Purro Birik - 10

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Purro Birik - (Healthy Spirit)



5.1 Accessibility and Responsiveness of Mental Health Services


In some areas, rural Koori health services reported that accessibility and responsiveness is generally improving as a result of local protocol and liaison arrangements being developed with mental health services.


However, it was also reported that confidence in the mental health system remains low due to previous bad experiences with clinical and administrative staff, cumbersome paperwork requirements, poor provision of information on the management of mental illness, inadequate response to crises situations (particularly after hours), difficulties with cross border issues, exclusionary language used by mental health clinicians, and the lack of culturally sensitive inpatient mental health services, particularly in rural areas.


The consultations also identified that mainstream mental health service criteria often resulted in very needy people missing out on support because they do not fit a particular profile, that secondary consultation was difficult to access unless local agreements were in place, that mental health services were often unwilling to see people at Koori health service consulting rooms, and that the 'human response' from staff at mental health services was often disrespectful to Koori people.


Difficulties with cross-border issues are not limited to along the Murray River. Koori health services have reported problems with accessing services across mental health service boundaries, and with people with high needs arriving from other capital cities. 


The issue of gaining access across public mental health service boundaries was raised particularly in relation to providing services to Koori people whose permanent address is outside of the area where the presentation for admission or assessment is made. There has also been some difficulty with area restrictions that some metropolitan child and adolescent mental health services (CAMHS) have applied to the relationships established with the Koori Kids Program at the Victorian Aboriginal Health Service.


The metropolitan consultations emphasised that partnerships with public mental health services are difficult to establish due to the small number of Koori health services in the metropolitan area and the larg~ number of mental health services. The arrangements between St. Vincents Hospital Mental Health Service and the Victorian Aboriginal Health Service were recognised as positive, however, it was also recognised that better relationships need to be established, particularly with crisis assessment and treatment teams (CATTs) and other inpatient units.


The need for effective partnerships between psychiatric disability support services (PDSS) and Koori Health Services was raised at one of the metropolitan consultations. PDSSs provide an extensive range of ongoing care programs, including supported accommodation, day programs, arts, employment, health promotion and recreation programs. The consultation participants emphasised the importance of Koori people being able to access these services independently or through a partnership with Koori health services.


5.2 Quality and Effectiveness of Mental Health Services


A number of consultations expressed concern for the quality and effectiveness of mental health services. Several Koori health services raised issues related to: the overuse of medication; a lack of process to review use of medication; unclear treatment plans; poor responses to treatment; and misdiagnosis (often associated with an unwillingness on the part of mental health services to include family and/or Koori health workers in the assessment process).



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