
Mental Health and Wellbeing Act
Members will be aware the Andrews Government introduced the new 700-page Mental Health and Wellbeing Bill into Victorian Parliament on 21 June 2022. The following information provides further explanation about the mental health royal commission’s recommendation for new legislation, how the new draft Act was developed and what has changed in the bill.
What did the royal commission say?
In recommendation 42, the royal commission recommended that the Victorian Government:
1. repeal the Mental Health Act 2014 (Vic) and enact a new Mental Health and Wellbeing Act, preferably by the end of 2021 and no later than mid-2022, to:
a) promote good mental health and wellbeing;
b) reset the legislative foundations underpinning the mental health and wellbeing system; and
c) support the delivery of services that are responsive to the needs and preferences of Victorians.
2. Ensure the Mental Health and Wellbeing Act
a) includes new objectives and mental health principles, with its primary objective to achieve the highest attainable standard of mental health and wellbeing for the people of Victoria by:
– promoting conditions in which people can experience good mental health and wellbeing;
– reducing inequities in access to, and the delivery of, mental health and wellbeing services; and
– providing a diverse range of comprehensive, safe and high-quality mental health and wellbeing services.
b) clarifies the roles, responsibilities and governance arrangements of the new mental health and wellbeing system;
c) establishes the bodies and roles referred to in other recommendations, including the Mental Health and Wellbeing Commission (refer to recommendation 44), the Chief Officer for Mental Health and Wellbeing (refer to recommendation 45(1)) and Regional Mental Health and Wellbeing Boards (refer to recommendation 4(2));
d) strengthens accountability mechanisms and monitoring arrangements for service delivery;
e) specifies measures to reduce rates and negative impacts of compulsory assessment and treatment, seclusion and restraint;
f) simplifies and clarifies the statutory provisions relating to compulsory assessment and treatment such that they are no longer the defining feature of Victoria’s mental health laws.
g) specifies the ways in which information about mental health and wellbeing may be collected and used.
What are the key steps in the development of the new Act?
June – August 2021: public engagement
- ANMF made a submission to the Response to the Department of Health Mental Health and Wellbeing Act Update and Engagement Paper read via via www.anmfvic.asn.au/MHWAsub
- ANMF held three member workshops in July 2021
- ANMF facilitated an implementation session in October 2021
Late 2021: analysis of submissions used to inform development of the new Act
- release of What we heard report (December 2021), read via engage.vic.gov.au/mhwa
Late 2021 – mid-2022: legislative drafting and government approval processes
- ANMF provided feedback on key components of the draft with the assistance of our mental health members and the monthly ANMF Mental Health Royal Commission Working Group which comprises mental health nurse members.
Mid-2022 Victorian Parliament considers the draft Bill
- The new bill was introduced to Victorian Parliament on 21 June.
23 July 2022: Victorian Health Department’s mental health workforce draft legislation update
- This 30-minute recorded session can be viewed via bit.ly/3NGRrWD
2023: commencement of the new Act
- This is expected approximately a year after parliament passes the new Act, and no later than 1 September 2023, to ensure there is time to prepare for implementation.
Where can I read the draft legislation?
The 700-page Mental Health and Wellbeing Bill 2022, Explanatory Memorandum, Statement of compatibility and the Minister’s second reading speech are available via bit.ly/3IfZSY6
The Mental Health and Wellbeing Bill 2022 information sheets can be found via engage.vic.gov.au/mhwa
What has changed?
Key changes in the new Mental Health and Wellbeing Bill 2022 include:
- Foundations: a broader group of more mental health and wellbeing providers to be regulated to allow an inclusive, flexible, responsive, and compassionate system.
- Aboriginal social and emotional wellbeing: a statement of recognition and acknowledgement of treaty process and new cultural safety principles.
- Rights-based objectives and principles: to drive the highest attainable standard of mental health and wellbeing for Victorians and strengthened obligations for service providers.
- Supporting individuals to exercise their rights: requiring services that are responsive to an individual’s needs and preferences. The bill contains better support for dignity and autonomy and people will be able to opt out of non-legal advocacy.
- Lived experience at the centre: people with lived and living experience will be at the centre of the redesigned mental health system. They will also hold leadership roles, as will carers, family and supporters.
- Treatment and care: reduction in the use and impact of compulsory assessment and treatment and restrictive interventions, including:Revised targets for seclusion set at five episodes per 1000 occupied bed days for child and youth and aged services, and at eight episodes for adult and forensic services.The draft laws also have safeguarding measures (such as use of advanced statement of preference). Chemical restraint use is regulated. Community treatment orders can be for a maximum six-month duration compared to 12 months currently.
- Health-led response to mental health crisis: legislative framework for a health-led response to mental health crises in the community. Includes the principles that, wherever possible, health professionals, including paramedics, will lead responses rather than police or protective service officers and that powers should be exercises in the least restrictive way possible. The draft legislation seeks to support people at a time of crisis by shifting to a health-led response and reducing reliance on Victoria Police as first responders.
- Information sharing: consent-based information sharing and circumstances when information can and should be shared with families, carers, and supporters.
- New roles and entities include:
- Regional Mental Health and Wellbeing Boards
- Regional and statewide multiagency panels
- Chief officer of Mental Health and Wellbeing
- Mental Health and Wellbeing Commission
- System-wide oversight of the quality and safety
- Statewide oversight, including complaints
- Youth Mental Health and Wellbeing Victoria
- Sustainable resourcing: the mental health and wellbeing surcharge began on 1 January 2022. It is paid by employers if they pay Victorian taxable wages depending on annual thresholds. The surcharge was a royal commission recommendation to ensure sustainable funding for the new system.
What is changing in relation to compulsory treatment?
An independent review of compulsory treatment criteria and alignment of decision-making laws will also start in October 2022.
The independent review’s work will be guided by terms of reference which will be developed by a dedicated working group made up of consumers, families, carers, supporters, workers and service providers. Expressions of interest to be on the working group closed in June 2022.
On 23 June 2022, the Andrews Government announced Justice Shane Marshall AM will lead the independent review panel. Justice Marshall has 20 years’ experience as a Federal Court judge.
Implementation – (once the Act is passed by parliament)
The new legislation, which will underpin the new mental health system, will mean significant change for the system and the workforce.
As part of our submission, ANMF called for funding to support the implementation of the new legislation. Following ANMF’s recommendations, $29.3 million over four years has already been funded for dedicated resources to support implementation of the new legislation, including through comprehensive workforce training and support for consumers, families, carers and supporters to understand their rights under the new legislation.
What is missing?
ANMF understand members are apprehensive of the elimination of the restrictive interventions, with the under-preparedness of the current mental health sector.
Whilst the royal commission did acknowledge that elimination must be staged over a ten-year period, in our submission on the Health and Wellbeing Act, ANMF made the following recommendation;
Embed an occupational health and safety committee into the new Act to provide oversight and monitor compliance with both the new Act and the OHS Act and support continuous improvement and best practice by:
- considering workplace safety during the implementation of the new Act, and ensuring potential health and safety impacts on staff are identified and eliminated or mitigated
- considering workload management during the implementation of the new Act, and making recommendations to rectify impacts
- monitoring and making recommendations to improve workplace safety across the lifespan of the new Act
- participating directly in the review of the new Act at years five and seven
- supporting ongoing research into workplace safety in mental health settings.
Disappointingly, this recommendation was not included in the final bill.
ANMF will continue to advocate strongly for workplace safety with the Department of Health throughout the implementation of the Mental Health and Wellbeing Act, and work with members to ensure that employers uphold their responsibility to protect the health and safety of their employees while at work.
Inquiries
ANMF will continue to update members on the mental health reform implementation. Please contact Mental Health Nursing Officer Jade Chandler if you have any queries via records@anmfvic.asn.au