It is now six years since the MMHA Project was established. The collective body of work undertaken in the course of this review clearly shows the need for some sort of driver (whether a project or some other entity) to progress the multicultural mental health agenda in Australia remains.
In that time the multicultural mental health landscape in Australia has shown considerable change, and continues to do so. There are now a greater number of more diverse CALD communities in Australia, many of whom have complex needs. Very little is known about the mental health needs of CALD communities.
The service provider profile similarly has changed: not only is there an increasing number of providers but there is a greater involvement by the NGO sector. This in turn has increased the work required to educate/train these providers in the delivery of culturally appropriate services and support for individuals from CALD backgrounds with mental health issues.
The findings of this review indicate that the Project has become 'out of step' with the reality of recent changes in the multicultural mental health landscape. It is vital that this mechanism is able to remain aligned with this landscape. This is even more important in view of the markedly different profiles of newer immigrants to Australia. It is acknowledged that the ability to do so is somewhat hampered by a general paucity of baseline data on the mental health needs of CALD communities.
Further the review has highlighted that the project portfolio pertaining to suicide prevention has maintained a lesser profile and it is unclear whether this reflects a lack of priority on behalf of the stakeholders, a lack of resources or skill set within MMHA or a lack of need within this cohort. This is partly driven by the lack of baseline data in this area.
The findings of this review reveal that the effectiveness and efficiency of the Project has been undermined by a lack of alignment with the changing multicultural mental health landscape. Moreover, deficiencies in the Project's planning processes, governance and accountability arrangements and financial/service management structure have also served to undermine the potential impact of the Project
Whether funded in the future as a project, program or some other entity, the findings of this review point to some key changes that must be considered with respect to its operation and management.Top of page
It must be:
- underpinned by appropriate and sound planning processes, including the development of a strategic plan in consultation with all relevant key stakeholders
- capable of effectively engaging all relevant key stakeholders to assist in the identification and setting of work priorities and strategic directions in a manner that is appropriate to their respective knowledge, expertise, and capacity to contribute
- capable of ongoing effective monitoring of target group need and able to identify and respond to changes in need in an appropriate and timely manner.
- supported by appropriate and sound governance structures to ensure clear accountability, transparent decision making, and effective stakeholder communication.
This review has been conducted in a dynamic environment: one which is characterised by an increasingly more diverse and complex multicultural mental health landscape, both in terms of the primary target audience (i.e. individuals from CALD communities) and the service providers that support them. Against this backdrop governments face increasingly more stringent community expectations with respect to the transparency and accountability of funded initiatives, programs and services.
Accordingly the review has with respect to the original terms of reference concluded:
- MMHA is achieving to a limited extent the outcomes that were originally identified, with work in suicide prevention being less apparent and providing limited strategic/policy input at a national level.
- The internal structure and decision making processes of MMHA are not clear, transparent and are less than effective in its current form.
- As a consequence, the current model of the MMHA project is not structured to operate effectively nor is it sustainable.
- Evidence to underpin the development of appropriate preventative and intervention based services for the CALD community in the area of metal health services and suicide prevention has been identified as a significant deficit in Australia. Addressing this aspect via appropriate studies and research should be a priority for the MMHA project. A lifting of the profile of the project is warranted and greater focus on national strategic policy development by the MMHA is warranted.
In order to achieve this either a re-constituted entity needs to be considered, or significant changes need to be made to the MMHA project and management of the project.
If the latter is to occur, then a number of aspects of the operation and management of the Project will require change if the suitability/appropriateness, effectiveness and efficiency of the Project is to be maximised/fully realised. These include the:
- Planning processes – must ensure appropriate and effective engagement of all relevant stakeholders; ability to be flexible and responsive changing need
- Governance arrangements/structures – must ensure clear and transparent lines of accountability, clear delineation of roles and responsibilities, decision making processes
- Project model – must ensure that it is appropriate, flexible, responsive and sustainable
- Financial and service management – clear roles and responsibilities, clear lines of accountability, transparency, ability of project to operate independently
- Performance measures – that are relevant, appropriate and have an outcomes and quality focus.