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In introducing the Mental Health and Wellbeing Bill of 2022 into Parliament in Victoria, Australia, the state government claimed that the new legislation “delivers on the vision for rights-based mental health and wellbeing laws.” This paper examines the new legislation in light of both local human rights legislation and international human rights law. Drawing primarily on the United Nations Convention on the Rights of Persons with Disabilities and the Victorian Charter of Human Rights and Responsibilities Act of 2006, this paper argues that while the new legislation is not, in fact, rights based, it does represent some rights-related improvements over existing legislation. The paper concludes with a discussion of how rights-based legislation could be applied to the Victorian context, using the latest guidance from the World Health Organization and the United Nations.

This report presents the findings of the evaluation of the first three years of Eastern Community Legal Centre (ECLC)’s elder abuse service trials – a specialist elder abuse unit, Rights of Seniors in the East (ROSE), and a health justice partnership, Engaging and Living Safely and Autonomously (ELSA). ELSA and ROSE were funded by the Commonwealth Attorney-General’s Department as part of the National Elder Abuse Service Trials, and have both since converted to ongoing programs. ELSA and ROSE provide an elder abuse response service in Melbourne’s East, using an integrated practice model of legal advice and casework, financial counselling and advocacy. ELSA and ROSE also provide secondary consultations and advice to health and welfare professionals and community education. ROSE operates in partnership with Oonah Belonging Place and ELSA is a health-justice partnership with Eastern Health. The evaluation conducted interviews and focus groups with 19 people who had used ELSA or ROSE, 18 ECLC staff, and 25 external stakeholders from services who had engaged with the service trials. The evaluation also drew on internal ELSA and ROSE service data and data from a range of external sources, including recently available data on the prevalence of elder abuse. Overall, nearly all clients valued the services they received highly, even in situations where the abuse was ongoing or issues unresolved. ELSA and ROSE have been shown to be very effective at addressing and responding to elder abuse in roughly half of cases. Where they were not able to resolve the abuse or other issues, this was due to system gaps, failures in the broader health and welfare systems, and/or clients not being able to take up advice due to the complexity of their experience. The key elements underpinning the success of ELSA and ROSE are the integrated interdisciplinary practice model, which provides a wide range of support options, and the partnerships with health and welfare services. The secondary consultation and community education elements of ELSA and ROSE were highly valued by external professional stakeholders. Despite the challenges posed by COVID-19 restrictions, both programs have achieved their goals to the highest level possible in the circumstances. The program-level recommendations below largely relate to building on the success of the program or fine-tuning accessibility and service delivery. Where substantial program-level issues, such as inconsistent referrals, were identified, they were outside of the control of ECLC and resolution relies on working with partners who are also responding to COVID-19 restrictions and other challenges. The most substantial recommendations relate to systemic barriers, particularly failures in other health and welfare systems. The evaluation findings clearly support the adaptation of the ELSA and ROSE models to other geographical locations and their continuation and expansion within the eastern Melbourne region. Other specialist elder abuse services, including prevention, early intervention, mediation and family therapy, are also needed, but ELSA and ROSE provide an excellent model for future service expansion.

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This paper considers the problem of how Mad leaders might be authentic without resorting to discriminatory identity policing. The paper briefly charts the contemporary role of consumer/survivor/ex-patient/mad activism in mental health reform before drawing on the author’s failed attempt to grapple with authentic mad leadership. Drawing on Mad Studies theory and the wisdom of Lewis Carroll’s Mad Hatter, the author argues that the consumer/survivor/ex-patient/mad movement should welcome all experiences of madness, but only those who can exercise authentic leadership should lead the movement. This requires resistance against non-Mad ways of knowing and exercising power and for established power hierarchies to transform to allow authentic mad leadership.

In every Australian jurisdiction, legislation permits mental health service providers and/or mental health tribunals to force people with mental illness to engage in treatment, under Community Treatment Orders (CTOs). Despite considerable efforts made by every Australian state and territory to meet human rights obligations under the United Nations Convention on the Rights of Persons with Disabilities (CRPD) (2008; Maylea & Hirsch, 2017), Australia has rates of CTO usage that are very high by world standards (Light, 2019). Even within Australia, rates of CTO usage vary considerably between and within jurisdictions in spite of the legislation being very similar (Light, 2019; Adult mental health quarterly KPI report, 2019). This occurs in the context of mixed evidence about the efficacy of CTOs and a lack of clear understanding of their purpose (Segal et al., 2017; Kisely et al., 2017). The use of CTOs remains one of the most contentious issues in mental health service delivery. Not only is their efficacy unresolved, they also raise serious ethical and human rights concerns. The current debates, and attempts at reform, must be informed by valid and reliable data. This brief commentary will make the case for a research agenda that addresses the minimal research that has been undertaken to address the variations of CTO use across Australian jurisdictions.

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People in Australia living with disabilities who are also from refugee backgrounds, or who are seeking asylum, face enormous challenges. In addition to the traumatic histories they bring with them, the shifting political and policy landscapes have resulted in a fractured and disintegrated service response, with changes to immigration policy and the introduction of the National Disability Insurance Scheme set to exacerbate existing issues in the system. This paper outlines the shifting policy contexts and presents findings of a consultation process undertaken by the Refugee Council of Australia.