People power: the reform leaders

Last week, Minister for Health and Ambulance Services Dr Steven Miles launched Shifting minds: Queensland Mental Health Alcohol and Other Drugs Strategic Plan 2018-2023 at the Leading Reform 2018 Summit.

The summit, hosted by the Queensland Mental Health Commission, brought together 250 leaders in the fields of mental illness, mental health and wellbeing, suicide prevention, alcohol and other drugs, employment, and housing. It was a powerful opportunity to build momentum across sectors in an effort to tackle the fundamental question of ‘How do we do things better?’

I share with you my opening address in which I introduce the three focus areas of Shifting minds—Better lives, Invest to save, and Whole-of-system improvement …

We’re here for two reasons today. One: to launch Shifting minds, the renewed strategic plan for Queensland, and two: to bring together leading thinkers and influencers, clinicians, service providers, policy makers, planners, funders, decision makers, and people with lived experience, to drive the next phase of reform in Queensland.

Together—the Shifting minds strategic plan, and the Leading Reform Summit—will lead the agenda for reform to our mental health, alcohol and other drug, and suicide prevention and related systems.

During the two-day summit we will discuss the plan, as well as new initiatives and possibilities for change, to guide sector and broader community thinking about reform. We will showcase innovation in service delivery, best practice, and contemporary evidence, from state, national and international examples.

Shifting minds has been constructed around three fundamental areas of need: the individual, the population and the system. This approach is supported by four pillars which includes timely access to quality clinical care; psychosocial support; housing; and education/employment.

This plan incorporates the spectrum of interventions from service delivery and treatment, to a population health approach, all of which must be supported by an authorising environment to achieve the outcomes that matter.

Focus area 1: Better lives

Under the ‘Better lives’ focus area, the aim is to achieve better life outcomes for people, by placing community-based services at the centre of integrated care, and emphasising social and economic inclusion and participation. Better individual outcomes require quality and timely supports, resources and services from within and beyond the healthcare sector.

This plan takes a holistic approach to wellness and wellbeing that recognises good clinical care, delivered alongside psychosocial support, and a range of human and social services, is vital. Having a safe, secure and affordable place to live, access to education, training and work, and good social connections are key to keeping well. This includes strengthening linkages and coordination across clinical mental health, AOD services, physical health care, and psychosocial, housing and employment services — and bridging public, private and non-government sectors.

The priorities include strengthening acute and crisis responses — including alternatives to the emergency department — for people experiencing mental health and AOD emergencies, and suicidal behaviour.

In addition, the plan recognises the continuing need to enhance the capability and capacity of the workforce and strengthen human rights.

Focus area 2: Invest to save

Currently, the system is largely geared to responding to crisis. The ‘Invest to save’ focus area seeks to realise the health, social and economic benefits of promotion, prevention and early intervention.

We don’t want to be picking up the pieces, we want to get in early in life, early in vulnerability and early in illness, by actively supporting individuals and communities to thrive and live well.

We need to shift our focus to environments, services and supports that maintain people’s health, wellness and quality of life in the community, so that hospitals are no longer the first point of call, but rather an option of last resort for people that require that level of care. This has universal benefit and will help reduce the medium to long-term costs to the health, education, welfare, justice and other systems.

We will work to strengthen mentally healthy environments by focusing on the ordinary, everyday settings in which we live and lead our lives, including families, schools, workplaces and communities.

We want to equip individuals and communities to better maintain their mental health and wellbeing, identify signs of emerging issues, and seek appropriate support where needed.

We also want to focus on giving infants the best possible start in life by improving family supports during the vital early development years; and enabling older Queenslanders to age well through social connection, economic participation and good physical health and wellbeing.

In developing the plan, we heard of the importance of flexible and tailored approaches to meet the diverse needs of Queenslanders, across their lifespan.

We also heard the need for strengths-based solutions and the need to avoid the deficit-based narrative that categorises people as lacking, and fails to promote the strengths and resilience that is evident in many groups we serve, including Aboriginal and Torres Strait Islander peoples, people from culturally and linguistically diverse backgrounds, and the LGBTIQ+ community.

Successful implementation will ensure the Plan meets the diverse needs of all Queenslanders, with priority towards tailored approaches for specific groups and communities.

Focus area 3: Whole-of-system improvement

Whole-of-system improvement is the third focus area and is fundamental to achieving real reform.

Continuing to balance investment towards community-based support as a real alternative to hospital-based treatment is high on the agenda; as is prioritising prevention and early intervention. This requires shared leadership, governance and accountability across policy, planning, funding, commissioning, and delivery. It also requires building on, and leveraging existing and new opportunities for collaboration and innovation.

Key priority areas outlined in the Plan have commenced through existing Government initiatives and governance arrangements, including those identified under Our Future State: Advancing Queensland’s Priorities, for example:

• Suicide prevention
• Early years
• Youth justice, and
• Employment.

To support implementation, a Strategic Leadership Group will be established to provide the authorising environment to oversee and align reform at every stage. This Group will work in close collaboration with key stakeholders and other governance mechanisms to drive the shared reform agenda.

Successful implementation requires leaders and practitioners from all sections of the community — but, we can only succeed if we meaningfully and respectfully engage people with lived experience, their carers and families.

Above all, shared ownership is critical to reform… because it’s not plans — as important as they are — that make reform happen… it’s people like yourselves who advocate for, and hold the levers of reform.

Over the next few days we will discuss some challenging issues, like drug law reform, but we also hope to engage, persuade and inspire… because you, as agents of change are essential for leading reform.

Underpinning all that we do must be the lived experience of individuals, families, carers and communities.

But let me be clear: reform is not an easy task. It takes sustained and collective action. There’s no great ‘eureka’ moment, no grand finish line. It’s a journey of a thousand miles… counted one step at a time, and a road we must travel together.

As former Prime Minister Julia Gillard wisely said: “Great reform takes time to grow deep roots.” 

I encourage you to take a look at Shifting minds: Queensland Mental Health Alcohol and Other Drugs Strategic Plan 2018-2023.