126, 80130, 80135, 80136, 80140, 80145, 80146 72,966 Social worker 80150, 80151, 80155, 80160