Get Real: Talking mental health & disability
Get Real presents frank and fearless conversations about mental health and disability, including people with lived experience, frontline workers in the sector, as well as policymakers and advocates. Get Real is produced and hosted by Emily Webb and co-hosted by Karenza Louis-Smith on behalf of ermha365 Complex Mental Health and Disability Services provider (https://www.ermha.org/).
Get Real: Talking mental health & disability
Mental health system reform in New South Wales
The mental health system in New South Wales has been in the spotlight of recent months. ABC’s recent Four Corners episode “Emergency” about the state’s mental health system highlighted the extreme system failures that happen when there is underinvestment in community-based mental health care. The program highlighted that people in deep psychological distress are being left in emergency departments for days, health workers are exhausted and the “missing middle”— those too unwell for a GP but not sick enough for hospital — are being left behind.
Our guest for this episode is Dr Evelyne Tadros, CEO of the Mental Health Coordinating Council in NSW, a peak member-based organisation for the community mental health sector.
We’ll be talking with Evelyne about where Mental Health system reform is at in NSW.
You can also listen to our previous episode with Mental Health Victoria CEO Pip Thomas about the system in Victoria and federally.
More info:
Course in Mental Health Peer Navigation
ermha365 provides mental health and disability support for people in Victoria and the Northern Territory. Find out more about our services at our website.
Helplines (Australia):
Lifeline 13 11 14
QLIFE 1800 184 527
13 YARN 13 92 76
Suicide Callback Service 1300 659 467
ermha365 acknowledges that our work in the community takes place on the Traditional Lands of many Aboriginal and Torres Strait Islander Peoples and therefore respectfully recognise their Elders, past and present, and the ongoing Custodianship of the Land and Water by all Members of these Communities.
We recognise people with lived experience who contribute to GET REAL podcast, and those who love, support and care for them. We recognise their strength, courage and unique perspective as a vital contribution so that we can learn, grow and achieve better outcomes together.
Get Real is recorded on the unceded lands of the Boon, Wurrung and Wurundjeri peoples of the Kulin Nation. We acknowledge and pay our respects to their elders, past and present. We also acknowledge that the First Peoples of Australia are the first storytellers, the first artists and the first creators of culture and we celebrate their enduring connections to country. Knowledge and stories celebrate their enduring connections to country knowledge and stories.
David:Welcome to Get Real talking. Mental health and disability brought to you by the team at ermha 365.
ermha365:Join our hosts, Emily Webb and Karenza Louis-Smith, as we have frank and fearless conversations with special guests about all things mental health and complexity with special guests about all things mental health and complexity.
Casey:We recognise people with lived experience of mental ill health and disability, as well as their families and carers. We recognise their strength, courage and unique perspective as a vital contribution to this podcast so we can learn, grow and achieve better outcomes together.
Emily Webb:Welcome to Get Real talking mental health and disability. I'm Emily Webb, erma 365 CEO. Carenza Louis-Smith is here too, and we are very excited to be speaking to Dr Eveline Tadros, the CEO of the Mental Health Coordinating Council in New South Wales, a peak member-based organisation for the community mental health sector, and it's also a registered training organisation. Eveline is a Board Director with Mental Health Australia St John Ambulance, new South Wales, and is on the board of Risk Governance and Nominations Committee for St Vincent de Paul in New South Wales. She has a doctorate degree in health science, behavioural and community health and is committed to supporting individuals and communities to thrive through systemic change and collaborative influence and action. Eveline is driven to advocate for mental health reform for and with people with lived experience of mental health conditions, along with their carers, and in championing the work of community managed organisations.
Emily Webb:Now the mental health system in New South Wales has been in the spotlight of recent months. Abc's recent Four Corners episode Emergency about the state's mental health system highlighted some extreme system failures that happen when there is an underinvestment in community-based mental health care. The program highlighted that people in deep psychological distress are being left in emergency departments for days, only to be sent home without the care they desperately need. Health workers are exhausted, psychiatrists are walking away and the missing middle those too unwell for a GP but not sick enough for hospital are being left behind. So we'll be talking with Eveline about where the mental health system reform is at in New South Wales.
Karenza Louis-Smith:Eveline, it's fantastic to have you here as part of Get Real. Can we just start talking a little bit about the Mental Health Coordinating Council, MHCC? Can you start by telling us a bit about the role and the work of the council and what you do, please?
Dr Evelyne Tadros:Of course. Well, first of all, thanks for having us, carenza. It's great to be able to talk to your listeners about the Mental Health Coordinating Council and everything that's happening in the mental health space. Mental Health Coordinating Council, also fondly known as MHCC, is the peak body predominantly for community managed mental health organisations, or what we call CMOs in New South Wales. We're also a registered training organisation delivering accredited and non-accredited training programs. We represent community-based non-government organisations who support people living with mental health challenges. We've got about 150 members assisting people who live well in the community by delivering a range of psychosocial supports, including social connection-based programs, rehabilitation and clinical services. We're also involved in policy leadership, promoting legislative reform and systemic change, and we work closely with Mental Health Australia on matters of national interest to the sector, including cross-government collaboration, bilat agreements and the NDIS, and we also work with the New South Wales Mental Health Alliance, which is a partnership of state-based peak bodies and professional associations, on matters of mutual interest in New South Wales.
Emily Webb:Now Evelyne. Recently on ABC Four Corners, doctors and frontline health workers in New South Wales told some pretty dramatic stories. They can't stay silent anymore. They're warning they're witnessing the collapse of public mental health care in the state. Cctv and internal figures showed patients in crisis, some waiting four days for care in one of the country's busiest emergency departments, and they're saying the delays are fueling violence and unsafe discharges, and it painted a very grim picture. Is this the reality that you are seeing and hearing about as the CEO of the MHCC?
Dr Evelyne Tadros:Thanks, emily. Look, it's a really complicated situation, and fixing the New South Wales mental health system at breaking point requires more than confronting images of emergency departments and stigmatising portrayals of people experiencing mental health challenges in distress. It demands investment in the community-based mental health services that prevent crisis in the first place. What often gets overlooked, I guess, is that the most effective and underfunded part of the solution is what MHCC has reiterated repeatedly that unless we invest in community-based mental health care, a continued over-reliance on emergency and acute services will perpetuate a system in constant crisis. The New South Wales mental health system is in crisis not because we lack solutions, but because we continue to under-invest in the parts of the service system that work Community-based mental health models, such as step-up, step-down programs that focus on people's recovery before crisis occurs. You know, I've always said things like prevention is better than cure, so putting things at the front end rather than back end of the system is what we would support.
Dr Evelyne Tadros:Community-managed programs are key to minimising the need for inpatient admissions and providing cost-effective wraparound supports.
Dr Evelyne Tadros:That evidence has clearly shown to have lasting positive outcomes both for individuals and the community.
Dr Evelyne Tadros:These programs offer safe transitions to and from services and parts of the service system but, most importantly, offer services that minimise the need for emergency interventions and reduce risk of involuntary orders and engagement with police and the criminal justice system. Whilst we acknowledge the extreme challenges experienced by individuals, their carers and staff in emergency settings and that is real what we need to address is the systemic issues that exist, including insufficient workforce, both inside and outside the public service system. Right, so it's not just about the psychiatrists and the workforce issues that they're facing, it's also about what our cmo sector experiences, and obviously we would just continue to advocate for you know the I think it's the four classics human-centered, trauma-informed, recovery oriented and you know, now we're certainly starting to push the agenda of supported decision making, so people just have to have access to wraparound services that meet their psychological needs, based on the social determinants of health and cultural diversity. First Nations and support that helps carers and families must be part of the mix.
Karenza Louis-Smith:So, eveline kind of, I think what you're describing is when someone's looking for kind of supports for mental health. There's not a lot there. You've got to get really sick and rock up to ED first, because the part that you talk about and I've read some of the things that you're saying about the missing middle and that's the part people who aren't so unwell that they don't necessarily need to go into hospital, into a mental health bed, but they need something in the community, and that's the gap that you're seeing and hearing about. Is that what I understand to be right?
Dr Evelyne Tadros:Absolutely, and it's about that, targeting prevention and early intervention rather than relying principally on emergency services. We'll build capacity for existing hospital workforce to meet the needs of people in crisis and keep them safe until they're stable and have plans in place to support them and their long-term recovery.
Karenza Louis-Smith:It's interesting because we chatted to Pip Thomas, the CEO of Mental Health Victoria, just a few weeks ago, just ahead of the Victorian budget, and, as you know, victoria's had a huge Royal Commission into mental health and they found really the sort of things that you're describing in New South Wales a service system that was broken over, reliance on emergency departments, not really any investment in community based mental health and that people, when they needed access to mental health services and supports, weren't getting it.
Karenza Louis-Smith:You know you had to become really, really unwell before you could get the sort of supports that you needed from a state government funded mental health service system. So it's interesting that New South Wales could have had a good look at what's happened in Victoria and gone OK. You know we don't want to go down the same path and make the same mistakes, but that obviously isn't happening. I mean, you're quite strong in your views. Crisis management isn't the answer. You know you're saying the system is broken that's certainly what the Royal Commission has heard in Victoria and a strong need to invest in what they call mental health and wellbeing hubs across the whole of the state where people could walk in without an appointment, without need you know, and just to be able to actually immediately get access to mental health supports. Is that the sort of thing that you're wanting to see in New South Wales, or are you talking about different types of investment or different things?
Dr Evelyne Tadros:Look, I think the New South Wales government needs to seriously invest in the entire mental health system Tinkering around the edges and the band-aid solutions on offer are unviable both in terms of sustainability, monetarily, as well as just in terms of the workforce. So we need multidisciplinary community care teams to engage with people, as I keep saying, prior to crisis, that facilitates their transition back into the community. Step-up, step-down models that provide short-term residential mental health programs to help people avoid or reduce hospital stays or transition them back into community after inpatient care. These voluntary, accessible services offer a safe, supportive space focused on recovery and independence, and I guess I could give you a couple of examples of those, if that's okay. The Prevention and Recovery Centre, for example, I think, was launched a couple of months ago. The report and the outcomes report of that and it's shown to reduce emergency department presentations by 33% to 44% and cost one third of inpatient care. So I'm just going to repeat those stats again it's reducing emergency department presentations by 33% to 44% and it costs one third of inpatient care.
Dr Evelyne Tadros:We've got another example of the. It used to be called the Housing and Support Initiative, also commonly known as HAZI, but it's also known as Community Living Support. They've got kind of dual names but they deliver the same thing. They support people out of hospital to appropriate community-based living environments and that program showed a 74% reduction in hospital admissions and the length of stay in hospital decreased by 75 over two years, 75% over two years. So we've got some really great evidence-based programs that work.
Dr Evelyne Tadros:Yet the investment seems minimal in those has. E would have been arguing for that program to be increased to at least 2,000 more to support 2,000 more individuals, but we can certainly get more people supporting that if there was the willingness to increase the funding in that space. And the Prevention and Recovery Centre, where there's only two of those programs in New South Wales. So there are, as I keep saying, evidence-based programs at work.
Dr Evelyne Tadros:The other thing that I'd commend is also the work of Mental Health Australia. They did a great piece of work which MHCC was involved in, and it was their advice to governments on evidence-informed and good practice psychosocial services that we contend the Australian government should fund to address the gap in psychosocial services outside the NDIS. It's a comprehensive piece of work. So we've got the evidence of what works. We just need the willingness and the political will. I'd say not even the willingness, the political will and investment. You know we talk about all these unmet needs but then we go from inquiry to commission and we don't really see the investment come through following any of the recommendations that come out of any of these inquiries and reviews that are conducted.
Karenza Louis-Smith:So I reckon you know, as taxpayers and voters, people would be listening to you and wondering why aren't people listening to those statistics? I mean, you've repeated them, they're pretty powerful. You know for every dollar that you're spending in the community, you're getting people early access to mental health treatment. You know, and I think the evidence shows that the earlier you know people need support when they need it, when, where and how. You know and the quicker you can get that and the quicker you can do that and get someone on that pathway to recovery is an important thing. So why do you think it's falling on deaf ears? You know, for want of a better phrase, it's a good question.
Dr Evelyne Tadros:I think they you know I don't envy the position of politicians because I do think they have a lot of people coming through their door with lots of demands, even in the mental health space. You know I've heard ministers talk about a fragmented system, but I guess that's our job in many ways to bring together the community-managed sector to talk and advocate and sing off the same song sheet and get those key messages out there. And our key message is community-based services work. And we've got the evidence base for that. I've just given the stats on two programs. There's an entire document from Mental Health Australia about all the other various programs and when we talk about programs it also goes into what works best for children and young people, what works best for children with autism or people with developmental delays or older generations with mental health challenges. So political will and just the guts to just give something a go.
Dr Evelyne Tadros:When I did the CEO Forum a couple of weeks ago, which brings together all my members, I pulled up a PowerPoint presentation that has all the national reviews, and there's nine concurrent simultaneous national reviews happening at the moment, and then in New South Wales we've got another 10. So between the state and the federal government. We've got some 20 different reviews that are happening simultaneously and any time I speak to a bureaucrat or a minister I say stop, no more reviews, no more commissions, no more inquiries. How about we just implement some of the recommendations on any of those reviews that have been conducted? So sometimes it's cheaper to conduct a commission or an inquiry. Or everyone wants it with their branding and their you know, labour government or the Liberal government. It's just like political nonsense. You know it's the typical utopia. Often I watch Utopia because I love it on ABC and I just see myself in that so much because I just think we just play these games and we're playing with people's lives. You know this is ridiculous.
Karenza Louis-Smith:It is people's lives and I think you know families would be saying to you I don't care about any of those things, or the stats or the numbers or the money. I just want to know that if someone that I love in my family needs mental health supports, I can get it. I can get it close to home, I can get the supports I need, whether it's for an eating disorder, anorexia, bulimia, whether it's, you know, for a young person has got you know, significant anxiety in their lives, or someone with a lower prevalence disorder like schizophrenia. You'd want to know that you can get that support now.
Dr Evelyne Tadros:Absolutely, and the challenge is that it can be really hard, even as someone who's in the system. I often get inquiries from different people and one of the challenges that I'm experiencing this week is who has drug use and mental health challenges and nobody will have a bar of it because they're like go sort out the mental health issue first, then we'll deal with the drug issue, or we'll deal with the drug issue, then we'll deal with the mental health issues. Like no, no, the person needs to be seen holistically for who they are, where they are, where they're at today, in their circumstances, not to fit into pigeonhole services. So it is really hard for people to access the right services and if you are isolated or if you can't afford it, or if you're in regional New South Wales or if you have other compounding factors, it makes it impossible to access.
Dr Evelyne Tadros:My mother is an NDIS participant who experiences physical and mental health challenges and you know I'm in the sector. So between my sister and I we try and support her as best we can, and it's not easy. It's definitely not easy. We see it day in, day out, not just with our mum but also with other members of the community who just happen to. We're obviously not a service delivery and we don't do direct services. But people contact us and then we re-divert as best we can.
Karenza Louis-Smith:I mean, Emily and I often talk about it as like a bowl of spaghetti. You know, it's like you're trying to navigate your way through the stuff Messy. It's really hard. You're very messy, and you're right, I think. Even if you work in it it's really difficult. You know, I suppose the burning platform in New South Wales, of course, is, you know, the Bondi Junction inquest as well. That's coming up now as well too. You know, and I suppose that paints a picture as to what can happen when someone does fall through the gaps and cracks in the service system where supports aren't there. I imagine that's going to be pretty stark when those findings are handed down as well.
Dr Evelyne Tadros:Yeah, I understand the findings will be handed down in December this year. So we'll be watching and listening and seeing what we can contribute to any of the findings and the gaps that are identified there, but certainly jurisdictional gaps between state and territories, and that's something the federal health and mental health ministers have recently been speaking about. In terms of data sharing and how do we do that better? Certainly in New South Wales, I sit on the Central East Sydney Primary Health Network regional planning and they're looking at how do they better share data across Central East Sydney and inform which is the New South Wales Health Data Centre, and they're just about to finalise a shared data agreement between those two parties, just so that in central East Sydney you can start to share data and it'll be de-identified. It's more just aggregated data so you can start to see themes and patterns, but it's a start.
Dr Evelyne Tadros:There needs to be data sharing. We obviously need to protect the privacy and confidentiality of individuals, but how do we better service individuals holistically if everyone's on the same data set and it's the same with police? Police are the ones that get called out when there's an emergency and the situation is escalating, but they don't have the same data as health, for instance. So ambulance officers would have different data set to what police have. So what opportunities are there? I mean, obviously we just got to navigate the challenging bureaucracy that exists in terms of, you know, different data sets for different parts of the organisation.
Karenza Louis-Smith:Yeah, they're really powerful observations. I mean, we certainly have, you know, seen and experienced some of those, I think, challenges in Victoria as well. Yeah, they're challenging times, so I go with you. It'd be, you know, sit back and look very carefully and see what the inquest actually finds and what recommendations it might make.
Emily Webb:We've touched on this a little bit, Eveline, but we mentioned again. We spoke to Philippa Thomas, the CEO of Mental Health Victoria, about the need to define investment to address unmet needs for psychosocial support outside the NDIS, which is a very big issue right now and the statistics say there's about half a million Australians missing out on psychosocial support. So, along with your counterparts in other states, you wrote an open letter to the government to act on this. So what do you think is the solution? What should the federal government be doing to support the states in this?
Dr Evelyne Tadros:I feel like this could be another hour podcast in and of itself, but let's give it a shot. So the health and mental health ministers met in Melbourne on the 13th of June to discuss key issues around the national mental health reform. The jurisdictions agreed to certain steps in child and youth mental health, unmet need for psychosocial supports and developing the mental health workforce. They recognised the importance of listening directly to lived experience representatives which was really positive, and I know Mental Health Australia had a strong position and a strong participation in that and to also consult more broadly with the sector. They also agreed to respond to the profound and increasing impact of mental health challenges. It's just the how they're going to do that. That will be a challenge. The ministers reaffirmed their shared responsibility for psychosocial supports, and by that it means the Commonwealth and the states agreed to all come to the party to contribute in terms of how they're going to meet crucial service needs. But they agreed to do that through the National Mental Health and Suicide Prevention Agreement, which comes to a conclusion in June next year, and the Productivity Commission will soon release their final report and findings. The ministers also committed to maintain existing funding for psychosocial supports which, quite frankly, is insufficient because the demand, as you said earlier, emily, is half a million unmet need between severe and moderate. Yet we're going to maintain the services until we come up with this agreement sometime next year. So, unfortunately, the meeting outcomes fell short in terms of genuine reform needed for communities. We and I certainly stand with Mental Health Australia in continuing to call for all governments to come to the table with tangible actions that prioritise mental health and supported by long-term investment plans.
Dr Evelyne Tadros:I think you know. You asked me. You know what are the solutions. I guess some of my key recommendations are that you know the half a million moderate, severe and unmet need. There was a group called the Psychosocial Project Group that were getting together to plan, prepare a plan to address the unmet need and you know there's always a plan for a plan for a plan or there's an inquiry to develop a plan. Anyway, I'll just stop being cynical for a sec. The call I make is to that group to release the plan but also ultimately quantify the cost of delivering the plan, because I think what you do is you get this, you know wonderful plan and it's like, okay, nobody actually costs out how much it's going to require for us to invest in. So release the plan to meet the unmet need, quantify the plan and ultimately invest in it, because again you might get a plan, then you might. It's a bit like the national stigma and discrimination strategy. It was a wonderful resource developed and then God knows where it's sitting In terms of Commonwealth stuff and the jurisdictional. I would say release the plan, quantify the plan and ultimately invest in the plan in terms of rolling out what the plan will do.
Dr Evelyne Tadros:The other part of me I try and always put the hat of the ministers on and I wonder whether or not the states and territories are unwilling to commit the 50-50 funds with the Commonwealth until they know what are they actually committing to and what services will they get for their commitments. You know, someone says to you you need to invest a million dollars or a billion dollars. Well, what am I investing in? What is that going to produce? Right now they're saying all the states and territories need to come to the party, but they're not clear about what they need to come to the party with. So again, release the plan and the quantification and that might also assist states and territories to understand what they're committing to.
Dr Evelyne Tadros:The other thing just very quickly, that I think a lot of people have been burnt by the NDIS. A lot of the states and territories had to cut back a lot of their own state-based programs to invest in the NDIS. And now, 10 years later, the NDIS is scaling back and leaving the states to respond to this gaping hole left behind. So a lot of states and territories and community members are saying you know, we have these wonderful programs and you folded them because you said you were going to invest it in the NDIS. And now you know there's NDIS taking out these psychosocial services and they're going to, you know, do these foundational supports and that's going to cut out people in the long term. So we need to understand what it is we're going to invest in and make sure that commitment is clear.
Dr Evelyne Tadros:And the last thing I'd say around federal government is workforce, workforce, workforce, workforce. We can talk about all the programs under the sun, but unless we have investment in the workforce, we're not going to get anywhere. And I would emphasise workforce must, must, must include the community managed organisations. The federal government released the National Mental Health Workforce Strategy for 2022 to 2032, and it didn't explicitly call out the community managed sector. So I would say, therefore, it's silent on it.
Dr Evelyne Tadros:Mhcc does a workforce profile report every two years, so we've got six years' worth of data and, based on our data, we make up a quarter of the mental health workforce in New South Wales. So you've got these wonderful national strategies. That is missing a quarter of the workforce. So you know we identified a solutions paper late last year that it's not rocket science, but we talked about things like workforce recruitment, retention, career promotion and pathways, training and education conditions and REM. It has to be equitable with our private health colleagues or our government health colleagues. So our staff leave our sector to go to the public health system because they pay better. So there's 10 top tips and we're calling on the government to invest 10 years so that we make sure the workforce is there to meet the demand.
Emily Webb:Eveline, a bit more about you. You were recently given the title of Adjunct Associate Professor at the University of New South Wales in the Faculty of Medicine School of Clinical Medicine, discipline of Psychiatry and Mental Health. Can you tell us about that and your work and what that's contributing to the sector, like what you're really passionate about right now? I mean, apart from the stuff you've been speaking to us about now?
Dr Evelyne Tadros:Look, emily, I think I'm still grappling with the school and the discipline and the title and it just feels like I'm making my email signature even longer. But, jokes aside, and it's really interesting that you asked the question, emily, after we've just spoken about workforce, because for me, I sometimes think about this role in terms of all our workforce advocacy and you know, just privately, I've reflected on my journey and for those of you following me on LinkedIn, I was sharing that. You know, just privately, I've reflected on my journey and for those of you following me on LinkedIn, I was sharing that. You know I'm the classic kid from southwest Sydney who spent most of my school years in what they call ESL classes English as a second language and my year 10 English teacher, who also happened to be our careers advisor everyone had duplicate roles back then once told me that they'd never make it to uni and you know, fast forward and got a couple of degrees in this honorary title and it's certainly clearly personally validating. But more importantly, how does it help me to contribute to the mental health system nationally and and in the state? And one of my favorite quotes is from Theodore Roosevelt that talks about the man in the arena and the sentiments are basically that you have to be in the circle rather than sitting on the outside critiquing, and so the sentiments resonate deeply with me because it emphasises the value of actively participating and striving for change rather than just merely critiquing from the sidelines. I think Brene Brown calls it the cheap seats. You know, when you're sitting at the cheap seats and you're sitting there and you're cussing and you're cursing at the person who's not getting the ball in the chute or whatever the case might be, you know you've got to be in it to win it, I guess.
Dr Evelyne Tadros:So how do I see myself as contributing? Well, there's a couple of things. I've already started delivering some lectures for a mental health practice post-grad that they're doing at the University of New South Wales, and so delivering lectures and collaborating on curriculum design. So there's ambitions for University of New South Wales to do some more master's degrees in mental health and more postgraduate degrees in mental health. So I can bring the lens of the CMO sector, which for me is really exciting. So it's not just about psychiatrists and psychiatry, it's about psychiatrists potentially in the community managed organisations. So a number of our organisation members employ psychiatrists within the organisation. So how they collaborate in that space, how they collaborate with GP networks, how do they collaborate with PHNs and LHDs. It's bringing the whole mental health system together in some sense. So being trauma informed, what I can bring to that role is also just the peer workforce and certainly things around mental health system reform.
Dr Evelyne Tadros:So research and policy discussions. I'll contribute to what they call applied and transactional research. So you can often do research and then you have to, you should be implementing it in practice. Or sometimes it's what practice can inform research. So if we've got great services out there, how can we get them evidence-based so that they can start to inform research? It's practice to research, research to practice. If you can imagine a circle and I'm in front of a whiteboard, that's what I would be drawing up for you. But a lot of my work in that research component will also be with MindGardens, the neuroscience network, on their psychosis flagship program and you know, I guess just mentoring students as they're coming through so that they choose mental health as a specialty. I mean, I'm only a couple of months into this role but maybe in year twos and three I can start to branch out to psychology and social work as well and start to work with those departments, not just psychiatry. But it's a great opportunity for the sector to lift up the voice of the CMO sector.
Emily Webb:I'd love to be in one of your lectures, Evelyne. I think you sound like you'd be fantastic.
Karenza Louis-Smith:Very passionate. I'd be babbling on much like I am now. Evelyne, I think you nailed it about workforce. You know it's huge, isn't it? I mean you can't. The sector can't make these changes, it can't do these things without a workforce. You know how do you get people to be excited about coming into mental health, what do those career pathways look like, and how does that support as well the kind of lived and living experience movement too? So I'm keen to hear a bit more, because you've launched a new accredited mental health peer navigation course in New South Wales starting in July. It's a sector first initiative and it's offering limited free places for New South Wales peers and lived and living experience workers. As for our listeners, let's just touch on what's the lived and living experience worker? How's that different, or is it the same as a peer worker, and what's the programme?
Dr Evelyne Tadros:Okay, lots there. So let me take a step back. Ten years ago MHCC Mental Health Coordinating Council pioneered the Certificate IV in mental health peer work and you know that's been a wonderful program to lift the voice of lived experience, lived experience workers and peer workers. It can largely be the same thing and now, as you've alluded to, we're thrilled to announce or introduce the peer navigator program, mental health peer navigator program, which is a new accredited program designed for peer workers and delivered by individuals with lived experience in mental health challenges and peer workers. So all our trainers are not only TAE training, assessment, evaluation I think it is qualified but they're also people with lived experience and have been peer workers themselves. So it's really exciting not only to deliver this program, we got funding from the New South Wales Mental Health Commission to scope out that program, so to design that program. So we designed it and we put it on scope so it's nationally available under the ASQA registration.
Dr Evelyne Tadros:And peer navigation is an emerging and distinct role within peer work. That is a response to extensive findings about the challenges for consumers in finding supports with a complex mental health service system, as Emily was talking about earlier. You know, trying to find services in the system is, first and foremost, one of the most challenging parts. Once you get in there, you've got to navigate the ups and downs of recovery, but just finding the right service in the first place is one of the biggest challenges. So we've been proud to lead the development and co-production of the course and it's based on, as I said before, those four key things that I keep talking about recovery oriented.
Dr Evelyne Tadros:And, as I said before, those four key things that I keep talking about, recovery oriented, consumer led, trauma informed. I'm going to add five it's human rights and probably supported decision making. You know kind of got to have a mantra of five different things that we go around talking about in terms of the programs that we deliver and the ways of working. So it's about connecting people with the right supports at the right time in the right place. The course was also developed and co-produced with people with lived experience, peer workers, key advocates, to ensure it spoke to the needs of those with mental health challenges. So it's pivotal and we're excited to accelerate it and to support the workforce through it.
Karenza Louis-Smith:And you're offering free places as well. So I mean, if people have you know, lived and living experience and listening and you know thinking about what's a career pathway into mental health, how can I, you know, use my own experience? This is a massive opportunity for people to kind of put their hand up and be part of this. How do people find out more of Evelina and get involved?
Dr Evelyne Tadros:Yeah, it's a good question, Karenza, and I think there's a couple of things. So I have this in my head. Doesn't exist elsewhere, but in my head. I have this kind of blow of where to start. If you're starting out fresh in the sector, peer navigator is probably a good one to start with, and then going to like a certificate for in mental health, peer work. And then we've also got something called peer work leadership. So that's for people who've been peer workers for a while and now all of a sudden they've got supervision responsibilities. So all our courses often have, at different times of the year, fully funded spots available and then, when fully funded spots have been taken up, you can get fee-for-service arrangements, so getting your employer to fund it. All the information is available on our website, mhccorgau. If you just click on training and go through all the material there, you'll be able to see which positions have the funded spots and which ones require fee for services.
Karenza Louis-Smith:And we'll put that in the show notes as well, so people can have a look.
Emily Webb:We certainly will.
Karenza Louis-Smith:Key navigators you talk about that. It's a really interesting concept, isn't it? And you said it's quite new. And my understanding tell me if you think I'm right or wrong is that you know, when you first come into a mental health service, you can actually meet with a peer navigator. This is someone with lived or living experience, who's experienced what it's like to be in the mental health service system and actually walks alongside you and helps to support you to navigate, to get to the supports that you need. Certainly, that's how I understand it in Victoria. Is it similar in New South Wales, or is it different?
Dr Evelyne Tadros:Spot on. That's exactly how it is. Carenza, Well done.
Karenza Louis-Smith:Thank you, and I just think that's what a powerful thing, hey, to be able to walk into a service. And here's someone you know, when you might be at a really low point in your life, you know, maybe seeking help for the very first time, here's someone that's kind of been there, navigated it, done it, and you can think there's a sense of hope for me. You know I'm not alone. This is someone who understands maybe where I'm at and you know I can. Yeah, I've got some hope that I'm going to get there. I'm going to get to a place that feels a bit better than where I'm feeling at the moment.
Dr Evelyne Tadros:Absolutely. I think just having someone to walk with you alongside until you get to the right support services is a wonderful thing. It's a bit like having a navigator in your car. Right, you're the driver, you're responsible for your life, you're in charge or should be, of your choices that you are able to make, and the navigator just helps you to go. Look, you've got a couple of different routes that you can take to get to the city. You can either go the m5, or you can go the m4, or you can go down canterbury road or you can go down him highway. You can tell I live in southwest sydney, so it uh, you know it's not too dissimilar to what you would have as a navigator in the car. Peer navigator is someone with lived experience who's navigated the system themselves and has also, you know, added tools to their toolbox to be able to help others navigate the system.
Karenza Louis-Smith:I just think that's massive. You know, and so you know I mean you were talking about got 150 members now of MHCC. What are community leaders and advocates telling you specifically? I mean, you've just hosted you mentioned your big leaders forum. You know you had a lot of the right people in the room. You also host as well, and I was fascinated by this. You know you've got the parliamentary friends of you know, so you bring key people from government into these conversations as well. What are you hearing and what are the top maybe two or three things that you know. If anyone listening has power to do some of these things, what is the sector saying is the most important things to be putting effort, time, attention into?
Dr Evelyne Tadros:Carence. I'm not going to answer your question by giving you two. I will struggle to narrow a whole day down to two, but let me share a couple of things that came out of it. The Minister for Mental Health, the Honourable Rose Jackson, addressed the group with key priorities that she sees for the New South Wales government, which would be useful for your listeners to hear about, which included Medicare, mental health centres, safe havens, psychosocial support and housing, which is similar to the community living support program that I spoke about earlier, crisis helplines and the whole of government approach to suicide prevention, which is an upcoming legislation that Parliament is currently looking at. So that's Minister Jackson's key priorities and her government's key priorities.
Dr Evelyne Tadros:The forum served, I guess, as vital platform for community leaders to address key issues with the health minister, but included things like housing intersections with housing, youth detention and the integration of mental health services across the service system. So I think that's always important to think about that. Mental health intersects with almost everything that goes on, whether it's prenatal, whether it's schoolyard bullying or whether it's aged care and end of life. Mental health intersects with so many different other service systems. One of the real standout presentations for me was from the wonderful Jessica Radican, who is the first principal statewide peer lived experience workforce officer that's a mouthful, but she works for the New South Wales Ministry of Health, who talked about the great work that's being progressed to integrate peer workers across the mental health service system. So they're coming up with a statewide strategy for peer workers and we also got some funding from that department as well for the scholarships that we spoke a little bit about earlier, those fully funded free spaces for peer navigator and the certificate for mental health. Those scholarships came from the department as part of their strategy.
Dr Evelyne Tadros:And the last thing that I'll share about what happened in the CEO Forum is I guess I was also able to provide an update on the mental health system reforms, both nationally and within the state, and reflect on the over 40 submissions that we've made thus far this financial year. And I know the financial year is not over yet, but Corin Henderson is my Director for Systems and Policy Reform and myself and Katie Sam between two of us and a little bit of Katie we've written over 40 submissions. So we've certainly been busy and all of our submissions for your listeners can be found on our website, so check it out. But the other thing that's really useful is that I was also able to talk about broader systemic reform issues and there's four key ones that I've been working with other sector colleagues. One is the Portable Long Service Leave Scheme, which is available for all community workers and there's all these other conditions but Portable Long Service Leave Scheme.
Dr Evelyne Tadros:There's something called secure jobs funding certainty, which is a state government commitment to, I guess, three key pillars, was to focus on long-term funding arrangements, so five-year contracts to be issued which will help the workforce stuff that we've been talking about. A funding framework which includes things like a pricing approach or some assumptions around pricing, and a whole of government pre-qualification schemes. So secure jobs funding certainly was the second one. The third one was around workers' comp reform, which has certainly been garnering a lot of momentum at the moment and there is a real desire to see reform, but making sure the system supports those with psychological claims and also makes the system viable. System supports those with psychological claims and also makes the system viable.
Dr Evelyne Tadros:And the last broader sector reform issue that I've been focusing on is the Shads Review, which is the main award that many of our frontline staff would be under and there is some significant reviews happening under that that we've been participating in. We've certainly made some submissions around, so the CEO Forum is a good opportunity to bring everyone together. It was great to have Minister Jackson there, great to have all our colleagues together, and the other thing is that the New South Wales Mental Health Commissioner held a workshop following our CEO Forum to also start to talk about the New South Wales mental health strategy, which is a whole of government strategy that is underway in terms of development, and you can have your say through the website. If you just go to the New South Wales Mental Health Commission website, you'll be able to find links to have your say about what should be included in the next 10-year strategy.
Emily Webb:Yeah, thanks for that. We'll certainly share that in the show notes, because it is really important for community engagement for people to actually contribute to these things. We saw that in Victoria with our Royal Commission. But, eveline, there's just so much going on. I can't believe we've done 40 submissions in this past financial year, which is not over. So absolute hats off to you.
Dr Evelyne Tadros:Thank you. That's why this is great, that this is digital, so nobody can see the gray hairs.
Emily Webb:Yeah, like amazing things when it's audio and editing and stuff. But honestly, there's so much that you've spoken about and Carenza and I just want to thank you so much for your time and the opportunity to get this information out for people to hear. So thank you so much, eveline.
Dr Evelyne Tadros:Thank you, and I'll just finish off by saying, if you're not already a member of Mental Health Coordinating Council, I encourage you to consider doing so, and membership information is available on our website, mhccorgau, and you can also sign up to our weekly newsletters, which is available for free. But thank you, emily and Carenza, it's been great chatting with you and I wish you all the best.
Karenza Louis-Smith:It's been an absolute pleasure. Thanks, Eveline, You've been listening to Get Real talking Absolute pleasure.
David:Thanks, eveline. You've been listening to Get Real talking mental health and disability, brought to you by the team at Irma 365. Get Real is produced and presented by Emily Webb with Corenza Louis-Smith and special guests. Thanks for listening and we'll see you next time.
.jpg)
