Integrating Health in Local Government Mental Health Its Everybodys Business

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Integrating Health in Local GovernmentMental
Health Its Everybodys Business

• October 16th 2003
• Robyn Duffy
• Baw Baw Shire Council

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Baw Baw Shire Council

• Rural Council located to the east of Melbourne
• Distance - reached within 1-1.5 hours car or rail
• Rapidly expanding towns of Drouin, Warragul,
  Yarragon and Trafalgar with a number of major
  subdivisions going through in recent years
• Population of approximately 35,000 which is
  expected to increase to 41,000 by 2011.
• 2nd highest growth rate amongst the Gippsland
  Councils
• Dairy, beef, sheep and timber industries

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Background

• In 2002 the Baw Baw Shire Council began updating
  the MPHP in the past this tended to be a fairly
  static document - written but left on the shelf
• Local service providers, community organisations
  and the general public were invited for input
  into the MPHP to determine which areas were of
  concern for these sectors and to determine which
  program could be developed from these health
  areas.

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Background

• BBSC draft Municipal Public Health Plan listed
• the following key health areas
• Mental Health
• Drug Alcohol Misuse
• Cancer
• Farm Safety
• Meningococcal Disease
• The first three were directly determined through
• the public consultation process the last two
  were
• included by Council

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Background

• Projected burden of disease data indicated that
• the dementia rate will increase in Gippsland
  faster than the general Victorian population
• data indicated that BBSC adults adolescents
  aged between 15 24 have a higher prevalence of
  social phobia
• the community consultation process indicated the
  lack of support from family and friends as
  critical risk factors and
• being safe in the home and neighbourhood as
  important protective factors for their health
  well being.

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Background

• Burden of Disease Report in 2002 indicated that
  the Disability Adjusted Life Years (DALY) ranking
  for Baw Baw Shire males were 54th and females
  26th out of the (then) 78 Victorian Councils.
• For specific health conditions the following
  DALY rankings were listed
• Mental Disorders 24th (male) 35th (female)
• Injury 75th (male) 48th (female)

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Background

• Of the injury ranking, suicide was responsible
  for
• a large percentage of the total rate, with the
• suicide rate for males within the BBSC being
• almost double that of Victoria.
• The VicHealth Mental Health Promotion Plan
• 1999-2002 states that people living in rural
• communities experience higher levels of poor
• mental health.

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Background

• VicHealth research indicated that there are
• increasing numbers of young rural people seeking
• help from mental health services and that there
• are higher rates of suicide among young people in
  
• country Victoria
• In 2002 BBSC prepared a submission for funding
• through the Department of Human Services Good
• Practice Project (which was prior to the MPHP
• being finalised)

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Background

• The stated project aim in our submission was
• To raise the profile of mental health issues
• within the community through advocacy, the
• engagement of service providers and the
• whole of Council and by the development
• and/or promotion of programs that are
• sustainable.

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Background

• This project aim was then further defined through
  
• a number of objectives and specific strategies
• through which the Committee planned to operate

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Objective One

• To provide a coordinated approach to the
  management of mental health issues within the
  community
• To establish a Mental Health Committee consisting
  of local service providers and a community
  representative to manage the implementation of
  the Mental Health Program
• To develop and print a service provider directory
  for the community and key stakeholders

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Objective Two

• To increase the feeling of belonging to and being
  a part of ones community
• To develop a mental health program that assists
  in connecting the Koori community back to the
  land
• To undertake research that identifies groups
  within the community who are most at risk of
  isolation, both physically and emotionally
• To identify, develop and/or support programs that
  promote social integration and social support for
  these at risk groups

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Objective Three

• To promote the impacts of poor mental health on
  the community
• To develop and have an ongoing community
  awareness program around key mental health issues

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Proposed methodology

• The BBSCs Municipal Public Health Plan was
• formally accepted by Council at the start of
  2003.
• Development of the Mental Health Committee
• with representatives from local service providers
  
• and across Council services.
• We would then
• survey the communities to determine their
  perceived feeing of being socially disconnected
• use focus groups to develop appropriate programs
  to address social disconnectedness

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Proposed program methodology

• Develop or refine skills within the community to
  run with identified programs.
• The Committee was to meet regularly, with
  minutes, motions and recommendations being
  documented.
• Establish the sub-committees to implement each of
  the strategies in the program proposal.

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Program methodology

• The Chair of each sub-committee would report to
  the Baw Baw Health Wellbeing Advisory Group at
  each meeting as to their progress
• Should the implementation of a strategy fall
  behind, the BBHAG will decide what action will be
  taken (eg expand what actions to be taken or
  provide more resources).

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Priority population groups

• There were three proposed at risk groups to
  work with during the project
• Young males (due to high suicide rate within the
  BBSC community)
• Koori community
• Other - to be determined through research to
  identify further at risk groups within the
  community (thought that due to the geographical
  isolation that those living within the smaller
  outlying towns will be will be a focus of this
  third group)
• this aspect of the project on hold due to time
  constraints

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Key stakeholders

• Initial key stakeholders with the Good
• Practice Project were those involved with
• the development of the MPHP, namely
• Central West Gippsland PCP (includes the primary
  care service providers and local council members
  from Latrobe and Baw Baw Shire Council)
• Baw Baw Shire Council
• West Gippsland Health Care Group
• Aboriginal Cooperative
• Medical Officer of Health
• Central West Gippsland Division of General
  Practitioners

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Key Stakeholders

• Upon formal adoption of the BBSC MPHP service
  providers and members of community organisations
  were invited to participate in the Mental Health
  Group which ultimately coordinated the various
  objectives of the Good Practice Project.

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Key Stakeholders

• The Mental Health Committee (later renamed as
• the Baw Baw Health Wellbeing Advisory
• Group) now has the following stakeholders
• West Gippsland Health Care Group, BBSC, Warragul
• Community House, Gippsland Child Adolescent
• Mental Health, Department of Education, Warragul
• Police, Central Gippsland Aboriginal Co-op,
  Primary
• Mental Health Early Intervention Services,
  Central
• West Gippsland Division of General Practice,
  Warragul
• District Ministers Association, DHS (Regional
  Health
• Promotion) and the Central West Gippsland PCP.

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The process

• The Mental Health Committee (now the Health
• Wellbeing Advisory Group) was established in
• August 2002 which was after the project proposal
• and submission was accepted and funded.
• The new committee wished to review the
• proposed objectives of the project to determine
• the relevance with their brief (MPHP) and amend
• if necessary.

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Project Process

• The revised objectives for the Good Practice
• Project were as follows-
• To provide a coordinated approach to the
  management of mental health issues within the
  community
• To enhance the Koori communitys capacity to
  develop their sense of belonging
• To identify and develop programs that promote a
  sense of belonging for young males

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Project Process

• The group wanted to set up the Young Males and
  the Koori sub-committees ASAP
• The BBHWAG had approximately 10 months in which
  to run the Good Practice Project
• The Koori sub-committee was set up using a
  pre-established and operational committee (Local
  Aboriginal Education Community Group) that wanted
  to achieve outcomes for the Koori community and
  in turn gave the project greater access to the
  Koori communities within the Council
• The Young Males committee was less successful as
  participants were more transitory (wasnt able to
  link in with a pre-established working group)

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Project Process

• The Koori Subcommittee met 6 times over the life
  of the project
• The Young Males Sub-committee met 4 times over
  the life of the project.
• The Young Males subcommittee became more of a
  project team that developed a project aim and
  sought outside expertise to achieve the aim(s)

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Discussion

• Often difficult to get the various organisations
  together at any one time (suitable times and
  dates)
• Difficult to get the full commitment from
  Committee members due to their other work
  commitments
• Meetings may have been scheduled but absentees
  (apologies) for meetings caused some scheduled
  meetings to be cancelled
• Council commitment was provided for the project
  (and the MPHP) but the expectation is that it is
  an Environmental Health Unit issue to deal with
  rather than a whole of Council and community
  responsibility

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Discussion

• There was some community involvement in the
• project but we hope that future projects have
• more community commitment. One possible reason
  is that the Good Practice Project was established
  before the MPHP was finalised possible lack of
  ownership with the project from the community
  viewpoint
• BBSC Environmental Health Unit represented
• by 2 staff - other staff had little involvement.
  Communication within Unit Council as to the
  progress must be improved in future projects
  (have also had the additional problem that the 2
  staff involved from the Unit have since left)
  creating a vacuum at present until other health
• staff take up the work with the committee

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Project Outcomes

• ?Printing a service provider directory - the PCP
• was developing this as a website based directory
  
• the BBHWAG did not wish to duplicate this
• Program pcpdirectory.health.vic.gov.au
• ? The Mental Health Committee was established
• now called to the Baw Baw Health Wellbeing
• Advisory Group (BBHWAG)
• ? Koori and Young Males subcommittees were
• established although the Koori subcommittee was
• more successful.

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Project Outcomes

• ? On-going interest in the existence of the
• BBHWAG
• ? Development of a funding application
• assessment process for mini one-off projects
• funded through this Good Practice Project
• (i) Koori Culture Day at Warragul Primary School
  to encourage student acceptance and understanding
  of Koori culture and traditions extend the
  reconciliation process between the school
  community and the local Koori community raise
  profile of the local Koori community within the
  school community

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Project Outcomes
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Project Outcomes
(ii) To promote health wellbeing through the
arts. Local Koori artists involved in the
Kidstuff Winter Festival at the West Gippsland
Arts Centre. Koori artists involved in teaching
the community their art form through various
workshops. (iii) Repair damaged rebound wall at
the Warragul Regional College allowing local
Koori artists to display their art on the
wall
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Project Outcomes

• (iv) Youth Information Card - card includes
• discount for some local business contact details
  
• for support services. The card was launched
• locally to coincide with the National Youth Week
• April 2003.
• The card was designed with input from kid in the
• community. The card is available from Council
• offices, WGHCG, Quantum and local businesses.

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Project Outcomes

• (v) Musical workshop for the Koori community to
• enhance musical skills with instruments and song
• writing. Workshop involved Kooris from South
• Australia.
• (vi) Developed a training program for people
• involved in running focus groups to upgrade their
  
• skills in being effective group facilitators.

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Project Outcomes

• ? Funded the development of a training
• program for Koori Youth, to build their
  leadership
• skills, with specific input from Koori elders to
• develop their skills as future leaders within
  their
• community. The West Gippsland Indigenous
• Youth Leadership Program ran for six weeks with
• 11 Koori Youth. Two Koori elders were
• employed part time to assist with the
• program.

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Project Outcomes

• ? Parent Forum at the Warragul Regional
• College Young as part of the Young Males
• subcommittee project(s).
• A clinical psychologist was organised to conduct
  a
• forum for carers of adolescents. Open to parents,
  
• teachers, youth workers etc. General
• advertisement in local paper to promote the
• evening. Outstanding response with 110 people
• attending. Completed evaluation forms at the end
• of the evening were collected from 80 of those
• attending. Indications are that additional
  sessions
• like this evening would be valued by the
• community.

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Project Outcomes

• ? Just for Boys was a one off program funded
• with Good Practice Project funds. Held in
• conjunction with 80 year 9 male students.
• Workshop held to
• raise and discuss mental health issues faced by
  year 9 boys and present some strategies for
  dealing with these issues
• to provide partnership between BBSC, Dept
  Education and services available in the community
• to find out what the boys wanted/needed (within
  the mental health context).
• This workshop was not as successful as hoped
• for a number of possible reasons including it
• wasnt considered fun to attend most said they
  
• did not learn of ways to cope with stress.

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