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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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