A five-year plan (2021-2026) to improve mental health, suicide prevention and alcohol and other drug treatment services in Western Queensland

A five-year plan (2021-2026) to improve mental health, suicide prevention and alcohol and other drug treatment services in Western Queensland

A five-year plan (2021-2026) to improve
       mental health, suicide prevention
   and alcohol and other drug treatment
        services in Western Queensland

                                    Sponsored by:
                              Western Queensland
                           Primary Health Network,
                                Central West HHS,
                              North West HHS and
                                  South West HHS

                              WESTERN QUEENSLAND
                           An Australian Government Initiative
A five-year plan (2021-2026) to improve mental health, suicide prevention and alcohol and other drug treatment services in Western Queensland
For inclusion in version 2 February 2021

A five-year plan (2021-2026) to improve mental health, suicide prevention and alcohol and other drug treatment services in Western Queensland
Forward 							2                                              Part B: Delivering change					27
List of acronyms						4                                       1. Building a connected and person-centred care sector		   28
Executive summary						5                                      2. Proactive prevention and early intervention			          31
Gayaa Dhuwi (Proud Spirit) declaration			                6    3. Promote and protect mental health and wellbeing
                                                              across the lifespan						34
How mental health impacts us					                        7
                                                              4. Supporting Aboriginal and Torres Strait Islander
Our plan							8
                                                              social, emotional and cultural wellbeing				               37
 State and national policy context				                   9
                                                              5. Strengthen and integrate alcohol and other drug
 Challenges and opportunities					10                          treatment and harm reduction within a stepped
                                                              care framework						40
 Developing this plan						13
                                                              6. Making suicide prevention everyone’s business		         45
 Summary of findings						15
                                                              7. Coordinating treatment and support for people who
 Our population						18                                       experience severe and complex mental health			             47
Part A: Transforming mental health care			               22   8. Building workforce capability and grassroots
                                                              training opportunities						50
 Place-based, co-designed planning approach 			          23
                                                              9. Responding to climatic extremes and these impacts
 The Western Queensland Health Care Home Model of Care   24   within rural and remote communities				                    53
 Stepped Care Framework for mental health services 		    25
                                                              Part C: Measuring change					56
 Making safety and quality central to mental health
 service delivery						26                                     Reporting and measuring progress				                       56
 Addressing stigma and discrimination				                26   Implementing the Plan					56
                                                              Performance monitoring indicators				57

                                                              Bibliography							58

A five-year plan (2021-2026) to improve mental health, suicide prevention and alcohol and other drug treatment services in Western Queensland
List of acronyms
ABS 		      Australian Bureau of Statistics                           MHNIP 		   Mental Health Nurse Incentive Program
ACCHO       Aboriginal Community Controlled Health Organisation       MHSPAOD    Mental Health Suicide Prevention, Alcohol and Other Drugs
ACCHS       Aboriginal Community Controlled Health Service            MICRRH     Mount Isa Centre for Rural and Remote Health
AEDC 		     Australian Early Development Census                       NDSS 		    National Diabetes Services Scheme
AIHW 		     Australian Institute of Health and Welfare                NGO 		     Non-Government Organisation
AHPRA       Australian Health Practitioner Regulation Agency          NHPA		     National Health Performance Authority
AOD		       Alcohol and Other Drugs                                   NMHSS      Nukal Murra Health Support Service
ASR 		      Age Standardised Rate                                     NMHSPF     National Mental Health Service Planning Framework
ATAPS 		    Access to Allied Psychological Services                   NWHHS      North West Hospital and Health Service
BAP         Better Access Program                                     NWRH 		    New Ways Real Health
CACH 		     Cunnamulla Aboriginal Corporation for Health              PBS 		     Pharmaceutical Benefits Scheme
CWHHS       Central West Hospital and Health Service                  PHIDU 		   Public Health Information Development Unit
COPD 		     Chronic Obstructive Pulmonary Disease                     PHN 		     Primary Health Network
CWAATSICH   Charleville and Western Areas Aboriginal and Torres 			   PP 		      Private Practice
		          Strait Islander Community Health                          RACF 		    Residential Aged Care Facility
CWHHS       Central West Hospital and Health Service                  RFDS 		    Royal Flying Doctor Service
ED 		       Emergency Department                                      SA2 		     Statistical Area Level 2
EPC 		      Enhanced Primary Care                                     SD 		      Statistical Division
FTE 		      Full Time Equivalent                                      SEIFA 		   Socio-Economic Indexes for Areas
GP 		       General Practitioner                                      SMO 		     Senior Medical Officer
HNA 		      Health Needs Assessment                                   SWHHS      South West Hospital and Health Service
HHS 		      Hospital and Health Service                               WQPHN      Western Queensland Primary Health Network
IRSD 		     Index of Relative Social-Economic Disadvantage            WQHSIC     Western Queensland Health Service Integration Committee
LGA 		      Local Government Area                                     WQ HCH     Western Queensland Health Care Home
LGBTIQ+     Lesbian, gay, bisexual, transgender, intersex,            QLD 		     Queensland
people		    and/or queer people
MBS 		      Medicare Benefits Scheme

A five-year plan (2021-2026) to improve mental health, suicide prevention and alcohol and other drug treatment services in Western Queensland
Executive summary


An Australian Government Initiative

A five-year plan (2021-2026) to improve mental health, suicide prevention and alcohol and other drug treatment services in Western Queensland
Gayaa Dhuwi (Proud             On 27 August 2015, the National Aboriginal and Torres Strait Islander Leadership in Mental Health
                               launched the Gayaa Dhuwi (Proud Spirit) declaration.
Spirit) declaration            This declaration sets out five themes that are central to the development and implementation of the Fifth
                               National Mental Health and Suicide Prevention Plan and the Western Queensland Social, Emotional and
                               Cultural Wellbeing Plan.

We are committed to working    1.   Aboriginal and Torres Strait Islander concepts of social and emotional wellbeing, mental health and
                                    healing should be recognised across all parts of the Australian mental health system, and in some
with Aboriginal and Torres          circumstances support specialised areas of practice.
Strait Islanders leaders to
                               2.   Aboriginal and Torres Strait Islander concepts of social and emotional wellbeing, mental health and
ensure Australia’s mental           healing combined with clinical perspectives will make the greatest contribution to the achievement of
health system achieves the          the highest attainable standard of mental health and suicide prevention outcomes for Aboriginal and
                                    Torres Strait Islander peoples.
highest attainable standard
of mental health and suicide   3.   Aboriginal and Torres Strait Islander values-based social and emotional wellbeing and mental health
                                    outcome measures in combination with clinical outcome measures should guide the assessment of
prevention outcomes for             mental health and suicide prevention services and programs for Aboriginal and Torres Strait
Aboriginal and Torres Strait        Islander peoples.

Islander peoples               4.   Aboriginal and Torres Strait Islander presence and leadership is required across all parts of the
                                    Australian mental health system for it to adapt to, and be accountable to, Aboriginal and Torres Strait
                                    Islander peoples for the achievement of the highest attainable standard of mental health and suicide
                                    prevention outcomes.

                               5.   Aboriginal and Torres Strait Islander leaders should be supported and valued to be visible and
                                    influential across all parts of the Australian mental health system.

A five-year plan (2021-2026) to improve mental health, suicide prevention and alcohol and other drug treatment services in Western Queensland
How mental
                                                                                      1 in 4
                                                     Neary half of all Australians                  (25%) of young adults
health impacts us                                    will experience mental health                  aged between 16 and 24
                                                     issues in their lifetime                       will experience mental
Over the course of our lifetime,                                                                    health issues2
every one of us will be touched by
mental health, suicide and alcohol
and other drug (AOD) issues.                     Mental health can be                               One in five (20%)
                                                                                                    Australians will experience
Getting the right type of support at
the right time is essential to improve
                                                affected by genetics,
                                          lifestyle and environment
                                                                                        20%         a common mental disorder
the mental health and wellbeing of                                                                  over a 12 month period2
our communities.

We all play a role in recognising the                Social problems include
triggers and warning signs of mental                                                  People living in low socio-economic
                                                     poverty, unemployment,
health issues in order to access                                                       areas are 1.4 times more likely
support for ourselves along with                     homelessness, isolation
                                                                                             to have mental health issues2
supporting friends, neighbours and                   and stigma
families to seek help.

All of have a responsibility to
promote protective factors for good      In Western Queensland                                  In Western Queensland
mental health and wellbeing, and to      people present to emergency                            risky alcohol consumption is
support the most vulnerable in our       departments with mental                                1.4 times more common than in
communities, including children
and young people whose future            health issues 1.6 times more                           other parts of Queensland3
health and wellbeing relies on the       than the rest of Queensland1
people around them, and access
to services.

                                                     Suicide and self-inflicted
                                                     injury rates are twice as high
                                                     in Western Queensland than
                                                     the rest of Australia2

A five-year plan (2021-2026) to improve mental health, suicide prevention and alcohol and other drug treatment services in Western Queensland
Our plan
                                                                The Plan
This comprehensive five year Mental
Health Suicide Prevention and             Regional approach for collaborative action on mental health
Alcohol and Other Drug (MHSPAOD)                            and related services.
Plan (herein known as the ‘Plan’) is a
refresh of the first Plan (2017-2020).
                                         Consumers, carers, people with a lived experience
Our Plan has been developed
using a co-design process with our
partners and other key parties who
have committed to working together              WQPHN Consortium representatives
to achieve better health and social              WQPHN
outcomes in Western Queensland                                               Nukal Murra Alliance
                                              North West HHS                 Health care providers
through integration in planning,
service delivery and evaluation.              Central West HHS                    Clinicians
                                              South West HHS                     Consumers
Importantly, it incorporates the ideas
and feedback from consumers, carers
and people with a lived experience.
                                                            Key stakeholders
The Plan sets out shared objectives,         Local government                    Peak bodies
an agreed set of actions and key          General Practice Networks
responsibilities to address priority                                         Health care providers
                                           Aboriginal and Islander           WQPHN Clinical and
areas. It includes a regional approach   Community Controlled Health
for collaborative action to improve         Services (AICCHSs)               Consumer Councils
integrated mental health and
related services.
                                                  Western Queensland Community

A five-year plan (2021-2026) to improve mental health, suicide prevention and alcohol and other drug treatment services in Western Queensland
State and national policy context
Our Plan builds upon the Fifth National Mental           Strategy and National Natural Disaster Mental
Health Plan 2017-2022 (Fifth Plan), existing state and   Health Framework.
commonwealth MHSPAOD services along with the
national health and mental health reforms.4              The Plan was developed following engagement
                                                         with target groups such as consumers with severe
It incorporates reform and system transformation         psychosocial disability and alcohol and other drugs
recommended by the PHN Advisory Panel on                 (AOD) services, to strengthen their interface with
Mental Health and also considers a range of state and    the National Disability Insurance Scheme (NDIS)
national mental health and suicide prevention policy     as mental health reforms are implemented across
reviews including:                                       communities.
y Productivity Commission, Mental Health
                                                         Finally, it has been shaped within the context of
  Inquiry Report5
                                                         Queensland Government’s Connecting Care to
y The National Drug Strategy 2017-20266                  Recovery 2016-2021 Plan9 for state funded mental
                                                         health, alcohol and other drug services, and within the
y The Queensland Mental Health Commission’s
                                                         vision of My health, Queensland’s future: Advancing
  (QMHC) Shifting Minds7 and Every Life
                                                         health 2026.10
  Strategic Plan.8
                                                         Our goals and vision align to create a system that
This is a dynamic Plan that will be regularly reviewed
                                                         works better for individuals, families and communities
and updated to ensure inclusiveness of contemporary
                                                         by strengthening collaboration and promoting
material such as the Productivity Commission, the
                                                         effective integration, thus enabling better connected
National Mental Health Commission releases, the
                                                         care and recovery oriented services.
National Children’s Mental Health and Wellbeing

A five-year plan (2021-2026) to improve mental health, suicide prevention and alcohol and other drug treatment services in Western Queensland
Challenges and opportunities
Challenges of delivering mental health
care in Western Queensland
Positive social, emotional and cultural wellbeing is
important for all people and communities in Western
Queensland. Yet the impact of mental ill health,
problematic AOD use and suicide across the region
presents many challenges.

A significant number of people in Western Queensland
continue to experience social dislocation, economic
hardship and isolation which contributes to poor
mental health and risky AOD use, with the impacts
going far beyond the health sector.

There is significant health disparity and gaps in
access to services and economic participation for the
most vulnerable and at-risk populations for Western
Queensland compared to city or urban regions.5; 11

Vulnerable communities
While there are pockets of social and economic advantage, large areas of
Western Queensland experience extreme disadvantage compounded by
social determinants which result in high levels of mental health issues or
distress, suicide and problematic relationship with AOD use.

The health workforce

The Western Queensland health workforce is predominately generalist in
nature. This presents a challenge in providing integrated, specialised and
holistic care.

Transient populations with high need

In Western Queensland, there are significant numbers of fly-in/fly-out
workers (FIFO), seasonal workers and tourists (particularly grey nomads)
leading to skyrocketing demands for health services during the
peak seasons.

Geographical challenges

Western Queensland’s vast landscape means people travel long distances
to access services. Many experience factors that contribute to increased
mental health risk including:12

y Geographical isolation
y Telecommunication constraints
y Poor access to public transport
y Extreme weather conditions such as flood and drought
y A small population spread across widely dispersed communities.

Opportunities for improving mental health            The region’s AICCHO sector has been strengthened       Partnerships
                                                     through the Nukal Murra Alliance improved social
care in Western Queensland                           and emotional wellbeing which provides significant     Continue building on local, regional and state
                                                     cultural leadership capacity and change needed to      collaborations and partnerships to support
Western Queensland’s MHSPAOD system has              address entrenched mental health-related stigma,       improvements and momentum to achieving
undergone significant transformation including.13    shame and discrimination for First Nations people in   better mental health and wellbeing outcomes for
                                                     the region.14                                          Western Queenslanders.
y Emphasis on recovery-oriented practice and
  widespread adoption of harm minimisation
                                                     Other opportunities for reform                         Western Queensland Foundation Plan
y Increased focus on creating pathways for
  consumers, carers and people with a lived          Place-based approaches                                 The Western Queensland Foundation Plan has
  experience to participate, influence and lead                                                             positioned the sector well to consolidate and build on
  co-design of a better mental health system for     Continue adoption of place-based approaches            the important ground work in the MHSPAOD space
  Western Queensland.                                to harness the strengths and enable communities        and lead reform across our region. Learnings and
                                                     to lead and support their own wellbeing including      recommendations from the Foundation Plan have
There has also been a shift away from siloed,        wrapping care around the people who need it most.      helped shape this Plan.
organisational centric care to a focus on a better
integrated and coordinated primary mental health
system of care.

Developing this plan
Review of the Foundation MHSPAOD Plan
WQPHN contracted the Substance Use and Mental
Health Unit at the Centre for Health Services Research
at The University of Queensland to conduct an
independent evaluation of the foundation MHSPAOD
Plan 2017-2020.12 Areas of evaluation included
implementation, effectiveness, achievements,
strengths and areas for improvement.

The evaluation consisted of semi-structured interviews
with key informants involved in a variety of roles related
to the planning or delivery of mental health services
across Western Queensland. The findings of this
evaluation have informed the direction and objectives
of this Plan.

Summary of findings
Areas of strength                                        Areas of potential improvement                     Recommendations

Overall, the majority of key informants were highly      While the majority of key informants praised the   1.   The development of a complementary
complementary of the Plan’s implementation (in           implementation and content of the Plan, key             communication strategy
particular its focus on place-based implementation       informants also highlighted areas of potential
                                                                                                            2.   The development of a complementary
and stakeholder input), and emphasis on                  improvement for the 2021-2026 Plan in the
                                                                                                                 implementation plan
collaboration, co-design, team care, cross referrals,    following areas:
and consumer input.                                                                                         3.   Formation of a new Consortium for the
                                                         y Greater distinction of:                               2021-2026 Plan
In particular, most key informants recognised the          ▸ Implementation milestones                      4.   Inclusion of an executive summary at the
WQPHN’s significant efforts in co-designing and             ▸ Service use characteristics                        beginning of the document
implementing an innovative Plan that represents
substantial progress in improving the mental health         ▸ Visibility of cross referrals                 5.   Further explanation of the Stepped Care model
and wellbeing of Western Queensland’s residents.                                                            6.   Review of the Plan by the Consumer
                                                            ▸ Improved mental health outcomes among
                                                              priority populations                               Advisory Council
Most key informants perceived that the Plan had a
strong focus on promoting consumers’ and service            ▸ Involvement of Aboriginal and Torres Strait   7.   Distribution of written and multimedia material
providers’ awareness of Western Queensland’s                  Islander people in the Plan’s design and           promoting the Plan
MHSPAOD Services across the continuum of care,                implementation                                8.   Host in-person and online workshops/training
and a promotion of General Practice settings as key                                                              introducing new Plan
                                                         y Utility and effectiveness of Stepped
providers of mental health care.
                                                           Care model                                       9.   Review and implementation of Patient Reported
The majority of key informants believed the Plan         y Involvement and activities of the Consumer            Experience Measures (PREMs) and Patient
had a clear focus on addressing existing disparities       Advisory Council                                      Reported Outcome Measures (PROMs) systems
in mental health support targeted at Aboriginal and                                                         10. As part of communication strategy, regular
                                                         y How to measure relevant outcomes
Torres Strait Islander and other priority populations.                                                          progress updates
In particular, several key informants commended the      y Occasional lack of integration, communication
Nukal Murra Alliance for allowing the perspectives         and collaboration between various agencies       11. Continued hosting of mental health round tables
of Aboriginal and Torres Strait Islander-led health        and services                                     12. Ongoing seminars to disseminate
services in creating and implementing the Plan.                                                                 data-driven updates.
                                                         y Lack of understanding of some aspects of the
                                                           Stepped Care model
Finally, the majority strongly endorsed the Plan’s
focus on integration of the Stepped Care model, in       y Lack of opportunities for consumer feedback.
particular the model’s promotion of cross-referral
between services.

Western Queensland Stewardship
The Western Queensland Health Service Integration Committee
(WQHSIC) has provided overarching stewardship for this Plan’s   The Western Queensland
development and will provide ongoing support for its approval   Consortium brings together
and implementation under the Maranoa Accord.                    stakeholders and consumer
                                                                representatives who have
Plan sponsors                                                   considered contemporary
                                                                evidence, Commonwealth and
y WQPHN                                                         Queensland policies and our
y North West HHS                                                unique local context in order
                                                                to consider joint approaches
y Central West HHS                                              that leverage from integrated
y South West HHS.                                               care, stepped care and joint
Plan partners
                                                                Our Plan is a road map
y Nukal Murra Alliance                                          grounded in evidence and
                                                                consumer expectations. The
y Clinical and Consumer Councils                                Consortium and working
y Health care providers                                         groups are the touch points for
                                                                implementation and co-design.
y Clinicians
y General Practice networks
y Aboriginal and Islander Community Controlled
  Health Services (AICCHSs)
y NGOs
y Local government
y Peak bodies
y People with lived experience and carers.

Western Queensland Stewardship

                         Western Queensland Health Services Integration Committee

                                              WQ MHSPAOD Consortium

                                                                                             Western Alliance
                                                                       WQPHN Clinical &
    Nukal Murra Alliance          QAIHC                 AOD                                   Mental Health
                                                                       Consumer Council

                                                                                            Queensland Health
         Headspace                RHealth           Child & Youth      Lived Experience
                                                                                             MHAOD Branch

     Qld Mental Health                                                                       North West HHS
                             Older Person's MH       MHNiGP rep        Roses in the Ocean
       Commission                                                                               MHAOD

       Psychological                                 GP (special
                                  QNADA                                    CheckUP          Central West HHS
          Society                                    MHSPAOD
        (Telehealth)                                  interest)

      Health Workforce        University of Qld   RFDS (Qld Section)         NDIA            South West HHS
             Qld                                                                                MHAOD

The Plan will not over-ride existing funding agreements, service agreements or broader jurisdictional planning
or business protocols. However, it will be used to guide commissioning and delivery of mental health, AOD and
suicide prevention services. Having clear roles and responsibilities linked to implementation at a regional level
will enable measurement and review of progress against the shared objectives and actions.

Community engagement
Our Plan:

                                                   of PARTICIPANTS
y Aims to improve mental health, reduce the
  risk of suicide and address AOD issues in a

                                                                                   31 EVENTS
  sustainable way
y Is underpinned by the principles of early
                                                   were carers and people with a
  engagement, inclusivity, transparency,           lived experience
  shared power, equity of knowledge
  and responsibility

                                                             11                    2
y Builds on the strengths and abilities of local
  communities and services
y Was developed through a 12-month
  co-design process
y Empowers local communities through
  co-creation and co-design.
                                                             LOCATIONS             SURVEYS

                                                              3 CONSUMER
                                                              FACEBOOK CAMPAIGNS


                                                                                                                                           WQPHN COMMISSIONING
                                                                                                                                           WQPHN COMMISSIONING
reek                                                                                                                                               Lower Gulf

                                                                                                                                                   Lower Gulf
                                                                                                                                                                               Our population
                                                                                                                                                   Mt Isa and Surrounds
                                                                                                                                                   Mt Isa and Surrounds
                                                                                                                                                   Western Corridor
                                                                                                                                                   Western Corridor            Geography and demography
              Winton        Burketown                                                                                                              Central West
              Winton         Muttaburra                                                                                                            Central West
                              Muttaburra                                                                                                                                       WQPHN is the fourth largest PHN in Australia,
                        Gregory                                                                                                                    Far South West
                                     Aramac                                                                                                        Far South West              with a total land area of 956,438 km2 – equating to
                   Longreach                                                                                                                       Maranoa                     55% of the total land area of Queensland.
                    Longreach     Barcaldine        Alpha                                                                                          Maranoa
                                  Barcaldine        Alpha
                                             Jericho                                                                                               Balonne
            Camooweal Isisford
                                             Jericho                                                                                               Balonne                    Home
                                                                                                                                                                          WQPHN       to:

     Stonehenge        Isisford        Blackall                                                                                            HOSPITAL AND HEALTH            LOCALITIES
                                       Blackall                                                                                            HOSPITAL AND HEALTH
                                                                                                                                                                              62,369 people
            Jundah    Yaraka                  Tambo                                                                                        SERVICE BOUNDARIES
            Jundah Mount Isa
                      Yaraka    Cloncurry Julia   Creek
                                               Tambo                                                                                       SERVICE BOUNDARIES                    Lower Gulf
         Windorah                            McKinlay                                                                                              North West HHS               Mt Isa and Surrounds
                                                                                                                                                                              10,435 17.2% are
                                                Augathella             Injune                                                                      North West HHS
              Urandangi     Dajarra             Augathella              Injune
                                                                                                                                                                                Western Corridor
                                                               Mitchell Roma                                                                                                  Indigenous Australians
                                                     Morven    Mitchell
                                                                Winton Roma                                                                                                     Central West
                            Quilpie                                            Muttaburra                                                          Central West HHS
                                                      Morven             Wallumbilla
                                                                                                                                                                              34 Aboriginal language groups
                                                                                                                                                   Central West HHS
                                Boulia                                   Wallumbilla
                                                                              Surat   Aramac                                                                                    Far South West
                                                                       Longreach                                                                                                Maranoa
                                                                                           Barcaldine          Alpha
             Thargomindah                  Cunnamulla                    St George

                                                                                                                                                                              34% under 25
             Thargomindah                  Cunnamulla                    St George                      Jericho
                                                         Bollon                                                                                    South West HHS
                           Bedourie                                       Isisford
                                                          Bollon Dirranbandi                                                                       South West HHS
                                                      Stonehenge Dirranbandi                   Blackall                                                                   HOSPITAL AND HEALTH
                                                                   Mungindi                                                                                               SERVICE BOUNDARIES
                                                                                                                                                                              88% of the population live in
                                                              Jundah     Yaraka                          Tambo

                                                                                                                                                                                North Westand
                                                                                                                                                                                           HHS very remote areas
                                                                                                          Augathella              Injune

                                                                                                 Charleville           Mitchell     Roma                                      61% of the regions population
                                                                                                                                                                              are  in the
                                                                                                                                                                                Central      two most disadvantaged
                                                                                                                                                                                        West HHS
                                                                                                                                          Surat                               quintiles (SEIFA)

                                                               Thargomindah                       Cunnamulla                        St George
                                                                                                                   Bollon                                                       South West HHS

37, 914

Prevalence rates
The National Mental Health Service Planning
Framework (NMHSPF) is a tool developed by
the University of Queensland to assist with the                                               5494
prediction of the prevalence of mental health
conditions and demand for mental health services.
It utilises national averages which are applied to the
population of a region (in this case the estimated
resident population in June 2018 as determined
by the Queensland Government Statistician’s                                        At risk    Mild     Moderate    Severe        Well
Office, Queensland Treasury).16 These averages                                                                                 population
do not yet account for rurality and remoteness,                    37, 914
Aboriginal and Torres Strait Islanders or people with
low socio-economic status – all of which are higher
in Western Queensland and are known factors
that contribute towards increased mental health                                                                   23%   At risk
prevalence. As such the figures from the NMHSPF
                       14351 to assist in planning and
are a conservative estimate
coordination of services.
                                                                                                                  9%    Mild

The figure to the right provides the estimated                                                                    4%    Moderate
mental health prevalence across severity levels
(severe, moderate, mild, at risk and well population)                                                             3%    Severe
in Western Queensland with the graph showing  2774the
estimated number of people in each category and
                                                         1836                                                     61%   Well population
the pie graph showing the percentage of
the population.
                     At risk      Mild      Moderate     Severe     Well
                                                                     Estimated prevalence of mental health in the Western Queensland population

Treatment targets

When adjusting for treatment targets based on
severity level relative to the estimated number
of people at each level, approximately 1 in 5
people are in need of mental health treatment.

This estimate of demand against the WQPHN
population of 62,369 suggests
that approximately:

y 3,129 (5.0% of the WQPHN population)
  will require early intervention and relapse
  prevention. They represent people who do
  not yet meet the criteria for a mental disorder
  and those that previously experienced
  a mental disorder, but no longer have a
  diagnosable disorder.
y 2,747 (4.4% of the total WQPHN population)
  will need a variety of services to treat mild
  mental illness/disorders
y 2,220 (3.6% of the WQPHN population)
  will need services for moderate mental
y 1,836 (2.9% of the WQPHN population) will
  need services for severe mental illness.

Overview of the Plan                               Part A: Transforming mental health care
                                                   y   WQ HCH – supporting a patient centred approach to care
Our Plan incorporates three discreet and           y   Embedding stepped care framework for mental health services
complementary areas of work including:
                                                   y   Adopting a place-based, co-designed planning approach
y Mental health                                    y   Making safety and quality central to mental health service delivery
y Suicide prevention                               y   Addressing stigma and discrimination.

y Alcohol and other drugs (AOD) services.

It identifies significant opportunities for both   Part B: Delivering change
service and system improvement based on            y Proactive prevention and early intervention
extensive engagement and feedback from
                                                   y Providing care across the lifespan
people who live and work in the region. This
includes improvement to existing services          y Supporting Aboriginal and Torres Strait Islander social, emotional
along with enhancements to commissioning             and cultural wellbeing
approaches and services.                           y Strengthening and integrating AOD treatment and harm reduction
                                                   y Making suicide prevention everyone’s business
The Plan also identifies opportunities to expand
                                                   y Supporting people who experience severe and complex mental health
and tailor service delivery in conjunction with
ongoing co-design and health planning linked to    y Building workforce capability and grassroots training opportunities
future service demand.                             y Responding to climatic extremes and rural decline.

It makes no commitment to funding for
additional future services, but instead commits    Part C: Measuring change
to shared regional resource planning through
the Consortium to consider proposed new or         y Measuring individual and service system outcomes
extended services.                                 y Reporting and measuring progress
                                                   y Implementing the Plan.

Make safety

Our vision: Western
                                             and quality
                                           central to health
                                           service delivery
Queenslanders and
their communities        Adopt

experiencing good     co-designed
                                                                        Embed a
                                                                      stepped care
mental health and                                                    framework for
                                                                     mental health
wellbeing.                                Part A:

                                     mental health care

                             Address                       the Western
                            stigma and                   Queensland Health
                          discrimination                    Care Home
                                                         (WQ HCH) model
                                                              of care

As individuals we contribute to and are    Place-based, co-designed
affected by both the social and physical   planning approach
environments of our communities.           Western Queensland communities face multiple
                                           challenges and often ‘wicked’ problems that are
                                           complex and difficult to solve. These problems often
                                           relate to living conditions, societal influences, limited
In turn, this can have an impact on        access to services, geographical isolation, and ‘siloed’
                                           funding models.
people’s health and wellbeing. A sense     To address these problems we require a coordinated
of belonging and feeling connected         and cohesive approach that recognises and champions
                                           the important role communities play in shaping services
to others with strong and supportive       and embedding consumer, carer and lived experience
                                           engagement into planning.
networks matters for people’s
wellbeing. As a community, this            This Plan presents our blueprint for implementing
                                           stepped care using place-based, co-design approaches.
protects against risk factors.17           It harnesses the leadership, resources and opportunities
                                           of people and seeks contributions to strategies
                                           and ideas to improve health, social, economic and
                                           environmental outcomes.17

                                           It embeds meaningful public and multi-stakeholder
                                           participation into service delivery and offers
                                           opportunities for Western Queensland organisations to
                                           address challenges and work together.

                                           Ultimately, this is about reducing inequalities by
                                           improving the social, emotional and cultural wellbeing
                                           of our people and places.

The Western Queensland Health
Care Home Model of Care

Western Queensland Health              WQ HCH provides the gateway
Care Home (WQ HCH) model               to the wider health system through
provides proactive patient-centred,    access to community-based
coordinated and flexible care with     multi-disciplinary team-based
a team of professionals working        care, early intervention services,
together to make sure the patient      and hospital and specialist services
receives care, based on their needs.   where these are required to:

At the heart of this model is a        y Identify lifestyle and other
whole-of-system integration              health risk factors early
approach that is focused on            y Proactively manage people with
improving patient outcomes and           chronic disease
experiences and places consumers
at the heart of the local primary      y Help vulnerable people navigate
care system.                             the health care system
                                       y Support people who
This model of care is conceptualised     are geographically isolated
within three core domains that           or who suffer economic
support general practitioners to         disadvantage
deliver holistic assistance close
to people’s homes; and where           y Support people with complex
individuals, families and carers are     mental health care needs
active partners in a person’s          y Remove the organisational
 care journey:                           and professional barriers that
y Ready Access to Care                   impact care and prevent better
                                         coordination across social,
y Proactive Preventative Care            primary and acute care settings.
y Engaged Chronic and
  Complex Care.

Step 4: Services for severe and
                                        3%               complex mental health needs                   Case management

                                       4%                    Step 3: High intensity
                                    Moderate                 mental health services                    Risk management &
                                                                                                                                          The stepped care approach
                                                                    Step 2: Low intensity              early intervention
                                       9%                                                                                                 is flexible - as a person’s
                                       Mild                         mental health services                                                needs change, the service
                                                                                                                                          changes with them,
                                                                                                                                          ensuring the service type is
                                     23%                                   Step 1: Identification,                                        right for them.
                                 At risk groups                            assessment, active
                                                                                                       Self management

                                     61%                                             Not receiving
                                Well Population

Stepped Care Framework for mental health services
The Stepped Care Framework describes a hierarchy           A stepped care approach to mental health service           y Define a comprehensive ‘menu’ of evidence
of interventions. These interventions range from           planning generally involves the following five               based services required to respond to the
lower intensity steps that support people before           core elements:18                                             spectrum of need
illness manifests, to higher levels of care for those
                                                           y Use the least restrictive or intensive treatment         y Match service types to the treatment targets for
who present with severe symptoms.
                                                             option appropriate to the individual’s needs               each needs group and commissioning/delivering
                                                                                                                        services accordingly.
Under this framework people are assessed on their          y Stratify the population into different ‘needs groups’,
needs and then allocated appropriate support.                ranging from whole of population needs for mental
Regular monitoring ensures that people continue to           health promotion and prevention, through to those
receive the right help as their needs change                 with severe, persistent and complex conditions
over time.
                                                           y Set appropriate interventions for each stratified
                                                             group (this is necessary because not all needs
The service intervention continuum allows people
                                                             require formal intervention)
to enter the mental health care system at any level to
make best use of workforce and technology.18
Making safety and quality                                 Addressing stigma and
central to mental health                                  discrimination
service delivery                                          Reducing stigma and discrimination is at the core
                                                          of all our efforts to improve mental health and
Our work across the mental health sector to advance       wellbeing, and break down barriers to
safety and quality in the health sector aligns with the   access support.
work of the Australian Commission on Safety and
Quality in Health Care (ACSQHC).                          Shame and discrimination can contribute to
                                                          unemployment, social exclusion and poverty
This Plan focuses on building a recovery-oriented         and can trap people in a cycle of marginalisation
culture across all health services involved in            that impacts on their physical, social and
the delivery of mental health, AOD and suicide            emotional health.
prevention treatment and care.
                                                          Our outback culture, lifestyles and social
This will be achieved by:                                 norms play a very important role in the way we
                                                          understand and talk about mental health, suicide
y Adopting the safety and quality commitments             and AOD use, including how, where and when
  of the Fifth Plan that include the National Safety      help is sought.
  and Quality Health Service (NSQHS) Standards
  (second edition) and National Standards for             Whether it’s those well recognised stoic
  Mental Health Services (NSMHS)                          behaviours within our farming communities, or
y Monitoring and improvement of mental health             the unique intergenerational experiences of our
  services through measuring progress and                 Aboriginal and Torres Strait Islander communities,
  reporting on indicators, such as timely access          or even the ‘she’ll be right’ attitudes and
  and effectiveness of care as measured by patient        mindsets that have prevailed across generations;
  experience and continuity of care as measured by        addressing stigma and discrimination will require
  follow-up after hospital admissions.                    disruption and this Plan needs to support
                                                          and enable Western Queenslanders through
                                                          understanding and adopting important protective
                                                          factors and normalising help seeking behaviours
                                                          linked to recovery and wellbeing.

PART B: Delivering change

Our Plan identifies system redesign priorities
through a commitment to nine focus areas
for change.
                                                  1. Building a connected          2. Proactive prevention         3. Promote and protect
For each focus approach area, we provide:           and person-centred              and early intervention       mental health and wellbeing
                                                         care sector                                                  across the lifespan
y Consultation insights
  from this strategy’s supporting community
  engagement program
y Shared objectives
y Priority actions designed
  to improve the quality, integration
  and coordination of MHSPAOD care.

                                                  4. Supporting Aboriginal        5. Strengthen and integrate    6. Making suicide prevention
                                                  and Torres Strait Islander        Alcohol and Other Drug           everyone’s business
                                                    social, emotional and       treatment and harm reduction
                                                      cultural wellbeing       within a stepped care framework

                                                 7. Coordinating treatment          8. Building workforce         9. Responding to climatic
                                                   and support for people         capability and grassroots           extremes and these
                                                 who experience severe and         training opportunities          impacts within rural and
                                                   complex mental health                                             remote communities

Focus area 1: Building a connected and person-centred care sector
                                                            ‘We need to open doors to care by      ‘We need 'community of
                                                            listening to people with a             excellence’ models with planned
                                                            lived experience’                      services and integration across all
                                                                                                   providers within one community
                                                            Lived Experience Participant
                                                                                                   or place’
                                                            ‘Using information systems that        NW Mental Health Roundtable
                                                            don’t talk is problematic and leads    Mount Isa
                                                            to consumers falling through the
                                                            gaps, lost data and a breakdown in     ‘We need to inter-link culture and
                                                            care continuity’                       clinical responsiveness in order
                                                                                                   to be able to deliver culturally
                                                            General Practitioner
                                                                                                   safe services’
                                                            ‘We need to recognise and be           Aboriginal Health Practitioner
                                                            responsive to the different cultures
                                                            across Western Queensland              ‘It’s no long a ‘taboo’ subject and
                                                            from Indigenous, Bush and              stigma has decreased somewhat,
                               GP practices, primary care
                                                            Mining cultures’                       but we still have a long way to go’
                               clinics and AICCHOs were
                              rated highest in supporting   Consumer Forum Meeting                 Lived Experience Focus Group
                               consumer confidence and
                                     recovery of care.      ‘We need to expand cross agency        ‘Stop the silo mentality with both
                                                            delivery of care using a partnership   funding and service provision’
       44% of survey                                        model focused on systems,
   participants referred to     WQPHN Online Lived                                                 Senior Executive
                                                            operations, commitment, joint
   a mental health service    Experience Survey Results
                                                            deliverables and outcomes’
    did not attend due to
         stigma/fear.                                       Anonymous

   WQPHN Online Lived
    Experience Survey

Focus area 1: Building a connected and person-centred care sector
Consultation insights

Having access to services centred around a person’s      Breakthrough Opportunities                              y Potential role telehealth and digital eMental Health
needs that are as close to home as possible is                                                                     tools play in addressing access issues relating to
essential, for people to be able to remain well and      y Continue to build on strong community leadership        distance and travel
connected to their family and community. This              to harness expertise to drive reform and to co-
                                                                                                                 y Data sharing for planning, evaluating interventions
includes supporting individuals to take proactive          design an integrated care agenda
                                                                                                                   and performance monitoring
steps, so they are not managing symptoms on
their own.                                               y Strengthen the collective voice of people with a
                                                                                                                 y Development of place-based health intelligence
                                                           lived experience so the service access points and
                                                                                                                   reports that have identified need and potential
                                                           system can be shaped around these needs
Challenges in Western Queensland                                                                                   service improvement strategies for interagency
                                                         y Strengthen the WQ HCH model in delivering               health planning.
y Not a ‘one size fits all’ approach                       coordinated and efficient primary care
y Low population density and tyranny of distance to      y Facilitating local stepped care reform that engages
  services and travel required to reach them               local commissioned service providers, general
                                                           practice and wider WQ HCH neighbourhood
y Lack of participation and engagement of those
  with lived experience                                  y Move towards a shared resourcing model                               Continuing to build on the
                                                           incorporating shared fund pooling, infrastructure                  WQ HCH model in supporting
y Siloed funding models                                                                                                           multidisciplinary team-
                                                           and workforce models
y Sustainability of private practice settings in rural                                                                           based care that connects
                                                         y Electronic shared digital referral
  and remote Western Queensland                                                                                                individuals with the broader
y Communication and interoperability challenges
                                                         y Build on high value care provided by AICCHOs                       health and social care system
                                                           and benefit of the block funding model                               is fundamental to driving a
  across provider networks
                                                         y Reform the funding model with a shift to a mixed                     person-centred approach.
y Knowledge and awareness of visiting services
                                                           model of private billing fee-for-service and
y Higher health care costs.                                population-based block funding based on the
                                                           population served and the health needs of
                                                           the community
                                                         y Support diversity and capability expansions
                                                           through cultural leaders, trusted advocates and
                                                           mentors as part of the broader team.

Focus area 1: Building a connected and person-centred care sector

     Shared objectives                                                     Priority actions                                            Lead agency

Shared objective 1 - Deliver    1.    Strengthen leadership development and partnerships to embed comprehensive responses across
person-centred services through       the continuum of care.
the WQ HCH and Stepped
Care Framework                  2.    Implement flexible models of care that support integration of primary and secondary care
                                      incorporating the stepped care framework to better connect consumers to services.

                                 3.   Broaden digitally enabled models of care, care pathways, information-sharing protocols and
                                      electronic health records in coordinating care.
Shared objective 2 - Increase    1.   Utilise engagement processes outlined in QMHC Stretch2Engage Framework and Lived
engagement and participation          Experience Framework that support inclusive engagement and incorporate peer workforce
of people who understand the          tailored for the Western Queensland context.
lived experiences of MHSPAOD
in place-based co-designed
planning and governance
Shared objective 3 - Making      1.   Develop an evaluation framework that incorporates safety and quality measures to support
safety and quality central to         planning, monitoring, evaluation and reporting on progress.
mental health service delivery
                                 2.   Adopt place-based, needs-based planning to inform Commissioning Locality funding and
                                      service enhancements.

                                 3.   Adoption of refeRHealth electronic referral to support coordination and team care.
Shared objective 4 - Address     1.   Develop a WQ stigma reduction strategy/framework that incorporates priorities around
mental health stigma and              engagement, training, communication, leadership and advocacy.
discrimination including
embedding principals of human    2.   Develop a safe language interagency terminology guide for service providers, consumers, carers
rights protection                     and people with a lived experience.

Focus area 2: Proactive prevention and early intervention
                                    ‘Under investment in prevention             ‘Help people understand the
                                    and early intervention, means that          warning signs and to not be afraid
                                    too many people live with poor              to seek help in the early stages’
                                    social and emotional wellbeing
                                                                                WQPHN Online Survey - Lived
                                    for too long’
                                    WQPHN SW Mental Health
                                    Roundtable, Charleville

                                    ‘We need to take a pragmatic
                                    approach and invest in evidence
                                    based interventions that we know                        Good mental health
                                    will work’                                               builds resilience,
                                                                                               buffers against
                                    CW Mental Health Roundtable,                           adversity, reduces the
                                                                                            chances of physical
                                    ‘Cannot underestimate the critical                       illness, promotes
                                    role of screening and health checks                   recovery and increases
                                    in early detection and prevention’                       life expectancy.21
                                                                       Early intervention
                                                                          services were
                                                                        identified as the
                                                                    highest priority area for
                                                                     service development.
                                                                         Lived Experience and

Focus area 2: Proactive prevention and early intervention
Consultation insights

Strengthening positive mental health and wellbeing,      Breakthrough opportunities
and preventing mental health issues, problematic
relationship with AOD use and suicide risk contributes   y Address workforce issues by upskilling
to better health, increased life expectancy, education     local providers
and employment outcomes, increased productivity,
community participation, social capital and              y Empower people to recognise early signs of
community cohesion.                                        vulnerability, distress, so they access support at an
                                                           early stage
These benefits span generations and highlight how we     y General practice and primary care providers
can help prevent the incidence, severity and impact        provide ongoing surveillance and ready access to
of mental illness, suicide and harm reduction. When        proactive preventative care
executed well, preventive actions are more effective,
less expensive and have a greater population impact      y Greater advocacy and promotion by primary care
than managing and treating ill-health.19;20                providers of evidence-based early intervention low
                                                           intensity programs and services
Challenges in Western Queensland                         y Identifying risk factors early through universal and
                                                           targeted screening                                      Widening ‘poverty gap’
y Poor understanding of low intensity early                                                                          in rural and remote
  intervention primary mental health services            y Standardising screening tools to drive
                                                           prevention efforts                                      settings highlights the
y Residents present late, are diagnosed late and at a                                                                need to strengthen
  more advanced stage of illness, with corresponding     y Building knowledge of what services are available        prevention and early
  physical comorbidities.                                  to provide appropriate and timely advice and             intervention efforts20
                                                         y Invest in prevention and early intervention, and
                                                           build the evidence base for promotion
                                                         y Use e-health as an enabler to deliver early
                                                           intervention services.

Focus area 2: Proactive prevention and early intervention

     Shared objectives                                                      Priority actions                                               Lead agency

Shared objective 1 - Increase    1.   Map existing resources to identify gaps or opportunities to support service delivery for agencies/
mental health, AOD and suicide        councils who provide MHSPAOD information.
prevention literacy

Shared objective 2 - Increase    1.   Expand screening and psychological service delivery through digital health and telehealth,
early intervention response           targeted events, GP health checks, workforce capacity, and joint commissioning (and other
                                      funding models).

                                 2.   Universal adoption of ‘best of breed’ strength-based eMental health programs including
                                      ‘Weathering Well’ and ‘Stay Strong’.

Focus area 3: Promote and protect mental
health and wellbeing across the lifespan

                                                    ‘We need to start with our mothers         ‘There is a need to develop
                                                    and babies so we can improve               better links between schools and
                                                    the life trajectory of our most            agencies to strengthen capacity
                                                    vulnerable families’                       for early identification of risk’
                                                    Anonymous                                  Psychologist, Health
                                                    ‘Regular health checks in the early
                                                    years are key to identifying mental        ‘Active engagement of the client
                                                    health and developmental issues            throughout planning of their care
                                                    early’                                     plan helps support health seeking
                                                                                               behaviour and patient activation’
                                                    Healthy Outback Kids
  Nearly 1 in 5, 15-24                              Coordinator                                WQPHN, Online Survey
year olds in WQPHN
region were admitted                                ‘It is critical we work with teenagers     ‘Older persons mental health
to hospital for Mental                              and young people to enhance their          services are really limited in most
                                                    coping abilities, so they are able         areas, or simply do not exist’
   and Behavioural
                                                    to respond in positive ways to the
     Disorders in                                   risks, stresses and adversities of life’
                                                                                               General Practitioner
                                                    Police Officer

                            Over one third (36%)    ‘We need to give youth and young
                            of Prep aged children   people agency of choice’
  15% of people living in     in WQPHN region       School Counsellor, Mental
  WQPHN region in the       are developmentally     Health Roundtable
   active GP population      vulnerable in one or
   were diagnosed with      more domains of the
    depression, anxiety,     AEDC (QLD 25%).22
  bipolar disorder and/or

Focus area 3: Promote and protect mental health and wellbeing across the lifespan
Consultation insights

Physical, social, emotional, cultural and                Breakthrough opportunities
environmental conditions impact people’s mental
health from infancy to old age.                          y Integrated school-based assessment to connect
                                                           young people to care
Supporting families through the early years of a
                                                         y Practical support tools for students and families
child’s life provides strong foundations for life-long
physical, mental, social and cultural wellbeing.         y Implement the WQ HCH model of care to help
                                                           identify risk factors and strengthen referral pathways
Challenges in Western Queensland                           and care coordination
                                                         y Older persons enrolment and health check to ensure
y Suitably skilled local health workforce to support
                                                           wellbeing and is part of individual needs, including
  the uptake and engagement of health services
                                                           access to psychosocial support
  by children and their families
                                                         y Integrate place-based primary health care approaches
y Coordination between visiting and local health
                                                           founded on strong and effective partnerships
  and social care services in remote communities                                                                    Photo courtesy of Gidgee Healing
                                                         y Messaging around healthy ageing topics such
y Collaboration between health and education
                                                           as dementia
  sectors to support prevention and early
  intervention                                           y Connectivity between the health sector and schools
                                                           to identify at risk children (and young people) and
y Enhanced co-design of services with youth and
                                                           demystifying mental health
  young people
                                                         y Stigma reduction strategy
y Interdependencies of social determinants on
  equitable access to services, resources and            y A Young Persons Positive Mental Health Strategy that
  clinical care                                            engages young people in its design and delivery
y Engagement and support for older peoples               y Expanded access to Headspace in the South West
  mental health
                                                         y Grow local health workforce through increased
y Loneliness and social isolation is an issue              participation in education
  for older people and for people who are
                                                         y Increase access to services such as active transport
  geographically isolated.
                                                           and telehealth-care.

Focus area 3: Promote and protect mental health and wellbeing across the lifespan

     Shared objectives                                                      Priority actions                                            Lead agency

Shared objective 1 - Promote     1.   Review existing WQPHN Child and Family Framework and Early Years Plan and existing programs
the best start in life                such as Healthy Outback Kids to ensure alignment and improved pathways to care.

                                 2.   Promote screening and early intervention to support good perinatal mental health.
Shared objective 2 - Embed       1.   Support key agencies to deliver place-based young person’s reference groups’ that links into
proactive planning and support        an overarching youth strategy. The group would help to inform workforce capacity building and
for young people                      support for vulnerable groups.

                                 2.   Embed proactive planning and support for children and young people involved in child protection
                                      and/or youth justice system focusing on SEWB and pathways to participation and inclusion.
Shared objective 3 - Strengthen 1.    Increase care coordination capacity to increase uptake of better access and more proactive
the WQ HCH model of care to           management of people with mental health issues.
support planned and structured
care for the adult population   2.    Configure primary mental health services to support stepped care approaches and meet the needs
                                      of the region.

                                 3.   Develop a WQ HCH place based neighbourhood strategy to support integrated
                                      person-centred care.
Shared objective 4 - Expand the 1.    Improve mental health and quality of life for older people, including early detection and
reach and diversity of MHSPAOD        intervention through measures such as risk screening, telehealth and increased training.
prevention services specifically
for older Western Queenslanders 2.    Expand and develop psychosocial support to increase social connection and reduce impacts from
(65+ years and 55+ years for          social isolation and loneliness.
Aboriginal and Torres Strait
Islander populations)

Focus area 4: Supporting Aboriginal and Torres Strait
Islander social, emotional and cultural wellbeing

                                    ‘Words are powerful, we need to        ‘Need to create opportunities
                                    use our stories to carry hope and      for non-clinical support to be
                                    possibility.’                          recognised as equally important
                                                                           in care approaches’
                                    Aboriginal Health Worker
                                                                           WQPHN Roma Mental Health
                                    ‘We must consider and harness our      Roundtable
                                    unique cultural strengths to deliver
                                    effective solutions for our people’    ‘Creating a culturally competent
                                                                           and safe workforce with training
                                    Stephanie King, Health Advocate
                                                                           in trauma-informed care must be
                                                                           a priority moving forward’
                                    ‘Shame for our People still exists
                                    and continues to be a barrier to       Mount Isa Mental Health Forum
                                    help seeking behaviour’

                                    SEWB Worker

                                     ‘We need to address the                      65% of all Mental
                                    interdependence of the                           Health ED
                                    socioeconomic and cultural factors            presentations for
                                    that contribute to risk factors for         15-24 year olds were
                                    poor mental health outcomes for            for Indigenous young
                                    Indigenous people’
                                    WQPHN Clinical Advisory
                                    Council member

Focus area 4: Supporting Aboriginal and Torres Strait Islander social,
emotional and cultural wellbeing
Consultation insights
Building a Plan that identifies the strengths and      Breakthrough opportunities                              y Recognise and value the role and function of
builds protective factors within Aboriginal and                                                                  Health Workers and other similar type roles so
Torres Strait Islander populations is a fundamental    y Nukal Murra Social and Emotional wellbeing              the workforce is well positioned to work at the
driver to preventing the onset and exacerbation          Framework to expand capacity of                         top of its scope of practice. This also includes
of mental health, problematic substance use and          AICCHO services                                         creating opportunities for clinical and non-
other issues. Through the Nukal Murra Social and                                                                 clinical support to be recognised as equally
Emotional Wellbeing (SEWB) Framework14 we have         y Culturally safe services and holistic family care       important in care approaches.
built the foundations for implementing strengths-        emphasises wellness, harmony and balance rather
based primary health care approaches within our          than illness treatment and symptom reduction.
Aboriginal and Torres Strait Islander communities      y Wrap care around families to reduce risk factors
in Western Queensland. It has been designed in           and enhance protective factors for social, cultural
close collaboration with Aboriginal Community            and emotional wellbeing.                                                            Indigenous people in
Controlled Health Organisations (ACCHOs) and                                                                                                 WQPHN have nearly
Alliance partners and draws on the intelligence and    y Expand leadership and governance structures to                                       double the number
knowledge of these institutions, but importantly         ensure a strong presence of Aboriginal and Torres                                        of mental and
also harnesses the cultural resilience within our        Strait Islander peoples.                                                            behavioural episodes
Aboriginal and Torres Strait Islander peoples.         y Co-design all aspects of regional planning                                           of hospital admitted
                                                         and service delivery with people who have                                             care compared to
Challenges in Western Queensland                         lived experience.                                                                     non-Indigenous.23
y Impacts of intergenerational trauma, institutional   y Integrate clinical and culturally informed services         60% of the MH
  racism and poor experiences of care                    which are supported by staff who understand the            ED presentations
                                                         interconnections of a holistic approach.                     are for people
y Poverty and economic barriers that impact access
  to care such as transport, telecommunications,       y Understand the service gaps in psychosocial                from Indigenous
  affordability and remoteness                           therapies encompassing digital and strengths                 backgrounds.1
                                                         based social and emotional wellbeing services such
y Low health literacy that impacts capacity of a         as the Stay Strong App.
  person to understand and apply information to
  make effective decisions                             y Promote Aboriginal and Torres Strait Islander
                                                         mental health as a career pathway to build local
y Integrating culturally safe and responsive             capacity and to address workforce shortages.
  MHSPAOD care into mainstream services.

Focus area 4: Supporting Aboriginal and Torres Strait Islander social,
emotional and cultural wellbeing
     Shared objectives                                                          Priority actions                                                Lead agency

Shared objective 1 - Continue    1.      Support ‘Stay Strong’ eMental Health Tool and promote routine screening wellbeing support,
to foster Indigenous self-               recovery and complementary therapy.
determination and leadership
through the Nukal Murra Alliance 2.      Empower self-determination through culturally centred processes of decision making
                                         (incorporating lived experience) that deliver solutions that respond to local context (in alignment
                                         with the Guyaa Dhuwi declaration).

                                    3.   Increase profile and role of Indigenous cultural mentors or consultants to ensure they have cultural
                                         authority to guide culturally responsive service delivery.
Shared objective 2 - Improve        1.   Promote a culturally competent workforce with training in trauma-informed care and in
culturally safe and responsive           identification of risk to deliver services to Aboriginal and Torres Strait lslander people.
MHSPAOD services
                                    2.   Adopt healing-informed approaches by service providers in their communication, policies
                                         and practices.
Shared objective 3 - Expand         1.   Support and build the Aboriginal and Torres Strait Islander health workforce, including Aboriginal
and integrate new care roles             and Torres Strait Islander Health Workers, Health Practitioners and community researchers as
into Aboriginal and Torres Strait        important cultural brokers.
Islander Health Workforce
                                    2.   Broaden non-clinical care connector and wellbeing roles into multidisciplinary team
                                         care arrangements.

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