10 results on '"Rosenberg, Sebastian"'
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2. Centralisation versus regionalisation: Designing the Sixth National Mental Health Plan.
- Author
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Rosenberg, Sebastian, Lawson, Kenny, and Hickie, Ian
- Subjects
HEALTH planning ,MENTAL health ,MENTAL health services ,HEALTH care reform ,CAPITAL cities ,REGIONAL differences - Abstract
In response to the recent Productivity Commission report into mental health, the previous Federal Government announced its intention to produce a new national agreement that lays the platform for Australia's sixth national mental health plan. It has been recommended mental health move to a more regional model of governance and planning, away from a centralised, top‐down approach, partly in response to broader reforms affecting health care, and partly in direct response to consistent inquiry evidence that the mental health system remains in crisis. The past 30 years of mental health planning have been centralised. Successive national plans set a broad framework, with real decisions about mental health funding and service allocation made in the health departments of our capital cities. Will the next plan sponsor or inhibit regionality in mental health planning? This paper assesses Australia's historical approach to health planning particularly as it affected mental health and the costs arising. In learning these lessons, we propose the necessary ingredients to facilitate a regional, innovative, and effective approach to decentralised planning, for better mental health outcomes. We cannot afford to replicate the failed planning approaches of the past. Summary at a glance Mental health has been challenged to replace historical, centralised approaches for decentralised regional planning approaches to foster choice, innovation, and effective service provision. The past 30 years of central planning have demonstrated its limitations. Federal and State governments should create an enabling environment to free‐up local implementation and operationalise a social determinants approach. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
3. New governance, new hope: findings and results of the taskforce to establish a Mental Health Commission for NSW
- Author
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Rosenberg, Sebastian, Rosen, Alan, and Wright, Nicola
- Published
- 2012
- Full Text
- View/download PDF
4. Shaping Mental Health Reform – Key Tasks for an Incoming Government.
- Author
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Rosenberg, Sebastian and Hickie, Ian
- Subjects
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HEALTH care reform , *MENTAL health , *MENTAL health services , *MENTAL health policy , *SERVICE industries - Abstract
Objective: To describe a recent process by which mental health service sector leaders identified key elements of strategic, systemic and structural mental health reform. These elements could guide an incoming Federal government. Method: The paper describes the process undertaken by the Sydney Mental Health Policy Forum between 2019 and 2022. This work generated principles, key domains and finally a set of actions. Results: Five immediate actions were identified that are cost neutral or require minimal investment. Five further actions requiring realignment of existing funds and/or new funds were also identified. Conclusions: The task of mental health reform in Australia is both large and overdue. Continued investment in fragmented or piecemeal programmes and services will not propel desired change. Reform must facilitate new regional control of planning, funding and responding to community mental health needs. The actions identified by the Forum set out a menu of opportunities to guide reform over the life of the next Parliament, starting now. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
5. Mental health reform: more of the same not an option
- Author
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Rosenberg, Sebastian
- Published
- 2009
6. Is Anybody Getting Better? Accountability for Mental Health in Australia
- Author
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Rosenberg, Sebastian Pascal
- Subjects
Commissions ,Mental Health ,Policy ,Accountability - Abstract
Aim This thesis investigates the extent to which Australia has developed accountability for mental health. Background Accountability for change was a core element of the first National Mental Health Policy in 1992. Weaknesses in extant systems of accountability were acknowledged and undertakings given to develop better systems. This thesis considers the extent to which these undertakings have been fulfilled. Does Australia have the robust system of accountability for mental health? Is it possible to discern the impact of care and drive quality improvement through effective benchmarking? Can you tell if people are getting better? Method This thesis provides an evaluation from three dimensions: 1. Policy Accountability - The study period was a time of unprecedented attention to mental health. Can these changes be monitored and reported in a way that drives systemic improvement? 2. Structural Accountability - Six of Australia’s nine governments have established a mental health commission. This thesis tracks their evolution, genesis and prospects. 3. Program Accountability - To June 2015 the Better Access Program has funded 53 million services, costing taxpayers $5.2bn or $15m per week. This thesis presents several articles in relation to this Program and the need for more multi-disciplinary approaches. Results This evaluation will demonstrate that accountability for mental health in Australia remains weak. Discussion This thesis then describes core elements of a better approach. Resources are too scarce to waste. Existing data collections must be traded for a more focused and strategic process. Mental health commissions need evaluation. Old models of program funding need to shift to foster collaboration. The importance of regional benchmarking has emerged. Existing systems are not fit for purpose. It is difficult to justify calls for increased expenditure in mental health. This thesis aims to record Australia’s efforts at accountability for mental health so far, and then chart a course for a more effective approach.
- Published
- 2016
7. No gold medals: Assessing Australia's international mental health performance.
- Author
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Rosenberg, Sebastian and Hickie, Ian
- Subjects
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HEALTH policy , *MENTAL health , *MENTAL health services , *PSYCHOLOGICAL tests , *SOCIAL participation , *FERRANS & Powers Quality of Life Index ,QUALITY assurance standards - Abstract
Objective:: The objective of this study was to present an assessment of Australia's mental health system performance, within its social context, by comparison with other countries.Method:: A review of existing literature and databases from both Australia and overseas was undertaken. Systems permitting international comparison of mental health and its social context are few. The review is limited in scope.Results:: Although Australia was one of the first nations to develop and adopt a national mental health policy (in 1992), the data that are available suggest that we are not World leaders across the identified domains.Conclusions:: While international benchmarking can play an important role in fostering quality improvement, there are only limited mental health or social system performance data sources to utilise. It would be desirable for a more systematic international process to be established to review existing approaches and design a new multilateral strategy. It would be important that this new strategy reflected the full experience of mental health and its broader social context. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
8. Can mental health commissions really drive reform? Towards better resourcing, services, accountability and stakeholder engagement.
- Author
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Rosenberg, Sebastian and Rosen, Alan
- Abstract
Objective: In this second and final part of this series about mental health commissions, we consider the extent to which it is possible to find hard evidence that these new structures really can drive mental health reform. Four key domains of improvement are established for the purposes of this review: do commissions lead to better resources, better services, better accountability and better stakeholder engagement? A review of the evidence from both Australia and overseas is presented. The article also considers how the commissions, federal and state, will organise their relationships productively to avoid duplication and promote synergy. What of those jurisdictions without commissions? Is this genuine national reform or merely more piecemeal activity in mental health? The authors have been informed by the varying structures and functions of mental health commissions internationally and were part of the New South Wales taskforce to establish a mental health commission. They had the opportunity to visit the Western Australian and New Zealand Commissions as part of this process. Conclusion: Addressing mental illness requires a joined up approach to government and services. Commissions offer a new organisational structure designed to deliver this contiguity. There is also evidence that nascent and established commissions are delivering real reforms, including in terms of additional resources and influence. Without concerted efforts to coordinate activity, the intersection between federal and state commissions will be confused and duplications might arise. The paper calls for a new network of commissions to be established across Australia and New Zealand, to share resources and common tasks, clarify roles and build common approaches. [ABSTRACT FROM AUTHOR]
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- 2012
- Full Text
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9. It’s raining mental health commissions: prospects and pitfalls in driving mental health reform.
- Author
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Rosenberg, Sebastian and Rosen, Alan
- Abstract
Objective: Partly in response to ongoing concerns about the state of mental health care, several jurisdictions across Australia, including the federal government, are hoping to drive change via the establishment of a mental health commission. This is the first of two articles in a series which aims to describe the background to this new trend. The commissions are being established with different powers and structures. This variety is explored and considered against a typology of commissions. Some consistent themes and goals emerge. The paper then provides a contemporary assessment of the ‘state of play’ of the nascent commissions and describes important emerging issues and differences between the models.Conclusion: There are significant differences not only in the construct of the respective commissions but also in the political circumstances in which each must work. At the same time, the problems facing mental health in Australia are ubiquitous and profound. For commissions to be successful they will require not only astute leadership but also durable, bipartisan political support and an enduring capacity to generate new resources for the mental health sector. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
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10. How to tackle a giant: creating a genuine evaluation of the Better Access Program.
- Author
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Rosenberg, Sebastian and Hickie, Ian
- Subjects
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MENTAL health laws , *LAW reform , *MENTAL health service laws , *GOVERNMENT programs - Abstract
Objective: This paper proposes a framework for a systematic evaluation of the Better Access Program, the largest single component of mental health reform announced under the Council of Australian Governments National Action Plan on Mental Health 2006-11. Method: The article explores the genesis of the Program and considers extant data sets and information available with which to establish the impact of the Program on consumers and service providers. Results: There are useful data available in Australia from which to derive pre- and post-implementation analysis about the impact of the Better Access Program. There is doubt as to whether these data form part of the Federal Government's current approach to evaluation of the Program. Conclusions: Anything less than a genuine and comprehensive evaluation will leave Australia unable to assess the real impact of the Better Access Program. The merit of further expenditure in the vital area of primary mental health care will be in doubt as a consequence. [ABSTRACT FROM AUTHOR]
- Published
- 2010
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