Regional Mental Health, Alcohol and Other Drugs Plan - July 2019 - June 2021
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Regional Mental
Health, Alcohol and
Other Drugs Plan
July 2019 - June 2021
Darling Downs and West Moreton PHN wishes to acknowledge Australia’s Aboriginal and Torres Strait Islander people as
the Custodians of this land.
We pay our respect and recognise their unique cultures and customs and honour their Elders past, present and emerging.
Darling Downs and West Moreton PHN gratefully acknowledges the financial and other support from the Australian
Government Department of Health. While the Australian Government Department of Health has contributed to the funding
of this material, the information contained in it does not necessarily reflect the views of the Australian Government and is
not advice that is provided, or information that is endorsed, by the Australian Government. The Australian Government is
not responsible by negligence or otherwise for any injury, loss or damage however arising from the use of or reliance on
the information provided herein.
2.
Contents
1 Introduction_______________________________________ 7
2 Development of the Plan_____________________________ 12
3 The Plan_________________________________________ 14
4 Next Steps________________________________________ 23
Appendix 1_________________________________________ 24
Appendix 2_________________________________________ 26
Appendix 3_________________________________________ 29
Darling Downs and West Moreton PHN, West Moreton Health and Darling Downs
Health would like to acknowledge the Queensland Health, Mental Health and
Alcohol and Other Drug Branch (MHAOD), Queensland Network of Alcohol and
Other Drug Agencies (QNADA) and the Queensland Mental Health Alliance for
their contribution to this Plan.
Regional Mental Health, Alcohol and Other Drugs Plan | July 2019 - June 2021 3.
Foreword
To ensure our region is best placed the mental health and alcohol and
to adapt to the changing needs of other drug service system’, the Plan is
our communities, Darling Downs and steered by the principles of:
West Moreton PHN, West Moreton
• reducing stigma
Health (WMH) and Darling Downs
Health (DDH) have committed • all services are culturally appropriate
to joint planning for integrated • people are at the centre of the
mental health, suicide prevention system and our services
and alcohol and other drug (AOD) • strong and effective communication
services. We recognise that we are • information sharing to improve
stronger together and that by working care that respects privacy and
collaboratively, we can effect change confidentiality
for those that are the most vulnerable
in our communities. We are committed to reducing stigma
within our own organisations, in those
The Regional Mental Health and we fund or commission and across the
Alcohol and Other Drug Plan is the health system.
first step in laying the foundation for
ongoing collaboration and improved We would like to take this opportunity
coordination to ensure that all people to thank those who have contributed
living with a mental health condition to the preparation of this Plan,
and AOD use in our region can access including those with lived experience,
representatives from the Aboriginal
effective and appropriate treatment.
and Torres Strait Islander and
Mental health, suicide prevention culturally and linguistically diverse
and AOD use continue to be key communities, working groups and the
priority areas for the PHN, DDH and steering committee who provided us
WMH. Preparing a regional plan with their unique insights through
presents our organisations with our consultation process. Over 100
the opportunity not only to lead the people, representing a wide range
of health, mental health and social
conversation and the work to ensure
service organisations across the
greater access for people, it also gives
region, participated in consultations
us the opportunity to collectively
and workshops to identify key issues
engage stakeholders across the
and develop priorities. We would also
Darling Downs and West Moreton PHN
like to acknowledge the Queensland
region to identify shared opportunities
Health, Mental Health and Alcohol
and goals for the future. This approach and Other Drug Branch (MHAOD),
aligns with the Fifth National Mental Queensland Network of Alcohol and
Health and Suicide Prevention Other Drug Agencies (QNADA), and the
Plan, 2017 and the Shifting Minds Queensland Mental Health Alliance for
Queensland Health, Mental Health, their contribution to the Plan through
Alcohol and Other Drugs Strategic their involvement with the steering
Plan 2018 - 2023 (Shifting Minds). committee.
Guided by a strong vision to provide We look forward to working with you
something that is ‘action orientated, to improve accessibility and delivery of
innovative and realistic – focused mental health, suicide prevention and
on people and their journey through AOD treatment services in our region.
Merrilyn Strohfeldt Dr Kerrie Freeman Dr Peter Gillies
CEO Chief Executive Chief Executive
Darling Downs and West Moreton Health Darling Downs Health
West Moreton PHN
4.
Vision for the Plan
The Plan is action oriented, innovative and realistic - focused on people and their journeys through our mental health
and AOD service system. The implementation of this Plan will lay the foundation for ongoing collaboration and improved
coordination leading to the development of a comprehensive plan by 2022.
Principles
Information
All services People are at the sharing to improve
Strong and effective
Reducing stigma are culturally centre of the system care that respects
communication
appropriate and our services privacy and
confidentiality
Priorities
Integration and Partnerships Information Sharing Workforce
Improve quality and sustainability
Improve access to current
of care in the community for Increase mental health
information about mental
people with severe mental health workforce capacity
health and AOD services
conditions
Maximise capacity and
Improve person-centred care Improve the quality and
capability of the peer
for people with mental health timeliness of referrals and
workforce as key contributors
conditions discharge across the system
to the service system
Develop confidence in
Improve understanding of needs of
organisations and individuals to
people with severe mental health
share information
conditions
appropriately
Improve availability and equity
of access to AOD services across
the region
Implementation of the Plan Development of Comprehensive Plan
Regional Mental Health, Alcohol and Other Drugs Plan | July 2019 - June 2021 5.
The joint Plan will provide
a regional platform for
developing a service system
to better meet the needs of
people and their families and
carers with lived experience
of mental illness, AOD
use and suicide.
6.
1. Introduction
The Darling Downs and West Moreton PHN, West Moreton Health (WMH) and Darling Downs Health
(DDH) have committed to joint regional planning for integrated mental health, AOD and suicide
prevention services. This joint planning approach aligns with the Fifth National Mental Health and
Suicide Prevention Plan, 2017 and the Shifting Minds Queensland Health, Mental Health, Alcohol
and Other Drugs Strategic Plan 2018 - 2023 (Shifting Minds).
The joint Plan will provide a regional health condition and reducing and communities, ageing well and
platform for developing a service early mortality; additional support for individuals
system to better meet the needs of experiencing adverse life events and
people and their families and carers 6. r educing stigma and discrimination; circumstances; and
with lived experience of mental
7. m
aking safety and quality central to •g
overnments by enhancing system
illness, AOD use and suicide. The
mental health service delivery; and efficiency and effectiveness through
overarching strategic framework to
whole of government leadership
guide coordinated government action 8. e
nsuring that the enablers of and accountability for integrated
in mental health reform and service effective system performance and policy, planning, funding and
delivery is the Fifth National Mental system improvement are in place. commissioning.
Health and Suicide Prevention Plan1
(The Fifth Plan). Shifting Minds is built around three
SHIFTING MINDS: focus areas:
The Fifth Plan outlines a vision for the
Australian mental health system that: QUEENSLAND MENTAL •b
etter lives;
• enables recovery;
HEALTH, ALCOHOL AND • i nvest to save; and
OTHER DRUGS STRATEGIC
• prevents and detects mental illness •w
hole of system improvement.
PLAN 2018 - 2023
early; and
• ensures that all Australians with a Shifting Minds promotes a whole-
mental health condition can access of-person, whole of community and CONNECTING CARE TO
effective and appropriate treatment whole of government approach to RECOVERY 2016 - 2021
and community support to enable improving the mental health and
them to participate fully in the wellbeing of Queenslanders.2 It Connecting Care to Recovery is
community. sets the direction for reform with the services plan for state-funded
a focus beyond the treatment mental health and AOD services in
The eight priority areas of the Fifth system proposing priorities for Queensland.3 The priorities of the
Plan are: cross-sectoral action. plan include:
1. achieving integrated regional The plan focuses on outcomes that • Priority 1: Access to appropriate
planning and service delivery; matter for: services as close to home as
practicable and at the optimal time.
2. effective suicide prevention; • individuals, families and carers
with a lived experience placing • Priority 2: Workforce development
3. coordinating treatment and community-based services at and optimisation of skills and scope.
supports for people with severe the centre of integrated care and
and complex mental illness; emphasising social economic • Priority 3: Better use of ICT
inclusion and participation; to enhance clinical practice,
4. improving Aboriginal and Torres information sharing, data collection
Strait Islander mental health and • communities by improving
and performance reporting.
suicide prevention; population mental health and
wellbeing through the best start • Priority 4: Early identification
5. improving the physical health in life, prevention and early and intervention in response to
of people living with a mental intervention in schools, workplaces suicide risk.
1 Commonwealth of Australia. The Fifth National Mental Health and Suicide Prevention Plan (2017)
2 Queensland Mental Health Commission, 2018. Shifting Minds: Queensland Mental Health, Alcohol and Other Drugs Strategic Plan 2018-2023
https://www.qmhc.qld.gov.au/sites/default/files/files/qmhc_2018_strategic_plan.pdf
3 Connecting Care to Recovery 2016 – 2017. Queensland Health 2016. www.health.qld.gov.au/__data/assets/pdf_file/0020/465131/connecting-care.pdf
Regional Mental Health, Alcohol and Other Drugs Plan | July 2019 - June 2021 7.
•P
riority 5: Strengthening patient’s
rights Mental Health Act 2016. QUEENSLAND Our region:
The Connecting Care to Recovery geographical area of over
Plan is supported by a resourcing
strategy of $430 million over five
95,500 km2
years for new operational growth = 5.5% of Queensland
and infrastructure investment.
Spans across 10
NATIONAL DRUG STRATEGY Local Government Areas
(in full or in part)
The National Drug Strategy 2017 - DARLING DOWNS
AND WEST MORETON PHN
2026 aims to build safe, healthy and
resilient Australian communities
through preventing and minimising
alcohol, tobacco and other drug-
related health, social, cultural and CHERBOURG
ABORIGINAL SHIRE
economic harms among individuals, SOUTH
BURNETT
families and communities. REGION
Kingaroy
Miles Chinchilla
The strategy has a balanced approach
across the three pillars of harm WESTERN
DOWNS
minimisation: REGION
Dalby Crows Nest
SOMERSET
REGION
Esk
Tara
•D
emand reduction - preventing the Oakey
Gatton IPSWICH
Toowoomba REGION
uptake and/or delaying the onset TOOWOOMBA
LOCKYER
VALLEY
Ipswich
REGION
of use of alcohol, tobacco and Millmerran REGION SCENIC
RIM
Boonah
other drugs; reducing the misuse Warwick
GOONDIWINDI
of alcohol, tobacco and other drugs REGION SOUTHERN
DOWNS
REGION
in the community; and supporting Goondiwindi
people to recover from dependence Stanthorpe
through evidence-informed
treatment.
For more information about the Darling Downs and West Moreton PHN region, please see Appendix 1.
•S
upply reduction - preventing,
stopping, disrupting or otherwise
reducing the production and supply MENTAL HEALTH AND Effectively, a stepped care approach
of illegal drugs; and controlling, ALCOHOL AND OTHER DRUG offers a broad spectrum of services
through which people may move up
managing and/or regulating the SERVICE SYSTEM
availability of legal drugs. and down and within based on their
1.1 S
tepped Care needs at the time. This allows for
•H
arm reduction - reducing the people to access services across the
adverse health, social and economic Stepped care is central to the continuum of care simultaneously. The
consequences of the use of drugs, Australian Government’s mental health Department of Health4 identifies four
for the user, their families and the reform agenda and PHNs are using a core elements of stepped care:
wider community. stepped care approach to guide the
development and commissioning of 1. Stratification of the population
mental health services. into different ‘needs groups’,
ranging from whole of population
Stepped care provides a continuum of needs for mental health promotion
support aimed at meeting the needs of and prevention, through to those
individuals from those with low levels with severe, persistent and
of anxiety and depression to those complex conditions.
with severe mental health conditions.
4 PHN Primary Mental Health Care Flexible Funding Pool Implementation Guidance – Stepped Care
8.
2. Setting interventions for each group
– this is necessary because not all
needs require formal intervention.
3. Designing a comprehensive menu of
Severe mental
evidence-based services required to
Moderate illness
respond to the spectrum of need. At risk
Mild mental mental illness
groups (early
illness
4. Matching service types to the symptoms,
Well
treatment targets for each needs previous
population
illness)
group and commissioning/
delivering services accordingly. Focus on Increase early Provide and Increase Improve
AIMS
promotion and intervention promote service access to
1.2 Spectrum of responses to prevention through access to access rates adequate level
AOD issues by providing access to lower cost, maximising of primary
access to lower cost, lower intensity the number mental
Figure 2 provides an overview of the information, evidence- services of people health care
spectrum of responses to AOD issues advice and based receiving intervention
used in the Queensland AOD Service self-help alternatives evidence- to maximise
Delivery Framework and public AOD resources to fact-to-face based recovery
services model of service. psychological intervention and prevent
therapy escalation.
1.3 Overview of current services Provide
service system wrap-around
coordinated
Figure 3 provides an overview of the care for
current responsibilities of different people with
complex needs
service providers in relation to the
stepped care model. The hospital and
Mainly Mainly self- Mix of Mainly Face to face
SERVICES
health services (HHS) predominantly publicly help resources resources face-to-face clinical
provide services to people with severe available including including primary care care using a
mental illness, while primary care and information digital mental digital mental services, combination
non-government organisations (NGOs) and self-help health health backed up by of GP care,
provide a range of services across the resources services and psychiatrist psychiatrists,
stepped care spectrum. low intensity or links to mental health
fact-to-face broader social nurses,
1.4 Planning Guidelines services supports psychologists
Psychological Clinician and allied
The Joint Regional Planning for services for assisted digital health
Integrated Mental Health and Suicide those who mental health Coordinated,
Prevention Services: A Guide for require them services and multi-agency
Local Health Networks (LHNs) and other low services for
Primary Health Networks (PHNs) intensive those with
services for a severe and
(the Guide) and a Compendium of
minority complex
Resources to assist LHNs and PHNs
mental illness
were endorsed by the Council of
Australian Governments (COAG)
Figure 1 Stepped Care Model5*
Health Council in August 2017. The
Fifth Plan represents commitment 5*
Adapted from PHN Primary Mental Health Care Flexible Funding Pool Implementation Guidance –
Stepped Care
from all governments to work together
to achieve integrated planning for the
delivery of mental health and suicide
prevention services.
Regional Mental Health, Alcohol and Other Drugs Plan | July 2019 - June 2021 9.
Figure 2 Spectrum of responses to AOD issues
The key objectives of the joint regional priorities including better • provide a systems approach to suicide
planning outlined in the Guide are to: coordination of services for people prevention, improving Aboriginal and
with severe and complex mental Torres Strait Islander mental health
•e
mbed integration of mental health, illness and linkages with social and suicide prevention; and
suicide prevention and AOD services support, employment, education
and pathways into a whole of system services and the National Disability • improve the physical health of
approach; and Insurance Scheme (NDIS); people living with mental health
conditions and AOD use.
•d
rive and inform evidence-based
service development to address
identified gaps and deliver on
regional priorities.
The intent of the joint approach to
planning is to:
Primary Care
Moderate Severe
• i nform coordinated commissioning mental mental HHS
Mild mental illness
of mental health and AOD services illness illness
across stepped care and across the
lifespan; At risk
Well
population groups
• s upport coordinated implementation
of regional, state and national NGO
Figure 3 Overview of current regional service system
10.This Plan provides a platform for joint action in the short to medium term and will contribute to the development of a comprehensive plan. Regional Mental Health, Alcohol and Other Drugs Plan | July 2019 - June 2021 11.
2. Development of the Plan
This plan represents a new approach to planning for mental health, suicide prevention
and AOD services in our region. It outlines agreed priorities for new and joint action by the
PHN, DDH and WMH.
Each of the partner agencies, along workshops to identify key issues and have recently developed regional
with other providers across the region develop priorities. suicide prevention plans. These plans
continue to implement a wide range were developed separately for the
of core services and programs to The process has been overseen Darling Downs and West Moreton
meet the needs of the community. by a steering committee which regions prior to work commencing
These have not been documented as includes representation from the on the joint Regional Mental Health,
a part of this plan but are an integral three partner agencies as well as the Alcohol and Other Drugs Plan. Many
component of the delivery of mental Queensland Health, Mental Health of the strategies included in this
health and AOD services. and Other Drug Branch (MHAOD), Plan complement and support the
Queensland Network of Alcohol strategies outlined in the two suicide
The priorities and actions have and Other Drug Agencies (QNADA), prevention plans. Addressing the
been agreed by the three partner Queensland Mental Health Alliance system issues identified in this Plan
agencies following a process of data and people with lived experience and will support and underpin ongoing
analysis, consultation and a series representatives from the Aboriginal work to implement the specific
of workshops as shown in Figure 4. and Torres Strait Islander community. strategies identified in the suicide
Key data sources included the PHN prevention plans. Mental health,
Health Needs Assessment (HNA) and This Plan provides a platform for
AOD and suicide prevention will be
the National Mental Health Services joint action in the short to medium
integrated in the comprehensive plan
Planning Framework (NMHSPF). Over term and is a foundation for the
to be developed by 2022.
100 people, representing a wide range development of a comprehensive plan.
of organisations across the region,
It should be noted that the PHN, in
participated in consultations and
consultation with the DDH and WMH,
Steering
Priority
Committee and Environmental System Vision
Consultations Working Initial Plan
Working Group Scan Workshop
Groups
established
• The PHN, • Review of • Consultations • Presentation • 3 workshops: • Plan agreed
DDH, WMH PHN HNA with over 60 of key system › Information by Steering
agree to • Review of organisations issues and Sharing Committee
develop a Plan other previous and themes to › Integration
by June 2019 planning and individuals to Steering and
reports identify key Committee Partnerships
strengths, • Prioritisation › Workforce
• Review of
issues and of issues for • Priority
NMHSPF data
opportunities inclusion in actions
the Plan identified
September 2018 - October 2019
Figure 4 Development of the Plan
12.While changing community
attitudes is beyond the control
of our organisations, we are
committed to reducing stigma
within our own organisations,
in those that we fund or
commission and across the
health system.
Regional Mental Health, Alcohol and Other Drugs Plan | July 2019 - June 2021 13.3. The Plan
The PHN, WMH and DDH are committed to implementing this plan in partnership with
organisations and individuals who are part of the mental health, AOD and suicide prevention
sectors across the region.
To support the implementation of the as a key priority in improving care for population from refugee backgrounds.
plan the PHN, WMH and DDH commit people with mental health conditions These groups have unique and
to strategies and principles that will and/or AOD related issues. We changing needs as they establish their
underpin our collaborative approach. recognise the benefits of a well- lives in our community. We recognise
Over time we will seek to embed connected service system and the the need to develop the capability
these strategies in relevant strategic importance of enabling consumers of the mental health workforce to
plans as well as in induction and and carers to make informed decisions respond effectively to the needs of
professional development programs about their care. In this context, we people from a refugee background.
for staff. These principles focus on: commit to the national standards in
relation to privacy and confidentiality
• reducing stigma associated as articulated in the National
with mental health conditions
3.1 PLAN PRIORITIES
Standards for Mental Health
and AOD use; Services (2010). The Plan sets out three high level
• creating a system built on strong and priorities identified through the
effective communication; Good communication is essential to consultation and workshop process:
consumer driven service delivery. In
• recognising the need for information
delivering services, we recognise that • integration and partnerships;
sharing while upholding agreed
effective communication has several • information sharing; and
principles of confidentiality and
key features including:
privacy; and • workforce.
• ensuring all services are culturally • clear and simple language;
These priorities reflect the key
appropriate and person-centred. • asking questions and encouraging underpinning enablers for a strong,
others to ask questions; effective and collaborative mental
We recognise that there is
considerable stigma associated with • using consumers’ words wherever health, suicide prevention and AOD
mental health conditions, suicide and possible; system. A summary of findings from
AOD use. While changing community • understanding who you are the consultation process is included in
attitudes is beyond the control of communicating with; Appendix 3.
our organisations, we are committed • active listening; and The implementation of the Plan will be
to reducing stigma within our own
• being aware of the possible influence overseen by the cross agency steering
organisations, in those we fund or
of bias or personal judgement. committee supported by a working
commission and across the health
group with representation from the
system. We commit to providing Cultural capability working with three partners, key health service
training and education for staff to Aboriginal and Torres Strait Islander providers and consumers and carers.
build respect and reduce stigma. people and recognition of diversity In addition, these governance groups
Education activities will focus on is fundamental to the provision of will also be responsible for leading the
identifying and addressing bias, equitable health care. We recognise development of the Comprehensive
promoting reflective practice and the need for our mental health, suicide Regional Mental Health, AOD and
providing support for supervisors prevention and AOD system to be built Suicide Prevention Plan.
in addressing stigma and bias with on a foundation of trust, respect for
their staff. Embedding peer workers diversity, fairness and social justice.
across the mental health, suicide We commit to working within our own
prevention and AOD workforce is a key organisations, as well as across the
strategy to assist in reducing sigma system, to improve understanding
and promoting client-centred service of the needs of diverse communities
provision for organisations providing within our region and to respond to
mental health services. their needs with dignity and respect.
Improving information sharing The Darling Downs and West Moreton
between services has been identified region has a large and increasing
14.Priority Issue: Development of Comprehensive Regional Mental Health, AOD and Suicide Prevention Plan
Goal: T o develop a Joint Comprehensive Mental Health, AOD and Suicide Prevention Plan for the Darling Downs
and West Moreton region
STRATEGIES ACTION WHO TIMEFRAME
Continue the Darling Downs Update and formalise membership Led by: DDH, WMH, July 2019 -
and West Moreton joint Mental and terms of reference for the steering PHN ongoing
Health Steering Committee to committee.
oversee implementation of the Establish mechanism to monitor
Plan and development of the and review implementation of the Plan.
Comprehensive Plan.
Establish mechanism to monitor
implementation of West Moreton
(WM) and Darling Downs (DD) suicide
prevention plans and to integrate action
where appropriate.
Develop a strategy for the development
of the Comprehensive Plan.
Establish a working group to Establish a Plan Working Group (WG) to Led by: PHN July 2019
support the implementation of the support the implementation of the Plan. WG representation
Plan. Agree and document: from:
• membership (to include health services, • DDH, WMH, PHN
PHN, NGOs, consume/carers, and • GPs
Aboriginal and Torres Strait Islander
• allied and other
representation as well as others as
mental health and
appropriate); and
AOD professionals
• Terms of Reference.
• Aboriginal and
Torres Strait Islander
and culturally and
linguistically diverse
(CALD) mental health
and AOD providers
• peer workers
• consumers/carers
Develop a region-wide approach Review WM and DD suicide prevention Led by: WG Jan 2020 –
to suicide prevention. plans to identify commonalities and Dec 2021
differences.
Agree on a region-wide approach to
identify the priorities from suicide
prevention planning within the framework
of the Comprehensive Plan.
Develop data capability to Identify performance indicators that are Led by: Steering Jan 2020 –
capture baseline mental health, measurable, informative and align with Committee Dec 2021
suicide and AOD data for the organisational aims
Comprehensive Plan. Develop mechanisms for measuring
indicators at regional level.
Develop baseline measures for inclusion in
comprehensive plan.
Regional Mental Health, Alcohol and Other Drugs Plan | July 2019 - June 2021 15.Priority Issue: Integration and Partnerships
Goal: To improve quality and sustainability of care in the community for people with severe mental health conditions by
developing new models of support to GPs
STRATEGIES ACTION WHO TIMEFRAME
Explore models of shared care WG to: Led by: WG Jan 2020 -
between general practice, • review existing models of mental health June 2022
psychiatry and allied and other shared care locally and across Australia;
mental health professionals.
• identify model(s) applicable to PHN
region;
• trial and review selected model(s); and
• develop strategies for region wide
implementation for incorporation in the
Comprehensive Plan.
Define pathways for referral into hospital Led by: DDH July - Dec
and health service (HHS) psychiatrist WMH 2019
sessions either for face to face or using
GPLO
telehealth.
Review existing services (e.g. psychiatrist
registrar consultant liaison) to identify
options for improved and/or expanded
delivery of community based psychiatry.
Investigate additional options for on-call Led by: DDH, WMH Jan - Dec
psychiatry consultant support for GPs: 2020
• describe current availability of psychiatry
support for GPs;
• review currently available services; and
• consider options for fund pooling within
and across regions (e.g. other PHNs and
health services).
Explore options to improve GP Investigate opportunities and capacity Led by: PHN Jan - June
confidence in managing mental to implement Project ECHO® model, DDH 2020
health in the community. other clinical team learning models
WMH
and peer supervision to improve GP
knowledge and skill.
16.Goal: To improve person centred care for people with mental health conditions, including people at risk of suicide
STRATEGIES ACTION WHO Timeframe
Raise awareness of the Encourage all service providers (acute Led by: WG Jan 2020 -
importance of individual mental and community teams, GPs, NGOs, allied Dec 2022
wellbeing and safety plans and/ and other mental health professionals)
or mental health treatment plans to identify if a person has an individual
among service providers and mental wellbeing and safety plan and/or
reduce duplication. mental health treatment plan:
• share a variety of types of plans between
organisations;
• encourage service providers to
collaborate in the development and
implementation of mental well-being and
safety plans;
• HHSs to undertake awareness raising
and training for all mental health and
AOD staff including questions at intake
about plans;
• PHN to undertake awareness raising
and training for GPs and commissioned
services and encourage questions about
plans; and
• develop the capacity of service providers
to support people with mental health
conditions to have a person-centred
individual plan for those that do not
already have one and seek a mental health
treatment plan from a GP where required.
Include individual mental wellbeing and Led by: PHN July 2020 -
safety plan templates in GP practice June 2021
software and link to GP Mental Health
Treatment Plan.
Goal: To improve understanding of the needs of people with severe mental health conditions
STRATEGIES ACTION WHO TIMEFRAME
Undertake a research project to Audit of ED presentations to Toowoomba, Led by: PHN Jan - Dec
understand the needs of people Ipswich and two rural hospitals to: 2020
with severe and complex mental • estimate the number of people with
health conditions who: severe and complex mental illness who
• do not meet criteria for acute have difficulty in accessing services that
mental health services; and meet their needs; and
• would benefit from alternatives • identify reasons for ED presentations
to emergency department (ED) that are and are not referred to acute or
presentation. inpatient services.
Investigate alternative service options
for meeting the differing needs of people
with severe and complex mental illness to
inform the Comprehensive Plan.
Regional Mental Health, Alcohol and Other Drugs Plan | July 2019 - June 2021 17.Goal: To improve availability and equity of access to AOD support services
STRATEGIES ACTION WHO TIMEFRAME
Improve equity of access to AOD Explore opioid substitution therapy Led by: PHN Jan
services across the region. opportunities in the region by increasing - Jun 2020
capability to prescribe and dispense
(pharmacy and GP).
Investigate the ‘Hospital in the Home’ Led by: DDH, WMH, Jan
and other models for community-based PHN - Dec 2020
withdrawal such as models utilising GPs
with nurse support particularly in rural
locations.
Priority Issue: Information Sharing
Goal: To improve access to current information about mental health, suicide prevention and AOD services
STRATEGIES ACTION WHO TIMEFRAME
Develop a public online portal of Develop and enhance existing mental Led by: DDH and WMH July 2019
services and referral pathways health, suicide prevention and AOD HealthPathways Team - ongoing
including clinical and non-clinical referrals through HealthPathways. GP Liaison Officers
responses. Continue mapping of clinical health,
PHN Health Service
mental health and non-clinical, community
Navigators
social supports and services.
System Integration
Coordinators
Explore options for using the community Led by: DDH and WMH Jan
portal in HealthPathways. HealthPathways Team - June 2020
GPLO
Build on HealthPathways to incorporate Led by: DDH and WMH Jan - Dec
psychosocial support and other NGO HealthPathways Team 2020
services.
18.Goal: T o improve the quality and timeliness of referrals and discharge across the mental health,
suicide prevention and AOD systems
STRATEGIES ACTION WHO TIMEFRAME
Develop overarching best-practice WG to: Led by: WG Jan
guidelines to inform content • review existing referral and discharge - Dec 2020
and processes for referral and practices across the system;
discharge including clinical • identify key elements of good content
and psychosocial/non-clinical and processes;
services.
• develop and disseminate guidelines; and
• support workforce to adopt and embed
guidelines into practice.
Examine existing referral and WG to: Led by: WG Jan - Dec
discharge tools to develop shared • identify common referral and discharge 2020
referral protocols informed by pathways and unique needs and features
agreed guidelines. of these pathways;
• develop draft tools and protocols to meet
needs of different parts of the system;
• trial and evaluate referral and discharge
tools and protocols with health
service providers and NGOs providing
psychosocial support services; and
• revise tools and protocol based on
findings of the evaluation.
Engage with the wider WG to: Led by: WG Jan 2020 -
sector to clarify referral and • engage with agencies in other sectors Education Dec 2021
communication protocols. e.g. education, child safety, and Child Safety
housing to identify referral patterns and
requirements; Housing
• adapt referral protocols to meet needs of
other sectors where required;
• trial and evaluate referral and discharge
protocols; and
• revise protocols based on findings
of the evaluation.
Goal: To develop confidence in organisations and individuals to share information appropriately
STRATEGIES ACTION WHO TIMEFRAME
Raise awareness of frontline Identify professional development Led by: WG Ongoing
workers of importance and activities and resources available and Other organisations
value of appropriate information relevant to privacy principles and including NGOs
sharing to ensure information information sharing.
is shared in the best interests Examine and share professional
of consumers. development opportunities between
Ensure frontline workers have organisations to educate and publicise
knowledge of information national privacy principles and application
that can be shared to promote for appropriate sharing of information
between services to foster collaborative care
collaborative care aligned with
e.g., through Mental Health Professional
national privacy principles and
networks, webinars and case examples.
legislative requirements.
PHN commissioning contracts require funded Led by: PHN July 2019
organisations to demonstrate mechanisms in – ongoing
place to appropriately share information with
other providers to facilitate collaborative care
for clients whilst maintaining high quality
and safety standards.
Regional Mental Health, Alcohol and Other Drugs Plan | July 2019 - June 2021 19.Priority Issue: Workforce
Goal: To maximise capacity and capability of the peer workforce as key contributors to the service system.
STRATEGIES ACTION WHO TIMEFRAME
Develop the peer workforce across WG to: Led by: WG Jan 2020 –
the DD and WM region. • support implementation of state level Dec 2021
Examine feasibility of developing peer workforce strategy in DD and WM
and implementing a regional region;
training program for peer workers. • examine current peer workforce
Support peer workers to availability across the region and identify
undertake recognised training workforce development requirements for
leading to a qualification. mental health, suicide prevention and
AOD supports and services across the
spectrum of care;
• co-fund training and development
activities;
• provide bursaries or cadetships as part of
employment contracts;
• provide resources for training of peer
workers through commissioning
contracts;
• deliver recognised Cert IV and other
training; and
• encourage industry placements.
Build the capability and Establish a peer network or expand current Led by: WG July 2019 -
sustainability of the peer network reach using the mental health Dec 2021
workforce. professional network model.
Increase the capacity of the Provide training on supervision of peer Led by: WG Jan 2020 –
mental health, suicide prevention workers including operational and ongoing
and AOD workforce to supervise professional support.
peer workers. Investigate options for regional
supervision (using face to face or
remote modalities) to support smaller
organisations to employ peer workers.
Align regional activity with state peer
workforce strategy.
Increase recognition and value of Create materials to support education of Led by: PHN July 2019 -
the role of low intensity mental GPs and other health professionals on the GPLO ongoing
health services and peer workers benefits of low intensity services and peer
in the mental health, suicide workers and how to utilise their skills and
prevention and AOD systems. experience effectively:
• recognising different perspectives of
clinicians and others and communicating
to reflect these differences; and
• using consumer stories of positive
experiences with low intensity services
and peer workers.
Use opportunities such as Grand Rounds,
videos and social media to raise awareness
and promote their roles.
Incorporate information about low
intensity services and peer workers into
HealthPathways.
20.Goal: To increase mental health workforce capacity
STRATEGIES ACTION WHO TIMEFRAME
Increase utilisation of provisional Investigate opportunities to increase Led by: PHN Allied Jan 2020 -
psychologists where appropriate. psychology supervision capacity in the Health Liaison ongoing
region: USQ
• encourage mental health professionals SQRH
to offer supervision for provisional
psychologists; and
• explore shared supervision models.
Expand use of provisional psychologists:
• partner with USQ and SQRH to expand
student learning clinics to rural areas
with supported supervision.
Build on existing workforce to Provide accredited training for practice Led by: PHN July 2019 –
enhance system capacity. nurses in mental health and AOD (such ongoing
as courses developed by the Australian
College of Mental Health Nurses),
potentially supported through
accessing allied health bursaries and
scholarships offered through Health
Workforce Queensland (HWQ).
Identify social workers and occupational
therapists with an interest in mental
health. Provide financial support for them
to undertake training to become accredited
mental health practitioners, for example; by
accessing HWQ bursaries and scholarships.
Increase use of telehealth as Identify rural locations with adequate Led by: WG July 2019 –
a mechanism for increasing connectivity and infrastructure to establish ongoing
access to psychiatry and telehealth hubs for psychological and
psychology services. psychiatrist telehealth interventions.
Identify psychiatrists/psychiatry practices
interested in providing Medical & Benefits
Schedule (MBS) funded telehealth
psychiatric services to clients in rural and
remote locations (building on learnings
from current arrangements between urban-
based psychiatry practice and GPs/ACCHOs
in Miles, Dalby, Chinchilla and Tara).
Facilitate the development of relationships
between those services and referring GPs,
providing education on when a psychiatric
intervention is required.
Investigate psychiatry and psychology Led by: WG July 2019 -
options for telehealth interventions for ongoing
refugees by linking with PHNs in areas
where there are high refugee populations
to identify mental health professionals
with specific expertise and experience in
delivering services to refugees.
Facilitate the development of telehealth
service delivery mechanisms for refugees.
Support professional development Identify priority topics for discussion at Led by: All Ongoing
for mental health professionals. the mental health professionals network, organisations
based on local needs, emerging issues and
culturally safe service delivery.
Regional Mental Health, Alcohol and Other Drugs Plan | July 2019 - June 2021 21.This Plan will inform
the development of the
Comprehensive Plan which will
be developed by 2022.
22.4. Next Steps
The Joint Planning Guide stipulates that comprehensive regional plans should be developed
by mid-2020 to coincide with the end of the Fifth National Mental Health and Suicide
Prevention Plan. The Plan provides a sound basis for ongoing collaborative planning between
the PHN, DDH and WMH.
THE PLAN WILL LAY THE FOUNDATIONS FOR THE COMPREHENSIVE PLAN WHICH NEEDS TO BE DEVELOPED BY 2022
2022
2018 2019 2020 2021
(and beyond)
Plan Development Comprehensive Plan Development
Short Term Priority Areas
Priority Medium Term Priority Areas
Areas
Long Term Priority Areas
Workforce
Cross
Cutting Information Sharing
Issues
Integration and Partnerships
Source: Adapted from Joint Regional Planning for Integrated Mental Health and Suicide Prevention Services
A Guide for Local Health Networks (LHNs) and Primary Health Networks (PHNs), October 2018.
Regional Mental Health, Alcohol and Other Drugs Plan | July 2019 - June 2021 23.Appendix 1
Overview of the Darling Downs and West Moreton region
GEOGRAPHY AND
DEMOGRAPHY
The Darling Downs and West Moreton
PHN region spans 95,639 square
kilometres and is situated in the south
east corner of Queensland, adjacent CHERBOURG
ABORIGINAL SHIRE
to Brisbane. There are 558,803 people
(2016 ERP) residing within the PHN SOUTH
BURNETT
region and of these people 24,549 REGION
(4.4%) people identify as Aboriginal Kingaroy
and Torres Strait Islander.1 Miles Chinchilla
The PHN region has a slightly higher
WESTERN
proportion of young people compared DOWNS
REGION
Crows Nest
SOMERSET
to Queensland (0- 4 years: 7.2%PHN Dalby REGION
Esk
vs 6.4% QLD; 5-19 years: 21.2%PHN vs Tara
Oakey
19.5% QLD), a slightly lower proportion Gatton IPSWICH
Toowoomba REGION
of working age people (20-64: 56.3% LOCKYER Ipswich
VALLEY
PHN vs 59.0% QLD) and a similar TOOWOOMBA REGION
Millmerran REGION SCENIC
proportion of elderly people (65+ years: RIM
Boonah
15.4% PHN vs 15.0% QLD).2 Warwick
GOONDIWINDI
REGION
Around one third (32.2%) of the PHN SOUTHERN
DOWNS
population live in a major city area; Goondiwindi
REGION
54.3% live in an inner regional area; Stanthorpe
12.5% live in an outer regional area;
and the remainder (0.9%) live in a
remote or very remote area.3
There are two hospital and health
services (HHS), 12 private health
facilities and six Aboriginal Medical
Services situated in the Darling Downs
and West Moreton region.
Darling Downs Health services
approximately 280,200 people and SOCIAL DETERMINANTS (19.3%), Leichhardt - One Mile (15.7%)
includes the local government areas and Goodna (13.1%).7
Unemployment
(LGAs) of Cherbourg, Goondiwindi,
South Burnett, Southern Downs, Crime
The Darling Downs and West Moreton
Toowoomba, Western Downs and a
PHN region has a similar unemployment The number of reported offences in
small portion of Banana.
rate to that of Queensland (6.1% PHN Ipswich and Darling Downs Police
West Morten Health services vs 6.2% QLD). The six areas with the Districts has steadily risen by around
approximately 278,600 people and lowest unemployment rates include: one third since last year with 4160
includes the LGAs of Ipswich, Lockyer Highfields (1.9%) and Middle Ridge offences reported in December 2018.
Valley, and portions of Somerset (81%), (1.5%) and areas with the highest The most common offence was theft,
Scenic Rim (33%) and Brisbane (0.6%). unemployment rates include: Riverview followed by drug offences.4
1 Department of Health. Primary Health Networks. PHN Profile Reports [Internet].
2019 Available from http://www.health.gov.au/internet/main/publishing.nsf/Content/PHN-Profiles
2 PHIDU. Data by Primary Health Network [Internet]. 2018 Available from http://phidu.torrens.edu.au/social-health-atlases/data
3 Darling Downs and West Moreton Primary Health Network. 2018 Health Needs Assessment. DDWMPHN (QLD:AU).
4 Queensland Police Service. Online Crime Map [Internet]. 2019. Available from https://content-gis-psba-qld-gov-au.s3.amazonaws.com/apps/OCM/index.html
24.Socio-economic disadvantage Areas of particular concern in prescribing for antidepressants
West Morton were: (women 2.5% higher than national
Around a third (31.4%) of the Darling level of 9%) and anxiolytics in outer
• Esk/Lake Manchester – England
Downs and West Moreton population regional areas of the PHN (3.1%)
Creek/Lowood (29.2 ASR)
fall within the most disadvantaged compared with national rate (1.5%).
quintile compared to 20% of • Lockyer Valley (25.4 ASR)
Queensland. SA2 Areas with a high • Brassall/Leichardt – One Mile (25.1) Aboriginal and Torres Strait Islander
proportion of the population in the • Ipswich East (19.9) Mental Health
most disadvantaged quintile include:
• New Chum/Redbank Plains (18.2 ASR) The PHN HNA 2019 has limited
Riverview (100%); Nanango (91.0%);
Goodna (74.6%) and Leichardt - One data relating to Aboriginal and
Darling Downs
Mile (74.0%).7 Torres Strait Islander Mental Health.
• Kingaroy Region – North Nanango However, 9% of PHN commissioned
Homelessness (26.9 ASR) services are provided
• Chinchilla/Miles – Wandoan/Roma to Indigenous clients (where status
The Darling Down and West (22.1) has been recorded).
Moreton region has a lower rate of
• Balonne/Goondiwindi/Inglewood –
homelessness (36.8 per 100,000) Child and Youth
Waggamba-Tara (18.0 ASR)
compared to Queensland (44.5 per
100,000). However, SA2 areas with • Kingaroy/Kingaroy Region – South • headspace operates from three
a high number of homeless persons (17.7 ASR) centres in the PHN region –
include: Ipswich- Central (n=118); • Stanthorpe/Stanthorpe Region Ipswich, Toowoomba and Warwick.
Darling Heights (n=115); and Kingaroy (16.1 ASR) Collectively these centres service
region- North (n=111).7 400-600 young people per month
In the Darling Downs region males (0.43% of persons aged 10-24 years).
Disability die by suicide at a higher rate than Nearly two thirds of clients (63%) are
females (7.2:1) with people aged aged between 12 and 17 years and
At present, 6.4% of the PHN
35 years and under representing 12.7% of clients are Aboriginal and
population (or 32,811 persons) live
nearly 44% of suicides. The veteran Torres Strait Islander.
with a profound or severe disability
community has experienced an
(5.4% QLD).6 The prevalence of • There are some differences between
increase in suicides.
psychosocial disability within the types of presentations to headspace
DDWMPHN has been estimated to Emergency Department Presentations services at Toowoomba, Warwick
affect 3593 persons under the age and Ipswich.
of 65 (Darling Downs, n=1717; West Across the PHN 4.5% of Emergency
• General assistance and care
Moreton, n=1877) and 1128 persons Department (ED) presentations are
coordination makes up one fifth of
65 years and over (Darling Downs, related to mental health, with two
services at Warwick compared with
n=673; West Moreton, n=456).5 thirds of these presentations occurring
2% in the other centres.
between 10am and 8pm
• Toowoomba sees more cases with
Suicidal ideation, anxiety, depression higher severity i.e. 47% of clients
PREVALENCE OF MENTAL and reaction to stress were the present as Stage 2 – threshold
HEALTH AND AOD DISORDERS most common presentations in the diagnosis) compared toAppendix 2
Overview of current service system
PRIMARY CARE SERVICES Mild to moderate: Targeted there is considerable fluidity in this
Psychological Therapies provide system due to the introduction of the
MBS Services treatment to people who may not NDIS and changes to previous funding
otherwise have access to services, arrangements. Psychosocial support
Medicare rebates under the Better focussing on vulnerable and services are predominantly provided by
Access to Psychiatrists, Psychologists marginalised groups. the NGO sector.
and General Practitioners through
the MBS (Better Access) initiative are Severe and complex: Mental Health
available for patients with a mental Nurse Care is for people who are AOD SERVICES
disorder to receive up to 10 individual diagnosed with a severe and complex
NGOs provide a range of AOD support
and up to 10 group allied mental mental illness who are currently being
services including counselling,
health services per calendar year. managed in the primary care setting
casework, case management, family
These services are generally provided via a GP and/or psychiatrist. Services
services and residential rehabilitation
in courses of treatment, with each are provided through a clinic setting
(based in Toowoomba).
course of treatment involving up to six or outreach model including clinical
services provided by an allied mental coordination of services by a mental
health professional. At the conclusion health nurse. HHS SERVICES
of each course of treatment, the allied
Health Service Navigators: Health Public mental health services are
mental health professional must
Service Navigators (HSNs) assist GPs, provided in each of the Hospital
report back to the referring medical
service providers, consumers and and Health Services. They deliver
practitioner on the patient’s progress
carers to navigate the services available specialised assessment, clinical
and the referring practitioner assesses in the region. They can provide treatment and rehabilitation services
the patient’s need for further services. information about and coordinate to reduce symptoms of mental illness
linkages to supports and services for and facilitate recovery. These services
PHN Commissioned Services
consumers. They are responsible for are focused primarily on providing care
Primary mental health care services mapping and identifying mental health to Queenslanders who experience the
funded by the PHN are delivered service needs and gaps in communities most severe forms of mental illness and
within a person-centred stepped care at the local level. behavioural disturbances, and those
approach. Stepped care enables the who may fall under the provisions of
Mild to Moderate Aboriginal and
PHN to deliver a broader range of the Mental Health Act 2016.
Torres Strait Islander Mental Health
service types with the aim to match
Services: These services provide free, Public mental health services work
the intensity and mode of treatment
culturally appropriate mental health in collaboration with primary health
services to the intensity of a person's
services to Aboriginal and Torres and private sector health providers
individual needs.
Strait Islander people with or at risk of who assist individuals with mental
Primary mental health care services mental illness. health problems and facilitate access
funded by the PHN are delivered by to specialist public and private mental
NGOs, private providers and Aboriginal health services when required.
PSYCHOSOCIAL SUPPORT
Community Controlled Health
DDH Services
Organisations (ACCHOs) within the Psychosocial support includes
following priority areas: supports and services which aim to The DDH public mental health services
help people with severe mental illness have a range of service components
Low Intensity: easily accessible who are not more appropriately funded providing access to crisis and
services offering short term programs through the NDIS to increase their continuing care services across the
for individuals with, or at risk of, low ability to do everyday activities through lifespan. These include:
levels of anxiety and/or depression. a range of non-clinical community
Programs are delivered face to face, based support. A range of programs • The 24-hour Acute Care Team (ACT)
over the phone, via video conference are funded by the Commonwealth based in Toowoomba Hospital
and through group sessions. and State governments. As of 2019 provides advice to the whole of
26.the DDHHS and has a broad role The Older Persons Service provides workers, psychologists, occupational
to specifically liaise directly with assessment, clinic and home nursing therapists and peer workers
people at risk of suicide arriving services as well as specialist support
•O
lder Persons Mental Health Unit
in the ED, home visit assessments, and outreach to people living in
(OPMHU) based at Ipswich Hospital
and outpatient acute care follow up. residential aged care services.
providing expert mental health care
The Acute Care Team also provides
• Specialist Inpatient Acute Mental to adults over the age of 65 years
a specialist Consultation Liaison
Health Services are provided at who are experiencing mental illness,
Psychiatry service to people in the
Toowoomba Hospital with age dementia with behavioural or signs
Toowoomba General Hospital,
specific Adult, Older Persons and of longstanding mental illness
• Community Mental Health Teams Adolescent inpatient units, complicated by age related illness.
(including mental health nurses, The team provides both short and
• A specialist Adolescent Day program
psychologists and other allied health longer term mental health care.
is provided in connection with the
staff) work closely with people in Adolescent Inpatient Unit for young • Continuing Care Teams: The Goodna,
crisis and collaborate closely with people experiencing difficulty Ipswich and Rural Continuing Care
General Practitioners and other in mainstream schooling, with a Teams (CCT) provide community
support agencies and services. specialist Education Queensland based mental health assessment,
There are mental health teams in teacher in residence, and treatment and support for adults
Warwick, Stanthorpe, Goondiwindi, (18-65 years) and their families
Kingaroy, Dalby, Chinchilla and • Specialist ambulatory Alcohol and
and/or carers living with mental
Cherbourg Hospitals. Each of the Other Drugs Services with hubs in
illness. They are multidisciplinary
rural services provide outreach Toowoomba and Kingaroy/Cherbourg
teams providing specialised
services to the smaller satellite and outreach workers in the Southern
mental health assessments and
hospitals and centres in the DDHHS. Downs and Western Downs.
interventions in a culturally diverse
These teams work Monday to Friday, • DDH also provides community population to enhance community
with after-hours support and advice residential mental health services integration and networking with
being provided via the Acute Care at the Toowoomba Community Care available support agencies.
Team, On-Call Psychiatric Registrars Unit and extended treatment and
and Psychiatrists, • Gailes Community Care Unit: This
secure rehabilitation services at the
unit consists of 18 one-bedroom units
• T he Darling Downs Child and Youth Baillie Henderson Hospital.
for adults in mental health recovery,
Mental Health Service (Darling WMH Services who require additional support to
Downs CYMHS) offers a free and build or regain independence in their
confidential service specialising in The WHM Mental Health and life. This might include things like
the assessment and treatment of Specialised Services (MHSS) aims help with life skills alongside long
children and young people (up to 18 to provide the best care to the West term therapy. The team provides 24
years of age) who are experiencing, Moreton community and beyond hour, 7 days a week care and support.
or at risk of developing, severe and with mental health issues, AOD The units are built to accommodate
complex emotional, behavioural or problems, and to those requiring a adult in each unit and emulate
mental health problems. There are health care in prisons. everyday living environment.
4 multidisciplinary CYMHS teams
The WM MHSS has five main areas: • Older Person’s Mental Health Service
based in South Burnett, Southern
(OPMHS): This service provides
Downs, Toowoomba, and Western • Acute Services: providing the
comprehensive multidisciplinary
Downs regions. CYMHS services first point of contact for anyone
assessment and treatment for older
also incorporate an Assertive Youth aged over 18. The team runs West
adults over the age of 65 years.
Mobile Outreach Service (AMYOS) Moreton Health’s 24/7 mental
The service cares for those who
and Evolve Therapeutic Services, health support line
have a mental illness, dementia
who close with Child Safety for
• Adult Mental Health Unit (AMHU) with behavioural or psychological
individuals with intensive support
based at Ipswich Hospital and symptoms, or a longstanding mental
needs. The CYMHS service works in
provides expert care to adults illness complicated by age related
liaison with Headspace Services in
between 18 and 64 years who are illness. It provides inpatient care for
both Toowoomba and Warwick,
going through a mental health crisis. both acute and extended treatment
• Older Persons Mental Health Services It is a safe, therapeutic place for with care provided by a multi-
provides specialist psychogeriatric people who cannot be adequately disciplinary team. It also includes
assessment and treatment to people supported in their own home. It care to older adults in the community
over 65 years of age, or who have operates 24 hours a day, 7 days a experiencing severe mental health
age related conditions impacting week. Services are provided by a problems including outpatient clinics,
on their health in addition to their team of mental health professionals reviews for people in residential aged
primary mental health condition. including psychiatrists, nurses, social care facilities and home visits.
Regional Mental Health, Alcohol and Other Drugs Plan | July 2019 - June 2021 27.You can also read
