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Overview of Mental Health in Western
Australia
Prepared for the Mental Health Advisory Council
Mental illness
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Mental illness describes a range of disorders such as anxiety, depression, bipolar and
schizophrenia.
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Mental health problems and mental illness will affect around 20% (1 in 5) of the adult
population in their lifetime and between 10% and 15% of young people in any one
year.
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The highest prevalence mental illnesses are mild and moderate disorders such as
anxiety and depression, with approximately 18% of the Australian population being
affected within any year.
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Severe illnesses affect around 3% of the adult population. They include psychotic
disorders such as schizophrenia, bipolar, severe depression and anxiety disorders.
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Psychotic disorders can be very disabling, leading to intermittent hospital admissions
and increased risk of homelessness and social isolation.
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Early steps to 1900 in WA
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… only by constant vigilance can they ensure that the days of indifference, neglect
and degradation of the mentally ill will never occur again1
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WA’s first patient – Dr Nicholas Langley arrived 1829
By 1831- three insane men in the Perth lock-up
Temporary asylum in 1857
Permanent asylum at Fremantle in 1865
1862 –It is never necessary to resort to seclusion for more than few hours at a time,
and not necessary in a whole year to use any mechanical restraint
1866 – control of the mentally ill became independent of the superintendent of prisons
1877 – Board of Visitors - ‘visit and inquire what occupations or amusements are
provided …’
1890- 1990 – various inquiries about conditions
1890 – recommend the demolition of the Fremantle asylum
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1 A.S. Ellis(1984) Eloquent Testimony: The Story of Mental Health Services in Western Australia 1830-1975 UWA
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Press
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1900 to 1970
• 1904 – the Claremont Hospital for the Insane
• 1950 – Royal Commission into ‘alleged cases of brutality’ at
Claremont
• 1960s – the beginning allied health professionals; day hospitals
• 1963-1977 – open days to ‘show you how your money is spent’ ;
Mental Health Week in 1966
• 1967 – Charter of Mental Health Services (see page 203)
• Voluntary organisations - The Mental Health After-Care Association
was the first of its kind in Australia, established Casson House in
1922
• 1960 – The Mental Health Association
• 1972 – Claremont Hospital closed
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Government structures
• State
– 1895 – establish the Medical Department
– 1903 –the Lunacy Department
– pre 1964 to 1983 – department for Mental Health Services
– July 1983 – Abolish Mental Health Services and absorb it into the
Health Department
– January 2010: Create a Mental Health Commission
• National
– 2011: Create a National Mental Health Commission
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Current Legislation
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Commonwealth
Human Rights and Equal Opportunity Commission Act 1986
Disability Discrimination Act 1992
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State
Mental Health Act 1996 (Minister for Mental Health)
Hospital and Health Services Act 1927 (Minister for Health)
Criminal Law (Mentally Impaired Accused) Act 1996 (Attorney General)
Equal Employment Act 1984
Disability Services Act 1993
Carers Recognition Act 2004
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International
Universal Declaration of Human Rights 1948
The Convention on the Rights of Persons with Disabilities (CRPD) 2007
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System Governance
at May 2013
Minister for Mental Health
Commissioner
Mental Health Commission
Chair, Mental Health
Advisory Council
Health and
Disability
Complaints Office
Minister for Health
Director General
Department of Health
Chief Psychiatrist
Office of the Chief Psychiatrist
Chief Executive
North Metro Area Health Service
Area Mental Health Service
President
Mental Health Review Board
Head
Council of Official Visitors
Chair
Ministerial Council on
Suicide Prevention
Consumer, family
and carer advice and
involvement
Women’s & Newborn’s Health Service
Chief Executive
South Metro Area Health Service
4 x Area Health Services
Community sector and
industry providers
Chief Executive
Child and Adolescent Health Service
Child and Adolescent Mental Health Service
Executive Director
Denotes funding
agreement
Office of Mental
Health
Chief Executive
WA Country Health Service
Northern and Remote Country Health
Southern Country Health Service
Statutory roles
The Mental Health Review Board is an independent quasi-judicial review body established under Part 6 of the
Mental Health Act 1996 (the Act). The Board's primary statutory role is to review involuntary patients, in
accordance with the Act. Involuntary patients are those people who have been placed by a psychiatrist on an
involuntary order under the Act.
The Council of Official Visitors has a statutory role with respect to involuntary patients and those people residing
in licensed psychiatric hostels. It undertakes, at the direction of the Minister, inspections of authorised hospitals
and private psychiatric hostels. As advocates for involuntary patients and residents, the Council can raise
concerns with the service managers or operators directly or through the Chief Psychiatrist or other statutory body.
It reports annually to Parliament
Chief Psychiatrist has a statutory responsibility for the medical care and welfare for all involuntary patients and is
required to monitor standards of psychiatric care provided throughout the State (Part 2 Mental Health Act 1996) .
Licensing Standards and Review Unit (LSRU) in the Department of Health has a statutory responsibility
under the Hospital and Health Services Act to ensure that operators of private health facilities and psychiatric
hostels are appropriately licensed and meet the relevant standards. LSRU have the legal authority to investigate
complaints about breach of the legislation or relevant regulations. LSRU have issued standards against which the
various licensed facilities are monitored. These standards include the Standards for the Management Staffing and
Equipment of Psychiatric Hostels.
Health and Disability Services Complaints office is an independent State Government agency established
by legislation to deal with complaints about health and disability services. It provides a free service to all users of
health and disability services in Western Australia. The Office has the power to deal with health and disability
complaints - the power to make recommendations following an investigation but no power to enforce compliance
with these recommendations.
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Mental Health Advisory Council
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Provide high level, independent advice and guidance to the Commissioner, Mental
Health Commission, on mental health issues including:
– Implementation of the WA Mental Health Strategic Plan 2010-2020
– Reform and implementation of strategies and broad directions in mental health
and well-being
– Improvements to funded programs to better support people with mental illness,
including through better coordination and integration of existing mental health
programs
– Strategies to focus mental health programs for people with particular needs
Act as a consultative forum to ensure that advice to the Commissioner reflects the
broad range of views and experience of people with mental illness, their families and
carers
Consult and liaise with the mental health and related sectors, including mental health
consumers and carers, professionals and providers in the non-government sector, the
private sector and the public sector
Provide advice on specific issues as requested by the Mental Health Commissioner.
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Public Mental Health Services 1
North Metropolitan Area Health Service has two mental health service providers:
NMAHS Mental Health is managed as a program across NMAHS, with a number of major mental
health programs:
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Adult Mental Health Program with community clinics and inpatient services
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Older Adult Mental Health Program with community clinics and inpatient services
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State Forensic Mental Health Service
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Statewide/Tertiary Services
– Centre for Clinical Research in Neuropsychiatry
– Mental Health Emergency Response Line
– Neurosciences Unit
– Creative Expression Centre for Arts Therapy & Reflections Art Studio
– Statewide Specialist Aboriginal Mental Health Service
– Centre for Clinical Interventions
– Post Graduate Training Program for Psychiatry
Women’s and Newborn Health Service
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WA Perinatal Mental Health Unit
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Mother Baby Unit
Public Mental Health Services 2
The South Metropolitan Area Health Service provides Mental Health
Services through four health services (effective 30 June 2012):
– Fremantle Hospital
– Royal Perth Hospital (including Bentley Health Campus)
– Armadale Hospital
– Rockingham Hospital
• Each supports a range of local Adult and Older Adult MH Services,
with community clinics and inpatient services.
• The Multicultural Mental Health Service is a statewide program, line
managed through Royal Perth Hospital.
• SMAHS Mental Health Strategic Leadership Unit supports MHS
across SMAHS.
Public Mental Health Services 3
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Country Health Services (CHS) covers the largest
regional area in Australia (2.55 million square
kilometres).
Consists of the Northern and Remote Country Health
Service (NRCHS) and Southern Country Health
Service (SCHS). There are four regions in NRCHS
and three regions in SCHS.
Provides a range of local Adult and Older Adult
Mental Health Services, Child and Adolescent Mental
Health Services, through community clinics and
inpatient services.
Four mental health inpatient facilities located at
Albany, Bunbury, Kalgoorlie and Broome.
Mental health services are integrated with
mainstream health care provision in the regions.
Works in partnership with government and nongovernment services such as Aboriginal Medical
Services, RFDS, and General Practitioners.
Public Mental Health Services 4
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Child and Adolescent Health Service – Child and Adolescent Mental
Health
In February 2011, CAMHS in the metropolitan area were consolidated under
the Child and Adolescent Health Service.
The new organisational structure is based on programs, rather than
geographical boundaries.
CAHS CAMHS programs:
– Community CAMHS (clinics at Armadale, Bentley, Fremantle, Peel,
Rockingham, Clarkson, Hillary, Warwick, Swan and Shenton);
– Acute CAMHS (Bentley Adolescent Unit, Transition Unit, Ward 4H at
PMH, Paediatric Consultation Liaison, Assertive Community Intervention
Team, and the newly formed Emergency Service); and
– Specialised CAMHS (Eating Disorders, Family Pathways, Families at
Work, YouthReach South, YouthLink, Multisystemic Therapy, Complex
ADHD Service).
Significant regular events
• Schizophrenia Awareness Week (May)
• World Suicide Prevention Day (10 September)
• Annual TheMHS conference (Sept)
• World Mental Health Day (10 October)
• Mental Health Week (October)
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