Case Study

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Fourth national mental health plan: an agenda for
collaborative government action in mental health 20092014
This sets an agenda for collaborative government action in mental health for five years from 2009, offers a
framework to develop a system of care that is able to intervene early and provide integrated services across
health and social domains, and provides guidance to governments in considering future funding priorities for
mental health.
An implementation strategy for the fourth plan was agreed by the Australian Health Ministers' Conference in
December 2010 and is available on the Mental Health Standing Committee website (see end of publications
list). This high level document articulates a process for developing detailed implementation for each action.
The fourth plan, launched by the Australian Health Ministers' Conference in November 2009, is the product of
twelve months of development work including a comprehensive stakeholder consultation process.
Endorsement of the plan represents commitment by all governments to implementation of the following
vision for mental health set out in the National Mental Health Policy 2008:
"… a mental health system that enables recovery, that prevents and detects mental illness early and ensures
that all Australians with a mental illness can access effective and appropriate treatment and community
support to enable them to participate fully in the community."
The plan identifies key actions that will make meaningful progress towards fulfilling the vision of the policy.
While led by health ministers the plan takes a whole of government approach through involving sectors other
than just health. The plan provides a basis for governments to advance mental health activities within the
various portfolio areas in a more integrated way, recognizing that many sections can contribute to better
outcomes for people living with mental illness.
The plan has five priority areas for government action in mental health:
1.Social inclusion and recovery
2.Prevention and early intervention
3.Service access, coordination and continuity of care
4.Quality improvement and innovation and
5.Accountability - measuring and reporting progress.
The plan is ambitious in its approach and for the first time includes a robust accountability framework. Each
year, governments report progress on implementation of the plan to the Council of Australian Governments.
The plan includes indicators for monitoring change in the way the mental health system is working for people
living with mental illness as well as their families and carers.
The components of the National Mental Health Strategy are connected with each other and the ministerial
councils as follows:
The Fourth National Mental Health Plan has two-way links with National Mental Health Policy, Mental
Health Statement of Rights and Responsibilities, and state and territory mental health plans and
frameworks; one-way links from health and mental health ministers and COAG National Action Plan on
Mental Health; and an indirect two-way link with ministerial councils.
In addition, COAG National Action Plan on Mental Health has one-way links to ministerial councils and

National Mental Health Policy.
In addition, National Mental Health Policy has two-way links with state and territory mental health plans
and frameworks and Mental Health Statement of Rights and Responsibilities.
In addition, health and mental health ministers have a two-way link with ministerial councils.
In addition, Mental Health Statement of Rights and Responsibilities has a one-way link to state and
territory mental health plans and frameworks.

Community Mental Health Nursing Diagnosis


Social isolation R/T anxiety as evidenced by withdrawal and uncommunicative behaviour.



Social isolation R/T maladaptive social behavior, inadequate resources AEB feelings of rejection, sad
and dull affect



Risk for self-directed violence R/T depressed mood, hopelessness AEB patient verbalizes suicidal
thoughts and feelings



Post-trauma syndrome R/T physical abuse AEB flashbacks nightmares and hypervigilence



Risk for suicide R/T depression and stressful life events as manifested by serious suicide attempt



Ineffective health maintenance R/T financial difficulties and depression as manifested by
noncompliance with medication



Imbalanced nutrition: less than body requirements R/T depression as manifested by decreased
appetite and weight loss



Sleep deprivation R/T depression as manifested by insomnia



Situational low self-esteem R/T medical illness, ad depression as manifested by inability to maintain
family finances and marital discord



Emotional Deprivation



Emotional Abuse



Emotional Negligence



Stress



Social Exclusion

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