Victoria fails royal commission timeline as mental health reforms delayed

The Allan government has backtracked on its promise to implement all recommendations from the Royal Commission into Victoria’s Mental Health System on time, missing several deadlines and rolling out a plan that changes the pace of its reforms.

Some policies are two years behind schedule, and The Age has uncovered evidence that work on some recommendations has been rolled back.

Victoria has altered the timeline of several recommendations from the Royal Commission into Victoria’s Mental Health System.Credit: Rodger Cummins

Former premier Daniel Andrews promised three years ago to deliver every recommendation of the royal commission, which included a timeline for when each change would be completed.

But the changes have been increasingly delayed and, in some cases, altered completely, prompting concerns from the mental health sector.

Amid this criticism, the Allan government on Wednesday announced its “Phase 2 Reform Plan” for mental health, which outlined some new timelines and changes.

That document said the next phase of the recommendations would have a “greater focus on prevention, promotion and early intervention so that more care is being delivered in the community, closer to home”.

The reform plan said the government had received feedback from the sector that it needed to manage the speed of the changes, prioritising some key areas and building up the workforce.

Changing the pace of the changes would allow the government to focus on “what’s most important now”, the plan said.

Progress reports given to parliament’s public accounts and estimates committee this week show that when compared with the implementation schedule provided in 2021, work on three royal commission recommendations went from “in progress” four years ago to “to be commenced” as of this year.

They are recommendations 22, to establish a responsive and integrated mental health and wellbeing service stream for older Victorians; recommendation 60, to build a contemporary system through digital technology; and recommendation 12, to develop new bed-based rehabilitation services.

The May state budget delayed the rollout of 35 local mental health and wellbeing hubs. A key pledge to set up an agency led by people with lived experience of mental illness was due by the end of the year, but the Phase 2 document now says it will “continue work” with a new deadline of 2025-26.

The Age revealed this year a key recommendation to deliver regional mental health boards had been abandoned completely.

The changes that are behind schedule have been tracked by several advocacy groups, including in the annual report tabled by the Mental Health and Wellbeing Commission (MHWC) in parliament last week.

These included changes to the sharing of mental health and wellbeing information, and improved services for older Victorians – both due by 2022.

Two social housing changes due by 2022 were to prioritise access to special housing for people living with mental illness, and ensuring homes are appropriately designed in step with services. Both have been marked as “in progress”.

A statewide mental health trauma service was also due by the end of 2022. The government named a consortium to run this body, but it remains in progress.

Mental Health Minister Ingrid Stitt wrote in Wednesday’s update that since the royal commission had been handed down, Victoria had faced “increasing demand for mental health and wellbeing services and support with bushfires, floods and the unprecedented challenges of the COVID-19 pandemic”.

Despite this, she said: “I want to reiterate the Victorian government’s commitment to delivering on every recommendation of the royal commission.”

The Health and Community Services Union (HACSU) has completed its own review into the progress of the royal commission recommendations.

The union’s state secretary, Paul Healey, said progress was “not spectacular”, and there had been no real change to the acute system, a disappointing lack of investment in staffing, and no significant improvement to the outcomes for people needing mental health support.

“Money is more of a driver than need at the moment,” Healey said.

Paul Healey pictured at a protest in 2018.Credit: Vicky Hughson

In last week’s annual report, the Mental Health and Wellbeing Commission warned of increasing levels of psychological distress and mental disorder diagnosis.

“Mental health presentations at emergency departments increased from 101,049 in 2019-20 to 108,696 in 2023-24,” the commission found. “Overall, this suggests a possible rise in the numbers of people in crisis.

“These trends indicate that while direct access to GPs and psychologists may have subsided to reflect longer-term trends, there remains a residual level of mental illness that is being treated by medication at a significantly higher rate than previously.”

The number of people accessing clinical mental health services rose by 21 per cent over the past four years, including a 71 per cent increase in those accessing specialist services.

In a media release responding to its annual report, an MHWC spokesperson said the Victorian community was facing significant and worsening mental health challenges.

“Now is not the time to let investment and reform pace slip,” the spokesperson said.

Opposition mental health spokeswoman Emma Kealy accused the government of changing deadlines to justify delays.

“Labor needs to be honest, admit they have failed to deliver what the premier promised, and be clear about when the recommendations will be implemented in full,” Kealy said.

Late on Wednesday, Stitt said no other state was doing as much to reform mental health.

“This is a bold reform agenda which can’t be achieved overnight – but we remain focused on the task,” she said.

Get the day’s breaking news, entertainment ideas and a long read to enjoy. Sign up to receive our Evening Edition newsletter here.