Integrating Public and Private Psychiatric Practice: From National Agenda to Personal Experience

Abstract

The National Mental Health Policy in April 1992 [1] highlighted the need to reform mental health care delivery. The policy suggested that mental health care be restricted to those with a ‘serious mental illness’ and that half of the people with serious mental illnesses were untreated whilst many with less serious illnesses were over-serviced. A key challenge for service reform from the outset was the need to allocate appropriate resources in a manner that reflected the point of care [2]. Several authors suggested that whilst the policy made recommendations regarding the process of reform, little mention was made of the resources required to accomplish such reform and that there was a significant shortfall of manpower [3,4].

Developing Partnerships Between Public and Private Psychiatry

“…When both sectors are involved there is often confusion about roles and responsibilities, and duplication of interventions. 2 In response to difficulties such as these, The National Mental Health Policy 4 highlighted the need to make changes to the way psychiatric services are delivered. While the initial focus was on State funded public services, the Second National Mental Health Plan 3 recognised the important role of private psychiatrists and other private services within the mental health sector.…”

Building a ‘National Coalition for People with Depression’

“…• Support for referral from specialist assessment services to public treatment services without the need to re‐enter via a non‐specialist ‘intake’ system. 18 …”

Leadership for change in complex systems

“…12 There are substantial inequities in the distribution, and accessibility, of mental health services that act to the detriment of people in rural and remote areas and in disadvantaged areas of cities. 13 Concern has been expressed about the perceived loss of role 14 and poor definition of roles 15 for psychiatrists, about whether psychiatrists are adequately prepared for management and leadership roles in this process of continuing change, 16 and about the nature of relationships between psychiatrists and other professionals in multidisciplinary teams. 17 All of this has led to a re-thinking of how the mental health (and broader health) system is best governed with, again, multiple processes being established that intend to improve governance arrangements.…”