Mental Health Reforms

21st July 2023

Background

In response to the request via Engage Victoria for feedback, VAADA coordinated an online
consultation session on the 13th July 2023 with workers from the AOD sector to gather their
perspective on the questions raised.

The following report details outcomes of this consultation session and highlights the need to
routinely incorporate perspectives from the AOD sector and people with lived and living
experience of substance use, their families carers and supporters in order to achieve the
elimination of seclusion and restraint.

1 June 2023

Background

Victorian Alcohol and Drug Association (VAADA) conducted a 2 hour consultation workshop
with members of AOD sector regarding questions raised in the consultation paper titled “The
Independent review of compulsory assessment and treatment criteria and alignment of
decision-making laws”.

Eighteen participants were involved in the discussion and below is a summary of their
feedback.

VAADA acknowledge that;

• People who use substances are often subject to compulsory treatment under the
  Mental Health Act (although data is not publically available).
• Access to AOD professionals (including LE professionals) for those on compulsory
  treatment orders is often minimal.
• There is a need to consider the safety and wellbeing of all (individual, family and
  supporters, workforce) as efforts to reduce the use of compulsory treatment are
  made.
• The best outcome for individuals presenting to mental health services with AOD needs
  will be via access to a specialist AOD workforce that can enable intervention across a
  harm reduction to abstinence spectrum based on an individual’s preference and
  balanced with a ‘dignity of risk’ lens.

1 February 2023

Background

VAADA is pleased to provide this submission to the National Mental Health Commissions draft
National Stigma and Discrimination Reduction Strategy consultation and welcomes the
Commission’s recognition of (i) the impact of stigma, (ii) the different forms of stigma – structural,
public and self – and (iii) the importance of society wide efforts to address and reduce stigma and its
harms.

As reflected in the draft strategy, stigma and discrimination towards individuals using alcohol and
drugs, their families, friends and supporters and those working in the AOD sector is experienced
every day. The impact of AOD-related stigma is far reaching and has been shown to negatively
impact recovery capitol, help-seeking behaviours, intergenerational patterns of substance use, and
sense of worth and connection. As noted by a UK campaign, stigma literally kills.

For people who use AOD, there is the added complexity of secondary stigma potentially connected
to criminality, unemployment, homelessness, social isolation, mental illness and behaviours
associated with intoxication and withdrawal. Addressing stigma is crucially important, and AOD is
one of the most highly stigmatised health and social conditions in society.

VAADA is, overall, very supportive of the actions described in the draft strategy. However, we are
concerned about the position of AOD within the strategy, a lack of definitional specificity when it
comes to the challenges people who use AOD face, and an apparent conflation of the specialist AOD
sector with the mental health services sector.

In addition to this submission, we have also included a detailed reply in the feedback on the
proposed actions survey.

December 2022

Background

The Mental Health and Wellbeing Promotion Office in its task to develop a Statewide Wellbeing
Strategy, following the recommendation from Victoria’s Mental Health Royal Commission, sought
submissions from various communities.

The Victorian Alcohol and Drug Association (VAADA) conducted a 2 hour consultation with 28
representatives of the Victorian alcohol and drug Sector in an attempt to highlight the specific
wellbeing needs of those who use substances within our community.

The session was facilitated based on the questions outlined in the Community engagement toolkit
prepared by the Mental Health and Wellbeing Promotion Office. Feedback was provided via the
survey link and the following section provides a summary of key themes from this consultation.

November 2022

Background

The Victorian Alcohol and Drug Association (VAADA) welcome the opportunity to comment on the
development of a new Eating Disorders Strategy in Victoria. As is recognised in the discussion paper,
and further through this document, there is a strong correlation between substance use, abuse and
dependence, disordered eating behaviours and eating disorders. The identification of this
relationship and reference to it in the State-wide Strategy is a key first step in reducing the impact of
eating disorders and increasing preventative efforts.

This identified pattern of co-occurring mental health and substance use issues is one of multiple
cohorts that will hopefully benefit from reform to Victoria’s Mental Health system and the vision of
the Royal Commission for mental health care to be person-centred, led by those with lived
experience as individuals, families and supporters; holistic -offering a more biopsychosocial model of
care and for integrated treatment, care and support for individuals and their families who are
affected by co-occurring mental health and substance use issues.

As illustrated below, VAADA, identify several opportunities within our sector that could aid in the
development of a responsive, inclusive and integrated system that supports individuals with, or at
risk of, an eating disorder across the continuum of care.

VAADA welcome further opportunities to collaboratively support the development of the strategy
with the aim of reducing prevalence and minimising harm associated with co-occurring eating
disorders and substance use.

October 2022

Background

The introduction of Local Mental Health and Wellbeing Services was a recommendation of the Royal
Commission into Victoria’s Mental Health System. The Department of Health has released the Local
Adult and Older Adult Mental Health and Wellbeing Service Framework which can be found here.
VAADA welcomes the release of this document and the opportunity to understand and explore how
the yet-to-be-defined ‘standalone AOD sector’, can intersect and continue to provide high-quality
services. The following summary outlines key elements of this Framework that relate to the AOD
sector. All italicised sections in this document are direct quotes from the Framework.

This summary has been prepared to both inform the AOD sector and to generate thinking and
opportunities for future collaborative AOD and Mental Health sector work on ensuring access to
treatment for all with co-occurring mental health and AOD needs.

We have included questions at the end of each section, following an analysis of the full document,
from an AOD perspective.

August 2022

Background

The Victorian Alcohol and Drug Association (VAADA) welcomes the opportunity to contribute to the Suicide
Prevention and Response Strategy. The strategy, along with the Victorian Suicide Prevention Framework
2016-2025, can provide a means of fostering social conditions that protect against suicide, identifying and
mitigating risk factors for suicide, and acute and targeted support and interventions to groups at greater
risk of suicide.

Suicide is devastating. The impacts of suicide are long-lasting and widespread, affecting families, friends,
colleagues and communities as a whole. Importantly, deaths by suicide are preventable.

While suicide can affect anyone, some populations are at greater risk. It is often the case that these
populations experience multiple and compounding risk-factors including disadvantage and poverty,
histories of violence and/or neglect, trauma, poor mental health and Alcohol and Other Drug (AOD) issues.

The causes of suicide are complex, often involving a combination of ‘background’ factors such as those
listed above as well as foreground drivers: acute stressors that, when combined with the background
factors, may precipitate suicidality.

The Royal Commission into Victoria’s Mental Health System found that the existing Mental Health
Act (2014) needed to be changed. To achieve this, the Department of Health engaged in a process
to gather feedback on features of the new Act including:

• aims and principles
• decision making
• how information can be used and shared
• compulsory treatment
• seclusion and restraint

The Victorian Government introduced the new Mental Health and Wellbeing Bill to the Victorian
Parliament in June 2022. The Bill is currently being debated in Parliament before it is due to be
enacted as Law later this year. The Act will come into effect 12 months after it is passed into Law.

The new Act will establish foundations for a redesigned mental health and wellbeing system. This
includes people with lived experience in system leadership, as well as the entities needed to enable
system accountability and transparency.

November 2021

Background

This document provides a summary of consultations undertaken by VAADA with
AOD sector representatives in late August and September 2021.

The consultations were designed to contribute towards the development of an
Integrated Alcohol and other Drug (AOD) and Mental Health and Wellbeing
Framework for Mental Health and Wellbeing Services.

The document presents an overview of:

• the consultation workshops including their content and engagement
  activities
• stakeholders that participated in the consultations
• a summary of the insights collected through the forum breakout sessions
• key messages and themes from attendees