New Mental Health and Wellbeing Act must bring about cultural change

New Mental Health and Wellbeing Act must bring about cultural change

Tuesday, 3 August 2021

Our new submission to the Department of Health highlights key themes that the new Mental Health and Wellbeing Act must focus on and the specific legal approaches needed to realise the vision of the Royal Commission into Victoria's Mental Health System. The submission is shaped by the leadership of members of Speaking from Experience (SFE) and reiterates that it is crucial that the reforms are led and genuinely informed by consumers, and that the re-designed system has consumer leadership embedded.

It emphasises the need for the new Mental Health and Wellbeing Act to create the environment for lasting cultural change in Victoria’s mental health system. ‘The new Act is an opportunity to promote and embed a truly rights-based and compassionate culture within the mental health system,’ said Rowan McRae, Executive Director of Civil Justice Access and Equity.

Our Senior Consumer Consultant Wanda Bennetts said we are striving for ‘a system that supports people’s choices and their recovery in ways that enable them to live the best lives they can, as determined by them’.

Two pillars for successful reform

To drive the change that’s needed, we believe two foundations must be laid down.

  • A new and ambitious Act: The new Mental Health and Wellbeing Act must provide the strongest possible foundation for the transformational system change envisioned by the royal commission. It must embed mechanisms that go beyond the current Act and create the conditions for the success of this crucial reform.   
  • A sustained commitment to effective, consumer-led implementation: Beyond the wording of the Act, the implementation of the Act must be comprehensive and sustained. This includes investing in systems and changes that will make improved practices possible, including embedding and resourcing consumer leadership, funding education, providing resourcing, and ensuring accountability.

Make compulsory treatment a true last resort

Guided by our work in the Mental Health Tribunal and with the Independent Mental Health Advocacy (IMHA) non-legal advocacy service which works with consumers across the state, a key recommendation is that the new Act acknowledge the harm that compulsory treatment can do and enable a shift away from its acceptance and use. As one of the members of our consumer advisory group, Speaking from Experience, explained:

‘In my experience, being forced to take medications that did not agree with me physically, affected me so severely that I felt like I had no hope. To feel that you have no choice in the matter, where you are being forced to take something that causes so much physical distress is not fair or humane’  – SFE member.

The royal commission acknowledged that the rate and duration of compulsory treatment was too high. ‘While it’s crucial that we get the legal framework right, it must be accompanied by investment in training, education, and properly resourced mental health services that people can access, to reduce the harm experienced by consumers as a result of over-reliance on compulsory treatment,’ said Rowan.

A robust accountability framework  

Victoria Legal Aid's specialist mental health lawyers and IMHA advocates work with people facing or subject to compulsory mental health treatment in every designated mental health service in Victoria. Through this work, we see the current disconnect between the provisions of the 2014 Mental Health Act and what happens in practice.

To address this, we recommend a similar framework to Victoria’s Gender Equality Act be included in the Mental Health and Wellbeing Act to drive and embed cultural change.

‘People have been complaining about the same issues for 30 plus years, yet each complaint is treated as something new and so nothing changes… this contributes to a culture that enables these issues to continue occurring' – SFE member.

The new Act should embed a framework that requires targets, timelines and public reporting and a greater role for the Mental Health and Wellbeing Commission. This should include a focus on the reduction in the use and duration of compulsory treatment, elimination of the use of seclusion and restraint, and implementation of strategies to embed supported decision-making and ensure access to legal assistance and non-legal advocacy.

Elevate and resource consumer leadership and embed a rights-based system

‘We need to move to a system where people understand and can exercise their rights and are supported to make their own decisions about their treatment and recovery’, said Rowan.

‘Through our IMHA non-legal advocacy service we see the role non-legal advocacy plays in building a rights-based culture of supported decision-making, where consumers are proactively supported to understand and exercise their rights’, she said.

The royal commission recommended that every person on a compulsory treatment order should be offered non-legal advocacy. Our submission outlines how the new Act can provide the best foundation for an opt-out non-legal advocacy model that is independent and state-wide. This is an important part of re-orientating and supporting the mental health system. ‘We are committed to working with government, lived experience experts, mental health services, oversight and safeguard bodies, and the legal assistance sector to shape and support the successful implementation of reforms needed to achieve the vision of the royal commission,’ said Rowan.

More information

Read our our submission.

Read a one-page summary, Act for Change – Realising the Vision of the Royal Commission into Victoria’s Mental Health System (pdf, 255.74 KB).

Watch an online panel discussion attended by over 270 people, about the opportunities for the new Act.

Read about our roadmap for reform for Victoria’s mental health system.

Was this helpful?