• We reviewed the content of the Strategic Roadmaps for the Foundational Elements and Focus Areas. While these are a positive first step, there is a need for additional steps to:
  • link service provision to the Plan as part of implementation
  • engage with and incentivise the private sector
• It is important to explain the purpose and structure of the Plan, with a detailed implementation plan outlining more specifics on ‘how’ we will work towards the Desired States in the Strategic Roadmaps.
• We discussed the importance of having a dedicated resource to drive implementation of the Plan, within organisations and across the sector

• We began to look at the system foundations, and what some of the key priority areas may be within the cohorts
• There is a need to have a common perspective for understanding people and their needs, the Common Approach framework may be a shared lens for understanding people.
• The NMHSPF taxonomy makes sense for describing the workforce
• When working through the foundations across the cohorts, there is a significant amount of content to process. We provided suggestions on structure and process for upcoming workshops.

• Agree with the multiple lenses for thinking about Stepped Care and that these frameworks are not a prescriptive solution but a mechanism to frame discussions, identify transition points that need extra attention, and discuss potential solutions
• The vision should emphasise people and not just systems, while also explicitly mentioning compassion and connection.
• The principles should reflect a commitment to equity and social justice.
• Discussed the National Mental Health Service Planning Framework and its limitations, especially for emerging professions and Aboriginal and Torres Strait Islander people.

The group identified the following challenges within Stepped Care:

• Gaps between categories of ‘severe’ & ‘complex’ and ‘crisis’: People are often not serious enough to have acute mental health issues requiring ongoing hospital involvement but they continue coming back in crisis. There is a gap for people that are not acute enough for hospital but GPs can find difficult to manage. Often these are people that are chronically unwell, and have functional impairment without acuity.
• Transition points: stepping up and down are challenging and risk points for clients, so the flow is incredibly important for Stepped Care to work
• Dual diagnosis: Evidence supports that engagement is key. A challenge in practice because often models of care do not support this engagement