What do the Victorian State Budget announcements about mental health funding mean for migrant and refugee communities?
This year’s State Budget includes one of the largest commitments to mental health in Victoria’s history. The Victorian Government has committed over $3.8 billion towards the mental health system over the next four years. This is part of the State Government’s promise to implement all of the recommendations of the Royal Commission into Victoria’s Mental Health System.
ECCV has reviewed the Budget measures to understand what the implications are for multicultural organisations, and for migrant and refugee communities. See below for our summary and analysis of:
More capacity for existing mental health services
There are significant commitments in this year’s Budget to increase access to services, including services for older people, young people and consumers of acute clinical services. This will involve expansion of a range of community-based and hospital-based services including:
- $954.3 million over 4 years for 22 area-based mental health services to replace existing services
- $195.8 million over 4 years for 13 reformed infant & child area mental health services, 3 infant, child and family mental health hubs, and community perinatal mental health teams
- $266 million over 4 years for youth area mental health services
- $173.4 million over 4 years for suicide prevention and response services
- Increased beds in services for young people, women and prisoners
- Increasing services in the justice system
- $7.5 million over 2 years to establish Ambulance Victoria as the first responder to mental health calls to triple zero.
These developments will be positive for people who are ending up in crisis because they are not able to access services in a timely way. Establishing Ambulance Victoria as a first responder, and ensuring people in crisis have access to a health-based response to mental health crisis is particularly important for people from migrant and refugee backgrounds. Too often the intervention of police results in people from migrant and refugee backgrounds becoming criminalised when they have a mental health crisis.
New services and programs
This Budget commits to a range of new services, and major reforms to existing services which will shift the focus of the mental health system. A signature reform, as recommended by the Royal Commission, is the allocation of $18.5 million to establish a lived experience organisation to put people with lived experience of mental health concerns at the centre of the system. A further $1.7 million is allocated to design a new state-wide trauma service to better support people with lived experience of trauma.
The Government has started working on a new Mental Health and Wellbeing Act to replace the previous Mental Health Act 2014.
Other new initiatives in this Budget include:
- $92.7 million over 2 years to establish 8 carer and family-led centres, and expand support for carers and families
- $263.7 million to establish 20 new adult and older adult mental health and wellbeing services
- $217.8 million over 4 years for a new School Mental Health Fund for initiatives in schools
- Trials of integrated alcohol and other drug (AOD) services within area mental health services
- $42.3 million over 4 years to establish state-wide specialist services in addiction medicine and hubs for people with both mental health conditions and substance use challenges.
Ensuring that people with lived experience are at the centre of the system is an essential transformation. ECCV applauds the Victorian Government for making an ongoing commitment make sure that people with lived experience are supported and resourced to participate in the re-design of mental health systems. Recognition and support for families and carers is also vital aspect of mental health reform. These services need to be inclusive of all types of families, including extended families and the family roles and relationships among all culturally diverse communities.
Capacity to design a new system
This Budget commits to several new agencies and bodies that will help to transform the way the mental health system works. This includes $71.2 million for the new Mental Health Division of the Department of Health, and establishment of a Mental Health and Wellbeing Commission.
The new bodies will also include:
- $18.6 million over 4 years for the Collaborative Centre for Mental Health and Wellbeing, to undertake research and inform best practice
- $34.8 million over 4 years for 8 new interim regional bodies and regional multi-agency panels that will be responsible for commissioning local services
- $206.3 million over 4 years for a range of workforce development initiatives, including training programs, graduate places, and scholarships
- $2.5 million in 2021-22 to develop a new approach to information management and data collection
- A new Performance Monitoring and Accountability Framework
- $24.1 million over 4 years to establish a new unit within Safer Care Victoria, and to end seclusion and restraint in acute mental health services
- $8.5 million over 4 years for regulation and complaints handling bodies
The budget also allocates funding to develop a capability framework for state-wide mental health services.
ECCV looks forward to working with these agencies to design the new mental health system.
Where to from here for multicultural organisations and communities?
The gap in services
The Royal Commission found that the Victorian mental health system is not culturally responsive and in many cases is unsafe and exclusionary.
The only specific initiative in this Budget to address the mental health needs of people from migrant and refugee backgrounds is an allocation of $3.9 million to continue provision of mental health supports for people seeking asylum who are ineligible for Medicare.
ECCV members have highlighted that there is a major gap in culturally-informed and responsive mental health care across Victoria. Few multicultural organisations are funded to deliver mental health support or to reach migrant and refugee communities.
This gap has grown exponentially over the COVID-19 pandemic, with people from migrant and refugee backgrounds, and multicultural community organisations consistently reporting that isolation, anxiety, depression and other mental health concerns have significantly affected communities.
A Diverse communities mental health and wellbeing framework
This Budget has allocated $4.6 million to develop a diverse communities’ mental health and wellbeing framework and blueprint for action. This framework is intended to address the needs of LGBTIQA+ communities, people from migrant and refugee backgrounds, and people with disability. It is positive that this framework is being developed at the outset of the reform process, and it is a necessary step to building capacity for a contemporary approach to the diversity of the Victorian community.
Transforming the current system into one that is culturally responsive, safe, and inclusive will take time and resources. A diverse communities framework that seeks to address the needs of people from migrant and refugee backgrounds, people with disability and LGBTIQA+ people will be limited as the needs of the population groups it will address are not all the same. For this approach to be effective we need to look beyond simply grouping together populations labelled as “other”, to an intersectional, human rights based model that addresses the systemic barriers faced by people affected by discrimination and exclusion.
Meeting the needs of people from migrant and refugee backgrounds
However, without specific initiatives involving migrant and refugee communities, there is a risk that the mental health needs of people from migrant and refugee backgrounds will continue to remain invisible within a mental health system that is not culturally responsive. People and families will bear the consequences through avoidable suffering, lives lost through suicide, unnecessary and avoidable contact with the justice system, homelessness, unemployment, and other adverse consequences.
To address the mental health needs of migrant and refugee communities, we need resources and services that are based in communities. It is multicultural and ethno-specific community organisations that hold the knowledge and capability in cultural responsiveness. The multicultural sector needs to be informed, proactive and engaged to be part of the reform process in order for migrant and refugee communities to have equitable outcomes.
The Royal Commission agreed:
The Victorian Government must now bring the knowledge and intelligence of diverse communities—and supporting government portfolios—together with the Mental Health and Wellbeing Division of the Department of Health and the Mental Health and Wellbeing Commission. Together, a plan must be established to ensure the mental health and wellbeing system meets the needs of diverse communities now and into the future, putting the rhetoric around inclusive and responsive services into action.
Achieving this will require coordinated and systematic reform across every domain of the mental health and wellbeing system, including the funding, commissioning, design and delivery of services and the governance, leadership and workforces that underpin the system. (Final Report: Volume 3, Chapter 21, p. 209)
ECCV has received funding from the Department of Health to share the findings and recommendations of the Royal Commission with our members. We have put together this Mental Health Reform webpage and will be sharing more information and seeking feedback from members.
4 June 2021