title: Using accountability for mental health to drive reform.
abstract: Greatly enhanced accountability can drive mental health reform. As extant approaches are ineffective, we propose a new approach. Australia spends around $7.6 billion on mental health services annually, but is anybody getting better? Effective accountability for mental health can reduce variation in care and increase effective service provision. Despite 20 years of rhetoric, Australia's approach to accountability in mental health is overly focused on fulfilling governmental reporting requirements rather than using data to drive reform. The existing system is both fragmented and outcome blind. Australia has failed to develop useful local and regional approaches to benchmarking in mental health. New approaches must address this gap and better reflect the experience of care felt by consumers and carers, as well as by service providers. There are important social priorities in mental health that must be assessed. We provide a brief overview of the existing system and propose a new, modest but achievable set of indicators by which to monitor the progress of national mental health reform. These indicators should form part of a new, system-wide process of continuous quality improvement in mental health care and suicide prevention.
authors.affiliation: University of Sydney, Sydney, NSW sebastian.rosenberg@sydney.edu.au.
authors.forename: Sebastian P
authors.initials: SP
authors.lastname: Rosenberg
authors.affiliation: University of Sydney, Sydney, NSW.
authors.forename: Ian B
authors.initials: IB
authors.lastname: Hickie
authors.affiliation: University of Melbourne, Melbourne, VIC.
authors.forename: Patrick D
authors.initials: PD
authors.lastname: McGorry
authors.affiliation: University of Sydney, Sydney, NSW.
authors.forename: Luis
authors.initials: L
authors.lastname: Salvador-Carulla
authors.affiliation: University of Melbourne, Melbourne, VIC.
authors.forename: Jane
authors.initials: J
authors.lastname: Burns
authors.affiliation: Black Dog Institute, Sydney, NSW.
authors.forename: Helen
authors.initials: H
authors.lastname: Christensen
authors.affiliation: University of Sydney, Sydney, NSW.
authors.forename: John
authors.initials: J
authors.lastname: Mendoza
authors.affiliation: University of Wollongong, Wollongong, NSW.
authors.forename: Alan
authors.initials: A
authors.lastname: Rosen
authors.affiliation: Australian National University, Canberra, ACT.
authors.forename: Lesley M
authors.initials: LM
authors.lastname: Russell
authors.affiliation: National Employment Services Association, Melbourne, VIC.
authors.forename: Sally
authors.initials: S
authors.lastname: Sinclair
mesh_terms: D000328:Adult; D001290:Attitude; D001315:Australia; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004651:Employment; D018166:Health Care Reform; D006801:Humans; D008017:Life Expectancy; D001523:Mental Disorders / Q000401:mortality; D008605:Mental Health Services / Q000592:standards* / Q000706:statistics & numerical data; D010359:Patient Readmission; D012941:Social Responsibility; D013405:Suicide / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult