Introduction
Mental health illnesses are the fastest growing cause of disability in Australia (Australian Government - Department of health, 2009). That statement alone underscores the greater need for reforms and policies aimed at ensuring that mentally ill individuals attain recovery and achieve a fulfilling life regardless of their conditions (Harvey, Wang, Mykletun, Butterworth, & Christensen, 2017). Recovery involves a personal process that reclaims the individual's self-identity, independence, self-worth, purpose and active living. Recovery-based principles ensure that attitudes, goals, values, perception, ideology, and approach to life are adjusted towards overcoming setbacks of mental illness and achieving a satisfying and hopeful life (Bejerholm & Roe, 2018).
The process calls for collaboration among different players such as the government, private care providers, NGO's, family and the society at large to re-instate wholesome living for the mentally ill individual. (Loganathan & Fulford, 2009). The Government plays a vital role in the establishment, implementation and follow up for policies on recovery at the national and regional levels. Shared responsibilities between federal government and state governments have been clarified to provide for a unified yet flexible framework of approaches that allows for successful recovery at all mental health level needs (Rapp, et al., 2005).
Mental health staff in collaboration with consumers and other involved social support systems play a huge role in line with recovery policies at all levels of government to achieve personal values, strength, and wellness for mentally ill persons (Tew, et al., 2011) (Oshodi & Rush, 2011).
This paper will focus on recovery-oriented principles and the underlying policies in Australia. It will evaluate the best way towards the integration of these policies by analyzing progress, identifying shortcomings and providing recommendations for best implementation strategies of recovery-oriented mental health care.
The Case for Australia
Australia just like most countries around the world has endeavoured to recognize the place of recovery as a model for productive mental health care. (Ramon, Healy, & Renouf, 2007). Since the '90s, clear national policies have been established that accentuate recovery as a process that aims at developing meaning, purpose and a stable sense of self to achieve overall personal wellness has been widely studied under the research area of positive psychology (Medibank, 2018) (Francesca C. Grace, Carstensen, Harris, & Whiteford, 2015). Australia, unlike America, has less involved recovery reforms with politics. Gradual developments have been realized in policies presenting crucial changes in mental health recovery. One of the significant rollouts of these developments has been the national mental health plans which have been in release every five years since 1992 underlining and documenting essential changes in mental health practice and service delivery in Australia.
Policy development in Australia has seen the implementation of recovery-based care being mainstreamed and prioritized. Policies underlining recovery as a tool towards personal well-being, power, and identity reclamation have been established (Whiteford & Buckingham, 2005).
The establishment of the National Mental Health Commission has been effective in providing a reference point to aid in long-term reforms in mental health care. Established in 2012, the commission served as an executive agency aimed at ensuring future-oriented planning on mental health reforms, enhancing transparency and ensuring national coverage of recovery-oriented mental health policies (David M Clark, Green, Layad, Pilling, & Jackena, 2017).
Major reshuffles have occurred through government legislation which have gone as far as restructuring the cabinet composition to provide a fully representative system that incorporates mental health care need in its structure. In 2011, the establishment of the National Mental Health Commission necessitated the promotion of minister of mental health to the cabinet. This change occurred at the federal level of governance. This has been further adapted into regional and local levels of government with states such as Western Australia and New South Wales establishing similar commissions on mental health into their governments (Liberman, Kopelowicz, Ventura, & Gutkind, 2002) (Government of South Australia, 2010).
Government financing and expenditure on mental health recovery is essential for the success of the process. Advancements have been realized in this area at national and local levels with the federal government spending more on mental health as compared to the previous years (Andrews & Slade, 2001)
The establishment of a national disability insurance scheme has been significant in ensuring inclusive service delivery and enhanced access to recovery-focused mental health services (Perkins, et al., 2010). Further, the government has been supportive of the not-for-profit players in mental health recovery in Australia. This has occurred through the establishment of government-supported programs of 'disability support centres' which offer services in the lines of rehabilitation, advice, housing, and employment assistance (Sponiol, Werwoski, Gagne, & Anthony, 2002) (Drake, Skinner, Bond, & Goldman, 2009).
Another important policy is the Prevention and Recovery Care of 2003 which aimed at improving access to clinical and medical interventions by individuals with severe cases of mental illnesses (Mind Australia, 2018). The goal would be achieved via the provision of recovery-oriented social and health support provided in care residential settings. The policy is another initiative that taps into the collaborative efforts of NGO's and private for-profit sectors' input into the mental health recovery framework.
Further policies have also been established seeking to enhance collaboration between the different stake holding sectors in the area of recovery-focused care. An example is the Consultant Liaison in Primary Care Psychiatry which is a model that relies on the collaboration of private practitioners and the public sector (Graham, Carol, Lynette, David, & Gillinder, 2007). The private practitioners liaise with community mental health service providers to provide clinical management services and share common patient registry and record systems. This allows for the effective continuation of care, follow-up and successful recovery path.
Additional policies have also been adopted that focus on social aspects of recovery and continuum of care. These frameworks of mental health emphasize the need to evaluate recovery in the context of the social impacts on individual and society (Andresen, Oades, & Caputi, 2006). Recovery-oriented mental health care consumers and providers recognize the need for social relations in the recovery process. This calls for the incorporation of appropriate environment essential for the furtherance of relationships between the service user, family, and friends. Social reclamation and re-incorporation back to society for the affected individual requires the provision of a socially active life even while under care. Relationships should not be curtailed, rather they should be maintained and enhanced. This has been majorly achieved under community-based care settings which work best at maintaining close social and intimate relationships which are essential for full recovery. Inpatient services have however experienced challenges implementing this, though initiatives have been adopted over the recent past that involve the creation of family rooms to provide an intimate space for engagement with loved ones (Curtis, 2001).
Contextualized care and service delivery is equally crucial. Recognizing the cultural, belief and religious differences existent among the different cultures in Australia is essential for the achievement of recovery aimed goals and objectives (Gopalkrishnan & Babacan, 2015). From its definition, recovery recognizes the need for social and cultural appropriateness in service delivery and care environments. Important too is ensuring that mental health service and strategies maintain dignified, respectful, socially inclusive interventions that encourage self-determination of providers and users.
The Housing and Accommodation Support Initiative is a policy established in 2002 that strives at ensuring that people living with mental illnesses live a full life socially and economically. The plan provides for independence and wholesome living for the mentally ill adults by providing for housing and accommodation support and other mental health packages through the collaboration of health, housing departments and NGO's (Bruce, Mcdermott, Ramia, Bullen, & Fisher, 2012)A similar NGO driven policy is The Personal Helpers and Mentors Initiative. This is a 2007 policy that aimed at ensuring that the mentally ill, especially the ones whose illnesses have led to the inability to live independently attain the needed support. The initiative is crucial in ensuring that the mentally ill are not neglected or left out in the society but rather are accorded the needed support especially in the social aspects of living. This is essential for the attainment of self-worth, value, optimism, and empowerment which are core in recovery.
Similarly, Headspace, a 2006 policy is another reform that is noteworthy in its recovery-focused impact. This National Youth Mental Health Foundation focuses on the younger demographic of individuals with mental health illnesses by providing opportunities for the wholeness of life in areas such as counselling, general health, drug, and addiction-related services, employment and education opportunities. Individual attention is accorded each user while also allowing virtual support via telephone and other online mediums (Diclemente & Prochaska, 1998) (Drake, Skinner, Bond, & Goldman, 2009)'Partners in Recovery' is one of the latest initiatives established in 2013 that incorporates the collaborative effort of federal funding and non-governmental organizations. Multiple services are provided through collaborative funding and services tailored to individuals depending on the particular level of need (Cheverton & Janamian, 2016).
The National Mental Health Plans have been exceptional at driving towards mental health reforms and the achievement of recovery as a core focus of mental health practice. Since 1992, The National Mental Health Plans have recognized the central place recovery-oriented policies play in mental health care. This has been grounded in the five national mental health plans that have been released since 1992 at a five-year interval. Each rollout has been aimed at addressing the shortcomings of the previous plan with major improvements aimed at social inclusion, mainstreaming, structural integration and unification of approaches at government levels CITATION hea09 \l 1033 (Australian Government - Department of health, 2009).
The first plan of 1992 was aimed at the integration of mental health services into mainstream health...
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