Review of the National Mental Health Commission


B. Additional Improvement Options



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B. Additional Improvement Options

Regardless of which of the above options is preferred, a number of ‘no regrets’ recommendations have been identified. These include sharpening the NMHC’s role and functions, increasing capacity and capability and strengthening the relationships and influence of the Commission.



Some of these additional possible areas of improvement for the NMHC also involve choices. Below, we identify the spectrum of options for future state improvements:

  • The current state is denoted by a blue triangle

  • The recommended future state is indicated by a green star.

Commissioner roles

Commissioner roles - current state and recommended future state diagram

As described above, there is currently some ambiguity in the role of the Commissioners and their interactions with the NMHC.



To the extent that either ends of the above spectrum are possible future-state options, this review recommends clarifying that the Commissioners act as a collective advisory group, who jointly input into the viewpoints and outputs of the NMHC. This does not mean that all Commissioners must participate deeply in all aspects of the work, but cohesion of voice should be achieved wherever possible.

Commissioner composition

Commissioner composition - current state and recommended future state diagram

Currently, the composition of Commissioners appears to strive to achieve both representation and some specific capabilities. This balance should be maintained going forward, with a pure ‘Representation’ Model to be avoided. In addition to the impossibility of adequately representing the diversity of stakeholders and perspectives as Commissioners, the risk of this model is that it may encourage Commissioners to limit their views and thinking to ‘their’ area of representation.



Instead, the Commissioners should be sufficiently representative of critical stakeholder groups (indigenous Australians, mental health consumers and carers, mental health practitioners, etc), without selecting specific Commissioners for those roles where possible. The Commissioners should be expected to bring expertise, primarily in mental health (all dimensions), but also as relevant across government, law, economics, etc.

Capacity and capability

Capacity and capability - current state and recommended future state diagram

As noted above, current capacity and capability is not sufficient to meet the NMHC’s objectives. Therefore providing a capable workforce with sufficient capability is paramount. In addition, it is acknowledged the work of the NMHC will continue to vary, with different priorities requiring different skills and experiences over time. Therefore, the NMHC should seek to build its own workforce to a sufficient level to lead, procure and oversee others in delivering on the NMHC’s work. This should include a boost to staff with mental health expertise, as well as ensuring that procurement capability is sufficient.

Policy functions

Policy functions - current state and recommended future state diagram

The NMHC could, in the future, take a more detailed and active role in its policy advisory functions. This would involve moving beyond issuing recommendations and into helping with the design of aspects of policy. It is premature to consider taking on such a role at this time, as building capacity and capability to perform existing reporting and policy advisory functions should be prioritised. Taking on greater policy development roles can be pursued on a case by case basis with the DoH.



Monitoring and reporting functions

Monitoring and reporting - current state and recommended future state diagram

The NMHC should consider expanding its capacity as an advisor to the system and focus on building improvements across the system. While not to the same extent this could be a similar role to the ACSQH. As with its policy role, this appears a premature step given current constraints. In the future this could be considered, particularly with regard to shaping the future of the system. It is noted that standards creation in partnership with the ACSQH has been a previous activity undertaken by the NMHC providing a potential link to such a role in the system.




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