State of the System December 2018
Reviewing Tasmania's mental health system and our State Government's commitments 

As we approach the end of 2018, MHCT has reflected on the state of our mental health system in Tasmania – what progress has been made this year, what we can expect for our communities in 2019 and beyond, and where we still have more work to do. 
 
In the lead up to the State Election in March, our major political parties all made a series of commitments about mental health delivery in Tasmania. MHCT has reviewed the returned State Government’s policy announcements and commitments from that period, and provided an update on:
·        each mental health commitment
·        confirmed funding by the Liberal Government in the 2018/19 state budget; and
·        progress on each mental health commitment (as at December 2018)
 
We hope this snapshot provides our Members and supporters with a good overview of the state of our mental health system, as we collectively continue working towards a mentally healthy Tasmania #forallofus
 
Join the movement www.mentallyhealthytasmania.com
 
25 New Mental Health Beds 
Tasmanian Liberals Election Promise
1.   10 New Beds at Mistral Place  
Funding of $14.2 million provided over the next six years to operate the additional beds. The State Government will start the relocation of staff and construction process immediately after the election, and the new beds will open as soon as construction is complete and staff are recruited, which we expect to be within twelve months of commencement.
2.   15 New Beds at the Peacock Centre 
The right model of care and staffing will be determined by clinicians, but it is estimated that 29 additional full-time equivalent staff will be employed, including more than 16 nurses, 4 allied heath staff, an additional doctor as well as operational and administrative staff. Funding of $15.8 million is provided over the next six years to operate the additional beds, and it is expected that construction will cost $9.2 million and take two years to complete. The new beds will open in 2020.
 
18/19 State Budget Allocation
A total of $8,043,000 was allocated in the 2018/19 state budget period, with the 2019/20 forward estimate being $7,467,000. Future forward estimates up to 2021/22 totalled $12,802,000 making a total between 28/19-21/22 of $28,312,000 of funding for these initiatives. For the 2018/19 budget, the allocation breakdown was a general funding amount of $1,203,000 and $6,840,000 was allocated specifically for infrastructure.
 
Current Status

The state government has expanded this initiative to 27 mental health beds - this will be delivered through the existing promise of 15 beds at the Peacock Centre, however the proposed expansion of Mistral Place will not proceed. It will be replaced by a new 12-bed dedicated mental health facility on a greenfield site at St John's Park in New Town, Hobart, due for completion in 2021. In the interim, a12 bed equivalent will be delivered through a Mental Health ‘Hospital in the Home’ (HITH) initiative, as recommended by the Department of Health and the Chief Psychiatrist, Dr Aaron Groves. HITH has delivered general health supports in the North of the state since 2016, and this will be the first time a mental health-specific HITH option will offered to Tasmanians in the south of the State.  HITH provides intensive hospital level care at home for people with acute illness – and this new service will focus on supporting individuals experiencing mental illness. This initiative will be only available to Tasmanians in the south of the state (within a 40km radius of Hobart).
 
16 Bed Adolescent Health Unit at the Royal Hobart Hospital
Tasmanian Liberals Election Promise
$30.9 million has been promised over six years to fully staff and open a 16 bed Adolescent Unit in the redeveloped Royal Hobart Hospital (RHH). The unit is to provide dedicated space for specialist mental health care for young people. The Liberal Party’s pre-election promise stated that these beds will provide integrated care for adolescents at the Royal Hobart Hospital, with capacity for medical and surgical patients, as well as the provision of safe rooms for young people receiving mental health treatment. The Tasmanian Liberal Party pre-election policy document stated, "Detailed service planning will occur with staff and stakeholders while the construction of the new inpatient building is completed, but it is expected approximately 50 additional full-time equivalent staff will be recruited, including 36 nurses, 4 doctors and 6 allied health staff. It is expected the new beds will open in 2020.
 
18/19 State Budget
The budget for this initiative is a component of the overall budget for the delivery of 250 more beds at the RHH. The 18/19 Budget stated: "Funding of $299 million over the next six years has been allocated to boost acute care in Tasmania by fully staffing 250 new beds at the newly refurbished Royal Hobart Hospital from 2020-21. These new beds will be progressively rolled out from 2020-21. This includes [… ] a dedicated 16 bed adolescent unit."
 
Current Status
This initiative is a component of the current RHH redevelopment. Health Minister Michael Ferguson advised in September 2018 that the Adolescent unit will open, "next year.” MHCT has also been advised that detailed service planning consultation will take place with staff and identified stakeholders, including families and consumers, prior to the completion of construction.
 
8 Beds on Ward 4K at the Launceston General Hospital
Tasmanian Liberals Election Promise
The initial pre-election promise stated $19.1 million will be invested over six years to fully staff and open 8  additional beds on Ward 4K at the Launceston General Hospital (LGH), on completion of the redevelopment, including specialist facilities for mental health care. The policy also stated that, "it is expected the new beds will open when the Ward 4K Redevelopment is complete in 2019" and "detailed service planning will occur with staff and stakeholders while the construction of Ward 4K is completed, but it is expected approximately 26 additional full-time equivalent staff will be recruited, including 18 nurses, 2 doctors and 3 allied health staff”.
 
18/19 State Budget
The 2018-19 Budget provides funding, commencing in 2019-20, for eight new beds on Ward 4K at the LGH. The budget consisted of $3,627,000 for the 2019/20 forward estimate, $3,718,000 for the 2020/21 period, and $3,811,000 for 2021/22 totaling $11,156,000.
 
Current Status
In early October 2018, the government announced that, "major excavation of the new Women’s and Children’s precinct site at the Launceston General Hospital is now complete and building work is progressing well." The announcement also stated, "the Ward 4K redevelopment will provide a new 36-bed contemporary facility, which will include Tasmania’s first dedicated Adolescent Mental Health Unit, along with a number of specialist clinics. Within the Adolescent Mental Health unit, there will be six single-bed rooms designed to meet contemporary adolescent mental health care requirements. There will also be separate lounge, dining and outdoor areas for patients." It was also noted that the first stage of the project, including the adolescent mental health facilities, is on track for completion in 2019.
  

In February, the Mental Health Council of Tasmania launched a public, year-long campaign #forallofus – ‘Moving Toward a Mentally Healthy Tasmania’.

The campaign launch was strongly attended by member organisations working in the mental health front line across our state, including: Lifeline Tasmania, Colony 47, Relationships Tasmania, Mental Health Carers and Youth Network of Tasmania (YNOT). Audience members stood together and made a firm commitment to join the movement, pledge their support for a mentally healthy Tasmania, and pass on the message to spread the word right across the state.


Our first campaign event was a public forum in Hobart, titled ‘Moving toward a mentally healthy Tasmania – what does success look like? A conversation with Professor Patrick McGorry AO’.

The public forum provided the opportunity to hear Pat, Tasmanian Health Minister Michael Ferguson MP, Labor politician, Sarah Lovell MP and Greens politician, Rosalie Woodruff MP explore how, collectively, we can bring about a strong and resilient system for mental health, wellbeing and suicide prevention in our state.

We would like to thank everyone who attended for their support of this event, and for those who were unable to make it, MHCT is pleased to be able to share Professor Pat McGorry’s presentation

Mental Health Peer Workforce Strategy
Tasmanian Liberals Election Promise
$120,000 in funding over two years for the Mental Health Council of Tasmania to work in partnership with the Government to develop a Tasmanian Peer-Workforce Strategy. The Tasmanian Peer-Workforce Strategy will provide the overarching framework to ensure Tasmania’s mental health and suicide prevention peer workforce is supported into the future, ensuring optimal outcomes for consumers, the peer workers and services.
 
18/19 State Budget
This initiative was funded as per the election promise within the 2018/19 budget.
 
Current Status
MHCT has finalised the project recruitment and project work will begin in the New Year with a range of consultations. The first year of this project will be focused on strategy and development, with the second year focusing on developing a range of resources to support the establishment of a peer workforce across Tasmania.
 
Eating Disorders Peer Workers Partnership
Tasmanian Liberals Election Promise
$400,000 over two years for a trial partnership between the Government and the Butterfly Foundation (which merged recently with Tasmania Recovery from Eating Disorders), to recruit peer workers to support Tasmanians living with eating disorders. These peer workers will provide support to both adolescents and adults, as well as their families and loved ones.
 
18/19 State Budget
This initiative was funded as per the original election promise in the recent state budget
 
Current Status
The National Eating Disorders Collaboration (NEDC) has been working on a review of government-funded eating disorders training in Australia and is in the process of releasing a draft report for consultation. The Government and the Butterfly Foundation have now agreed and executed the funding agreement to deliver on this commitment.  They are currently finalising the work plan which will see recruitment of peer workers occur in the first quarter of 2019. 


Mental Health Integration Taskforce
Tasmanian Liberals Election Promise
The original election promise was that, "a re-elected majority Hodgman Liberal Government will convene an expert taskforce to provide advice on improving integration of mental health services in Southern Tasmania." This pre-election promise also outlined that the taskforce would seek consultation from a number of stakeholders, stating: "Representation will be sought from health stakeholders, including the Mental Health Council of Tasmania, Butterfly Foundation, Flourish, Mental Health Carers Tasmania, the Australian Medical Association, the Australian Nursing and Midwifery Federation and Primary Health Tasmania".
 
18/19 State Budget
This pre-election promise did not have any funding requirements attached to this initiative.
 
Current Status
The Integration Taskforce was established in April and has had a number of meetings. The taskforce has also consulted with a range of stakeholders, as well as conducting a number of forums throughout the year with a range of industry representatives. The taskforce's report is due in the New Year.
  
Housing Accommodation and Support Initiative Trial
Tasmanian Liberals Election Promise
Pre-Election, the government promised funding of $500,000 per annum over two years to trial the Housing and Accommodation Support Initiative (HASI). This promise outlined, "HASI will be a partnership between the Tasmanian Health Service, Housing Tasmania and Colony 47 to provide Tasmanians with mental illness better clinical and psychosocial rehabilitation supports, linked in with stable housing and supported accommodation."

18/19 State Budget
This initiative was funded in the state budget, which stated: “Funding of $1 million over two years is provided to trial the Housing and Accommodation Support Initiative, which has been highly successful in New South Wales. HASI will be a partnership between the Tasmanian Health Service, Housing Tasmania and Colony 47 to provide better clinical and psychosocial rehabilitation supports to Tasmanians with mental illness. This will be linked in with stable housing and supported accommodation.”
 
Current Status
The Government, Colony 47 and the Tasmanian Health Service are finalising the model of care and operational arrangements for the service.  It is anticipated that the trial will commence in March 2019.


Rural Alive and Well (RAW)
Tasmanian Liberals Election Promise
This pre-election promise was additional funding for Rural Alive and Well (RAW) of $380,000 over the next two years.  The pre-election promise states that, "this funding will assist RAW to provide better outreach support, particularly focusing on older Tasmanians who are experiencing mental health concerns in regional areas." RAW was also promised $1.46 million under the Taking Agriculture to the Next Level Policy - making the total commitment to RAW $1.84 million.
 
18/19 State Budget
This pre-election promise was funded as per the commitment.
 
Current Status
The Liberal Government’s pre-election commitment to provide Rural Alive and Well (RAW) with additional funding was fulfilled through the first state-budget of the re-elected government.