NDIA Accountability Project

Submission 85 — NT Council of Social Services — The provision of services under the NDIS for people with psychosocial disabilities related to a mental health condition

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NTCOSS Submission to the

Joint Standing Committee on the NDIS – The provision of services under the NDIS for people with psychosocial disabilities related to a mental health condition

February 2017

Contact Details:

Wendy Morton Executive Director

Website www.ntcoss.org.au

ABN 19 556 236 404

psychosocial disabilities related to a mental health condition

ABOUT US

Northern Territory Council of Social Service Inc (NTCOSS)

NTCOSS is a peak body for the Social and Community Sector in the Northern Territory (NT) and an advocate for social justice on behalf of people and communities in the NT, who may be affected by poverty and disadvantage.

NTCOSS has a broad membership base, which is made up of non-government and community organisations, Indigenous organisations, and community councils across the NT as well as other

organisations and  individuals who are committed to  social  justice  issues  for people and

communities who are socially and financially disadvantaged in the NT.

NTCOSS is governed by a Board which includes representation from across the Social and Community Sector in the NT, including regional representatives and representatives from the range of social policy areas.

INTRODUCTION

NTCOSS thanks the Joint Standing Committee for conducting this inquiry and for providing us with the opportunity to make a submission.

The focus of this submission is on the perceived impacts on service provision and the health, social and emotional wellbeing of the NT community arising from changes to mental health services under the NDIS.

This submission contains contributions from NT individuals and organisations. Content was gathered through surveys and face to face interviews. This submission supports the following submissions made to this Inquiry:

 Community Mental Health Australia Submission

 Northern Territory Mental Health Coalition

 NT Shelter

Organisations consulted are primarily concerned with how clients with psychosocial disabilities will receive assistance under the NDIS. There seems to be a contradiction between the treatment approach for clients with episodic mental illness/psychosocial disability where emphasis is on recovery, and the NDIS Access requirements defining disability as permanent (lifelong).

NT people with psychosocial disability may be disadvantaged by the removal of block funding of mental health services because

a. They live in rural, remote and very remote locations b. They are more likely to be an Indigenous person than in other Australian jurisdictions due to the high percentage of Indigenous people living in the NT

c. There is a lack of choice of service providers for people living in very remote areas Page | 2 FEBRUARY 2017

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RECOMMENDATIONS

  1. Ensure the provision of services under the NDIS for people with psychosocial disabilities related to a mental health condition is delivered in keeping with the following:

a. A National framework for recovery-oriented mental health services: guide for practitioners and providers1

b. Fourth national mental health plan: an agenda for collaborative government action in mental health 2009-20142

c.  Working Together:  Aboriginal and Torres  Strait  Islander Mental Health and

Wellbeing Principles and Practice3

d. United Nations Declaration on the Rights of Indigenous Peoples4 e. Principles of Aboriginal Community Control Health Organisations5 f. Primary Mental Health Care model6. Organisations are concerned with how clients with psychosocial disabilities will receive assistance under NDIS. There seems to be a contradiction between the treatment approach for clients with episodic mental illness/psychosocial disability where emphasis is on recovery, and the NDIS Access requirements defining disability as permanent (lifelong).

  1. NDIS to develop processes relative to the NT population, geography and service delivery constraints.

  2. NDIS to implement a system where advocates are to be present at and bill for, all meetings between the person with psychosocial disability and the NDIS and NDIA unless the person asks for them not to be at the meetings. Advocates are to be involved through an opt out basis. NT advocates, including carers, report that people with psychosocial disability have not been able to effectively advocate for NDIS services on their own behalf. This includes not being able to articulate:

a. their diagnosed episodic or chronic psychosocial disability b. the support they currently receive from block funded service providers c. the support they currently receive from carers d. their goals and aspirations. 4. NDIS system of eligibility to be adjusted to match the nature of psychosocial disability. With the change to NDIA requirements, clients are now required to undergo a clinical diagnosis from either a GP or Psychologist. In the NT, these services are not freely available, are booked out for a long period of time, or specialists are not willing to take on any more referrals. People at greater risk of being ineligible for NDIS are those living with the most common

psychosocial  disabilities  including,  anxiety  (including complex  post-traumatic  stress

disorder) and depression7, and may include:

a. Current and returned service men and women b. Adults and children living with or escaping from domestic and family violence Page | 3 FEBRUARY 2017

psychosocial disabilities related to a mental health condition

c. People living with intergenerational trauma d. People living with alcohol and or other drug challenges e. Adults and children exiting custodial facilities including prison, NT Alcohol

Mandatory Treatment and mental health inpatient facilities

f. Children and adults with Fetal Alcohol Spectrum Disorder. 5. NDIS to articulate and distribute its appeals process in plain English. 6. NDIS to develop an evidence based assessment and planning process accessible for people with psychosocial disability and cognitive impairment.

  1. NDIS to develop an evidence based assessment and planning process accessible for people with psychosocial disability and cognitive impairment whose first language is not English.

  2. NDIS to ensure people with psychosocial disability have access to an interpreter if required. This is to be an opt out service and delivered in line with guidelines from Aboriginal Interpreter Service8 and Interpreting and Translating Service NT.9

  3. Northern Territory Department of Health to commence department wide utilisation of the EHealth / Telehealth system to facilitate streamlined NDIS planning and assessment for NT people with psychosocial disability.

  4. NDIS to include the activities provided by carers of people with psychosocial disability as a billable item.

  5. NDIS to review unit costing and pricing relative to cost of living and service delivery in regional, remote and very remote NT. For NDIS impacted organisations, unit costing of service and the ability for organisations to deliver services sustainably within the NDIA pricing model is a key concern for many, especially for clients where service delivery is significantly more costly to provide. Some organisations believe that due to a pricing model that is considered by many to be insufficient, the ‘provider of last resort’ option may need to be exercised more than envisaged in the NT.

  6. NDIS to be cognisant of organisational readiness. Organisations are in varied stages of readiness for NDIS; generally larger organisations which have a national presence (though are run independently in each state) report better NDIS readiness, as they have the funds and organisational structures in place to devote resources to change management, as well as cash flow to cover the change to income streams. Smaller organisations are generally managed with very limited funding and resources for service delivery. Some report that they ‘over-service’ clients (provide additional services over and above what they are funded to provide) due to increases in demand for services –

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without any increase in government funding. They do not generally hold strong cash reserves; therefore not in a position to devote resources to internal planning and change management.

  1. NDIS to be cognisant of organisational readiness in relation to markets. Organisations are still uncertain about the future demands for the range of supports available under the NDIS as there is limited information available. There is information on client demand for services they have provided, but this has been in an environment of more limited choice and clients may choose their supports differently when provided with choice. There is also concern over a potential influx of competition which may drive down pricing at the expense of quality (possibly to unsustainable levels for the provision of quality service.) This uncertainty makes planning difficult for organisations.

  2. NDIS to be cognisant of organisational readiness in relation to client choice. There is a concern that NDIS will pose significant strain on smaller, niche services and there may be organisation closures, leading to a market of larger, one-size-fits-all service organisations. Both small and large organisations have reported it is unlikely they will be able to provide services in some areas (particularly remote) at the fees set by NDIA and this could lead to a decrease in services. There is concern that these pricing issues could result in a decrease in choice, variety and quality for clients; the opposite of what NDIS intended to achieve.

  3. NDIS to be cognisant of organisational readiness in relation to marketing and digital presence. There is increasing awareness within the sector that marketing (traditional and digital) strategies are required to increase brand awareness and service utilisation, especially in the NDIS environment and sectors which charge clients individual fee-for-service rather than block government funding.

  4. NDIS to be cognisant of organisational readiness in relation to I.T. Aging or unfit-for-purpose I.T. hardware, software and processes are also a problem within financially stretched organisations and could pose problems for interfacing with online NDIS systems, financial management processes and reporting.

  5. NDIS to be cognisant of organisational readiness in relation to scope. There remains some confusion among services about the scope of NDIS; for example, how impartiality will be ensured when service providers are assisting participants with their service plans; the question of choice in relation to mental illness and decisions made via guardianship; or whether advocacy services will fall in or out of the scheme.

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  1. NDIS to be cognisant of organisational readiness in relation to changes to NT out-of-home care services. With out-of-home care services transitioning from government (Territory Families) to the NGO sector over the coming 7 years, (and the current government’s key focus on children and child protection) there will be a need for government to assist organisations with capacity building to cope with increasing demand.

  2. NDIS to immediately implement evidence based NDIA planner training in relation to psychosocial disability. In some cases, the NDIA planner is not adequately experienced with mental distress and underestimates or overlooks key issues that need support. Mental health participants generally need a lot of support during planning process, low self esteem/value, low concentration, traumas and emotional or cognitive difficulty caused by

    symptoms or medications cause the process and planning meeting to become

overwhelming.

  1. NDIS to expand its information provision to people with psychosocial disability, their carers, families and communities. Organisations are concerned their clients struggle to fully understand the scheme. It is challenging to communicate all the aspects of the NDIS and build the understanding of clients regarding the assessment process, how they will access services and how they may be affected if deemed ineligible. To overcome these issues there is continuous engagement with the client with the support of their family members, however this can be a long and resource intensive process. Clients can also be very transient and sometimes cannot be contacted for follow up.

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NORTHERN TERRITORY CONTEXT

The following information provides a snapshot of characteristics of the NT population. These

characteristics may inform  service  provision under the NDIS  for people with psychosocial

disabilities related to a mental health condition.

For age-standardised rates of mental health overnight hospitalisations per 100,000 people, by Primary Health Network area in 2014–15, the NT was statistical equivalent of North Western Melbourne, Eastern Melbourne and Western Victoria. For the same cohort, the NT was statically greater than the ACT.10

Age-standardised rates of mental health bed days for overnight hospitalisations per 100,000 people, by Primary Health Network area, 2014–15, the NT was statistical equivalent of Country WA. For the same cohort, the NT was statically greater than Western Queensland.11

The NT Aboriginal and Torres Strait Islander population is characterized by the following:12

  • The preliminary estimated resident Aboriginal and Torres Strait Islander population of the NT at 30 June 2014 was about 72,251 people (ABS 2014a), accounting for 10.1% of

    Australia’s Indigenous population. Indigenous people represent 29.6% of the NT

population, nearly 10 times the proportion of Indigenous people in the total Australian population (3%).

-   The  Aboriginal and Torres  Strait  Islander population has an age  structure  that  is

significantly younger than that of other Australians. For example, in the NT, people aged under 15 constitute about 31% of the Indigenous population, whereas this age group represents about 19% of the non-Indigenous population. Conversely, people aged 65 and over comprise less than 4% of the Indigenous population in the NT, but about 8% of the non-Indigenous population.

  • In the NT, the vast majority of Aboriginal and Torres Strait Islander people live in Remote (21.4%) and Very remote areas (58.3%). Around one-fifth live in the Outer regional areas (20.3%).

  • In comparison, the majority of non-Indigenous Australians live in Outer regional areas (71%) and Remote areas (21%). Nationally, over three-quarters of the total Indigenous population in Australia live in Major cities (35%), Inner regional (22%) and Outer regional (22%) areas, with about one-fifth residing in Remote (8%) and Very remote areas (14%).

NT Department of Health describes the following challenges it faces in service delivery due to demographic and geographic factors which include:13

  • Large, sparsely populated areas
  • High levels of chronic disease and co-morbidity
  • An ageing population and the accompanying burden of disease
  • Social and economic disadvantage with particular links to remoteness
  • The NT Health System covers 1.35 million square kilometres Page | 7 FEBRUARY 2017

psychosocial disabilities related to a mental health condition

  • Over 43% of the NT population reside in remote or very remote areas. There are over 600 communities and remote outstations in the NT, all with small populations, and the system experiences high fixed and unit costs associated with the challenges of the above factors.

  • There are 85 remote primary health care centres, 52 of which are operated by the NT Government and 33 by Aboriginal Community Controlled Health Organisations.

  • The Top End Health Service (TEHS) region covers 35.3% (475,338 km²) of the total area of the NT. As of June 2015 the resident population of the TEHS region was 195,330, representing 80% of the total NT population. Almost three quarters (141,850, 72.6%) of TEHS residents reside within the Darwin Urban area, of which the majority are non Aboriginal (89.2%). The distribution of the TEHS Aboriginal population varies within regions, with Darwin Rural (12,650, 79.1%) having the largest proportion, followed by East Arnhem (11,360, 66.0%), Katherine (11,010, 54.4%), and Darwin Urban (15,270, 10.8%).

  • The Central Australian Health Service (CAHS) region covers two-thirds (64.7%) of the total area of the NT, and includes 20.1% of the total NT population. As of June 2015, the CAHS region had an estimated resident population of 49,270 people, of whom 43.8% (21,570) were Aboriginal. The majority of the non-Aboriginal CAHS population reside in Alice Springs (83.2%). Of Aboriginal residents, 48.1% live in discrete communities within the Alice Springs Rural area, 30.3% reside in the Alice Springs Urban area and the remaining 21.7% live in the Barkly area.

  • In 2015 there were 16 3,282 admissions with mental health diagnosis NT Department of Education provides education to children with the following demographic and geographic factors14

  • In the NT, 73 per cent of government schools are located in remote and very remote areas with 46.3 per cent of our students enrolled at these schools. There is a diverse student population, with Indigenous students making up 44.4 per cent of the student population.

  • In government schools, approximately 48.8 per cent of NT students have a language background other than English.

  • The social, economic and health challenges in remote areas are significant. Over 67 per cent of NT Government schools are located in areas classified in the lowest decile on the national Index of Community Socio-Educational Advantage.

NT Department of Corrections provides the following information about the cohort of people involved in custodial settings15

  • The NT recorded the highest imprisonment rate in Australia, at 958.1 prisoners per 100,000 adult population in the March Quarter 2016. This is 4.7 times the national rate of 204.7 prisoners per 100,000 adult population.

  • During the March Quarter 2016, the NT Aboriginal and Torres Strait Islander imprisonment rate was 3,025.2 per 100,000 adult Aboriginal and Torres Strait Islander population. This is 29.4% higher than the national Aboriginal and Torres Strait Islander imprisonment rate of 2,337.6 prisoners per 100,000 adult Aboriginal and Torres Strait Islander population. The

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NT Aboriginal and Torres Strait Islander imprisonment rate was ranked second highest among Australian jurisdictions, behind that of Western Australia.

  • In the NT, Aboriginal and Torres Strait Islander people are imprisoned at 14.0 times the rate of non-Indigenous people (3,024.3 compared to 215.7).

  • At 26.4%, the proportion of Aboriginal and Torres Strait Islander adults in the NT’s adult population is 11 times the national figure of 2.4%.

  • Of all Australian jurisdictions, the NT recorded the highest rate of persons in community based corrections for the March Quarter 2016 at 615.5 per 100,000 adult population. This is 1.8 times the national rate of 339.5.

NT Department of Children and Families provides the following information about the cohort of children and families involved in the child protection system16

  • Of the 1,020 children in care, 89 per cent are Aboriginal, 50.3 per cent are male, and more than half are younger than 10 years old.

  • In 2015-16, 20,465 child protection notifications were received. 7,862 cases proceeded to investigation. 1,907 cases were substantiated, where children were assessed to have been harmed or at risk of harm.

  • 315 children were brought into care, bringing the total number of Territory children in care on 30 June 2016 to over 1,000.

NT Homelessness Indicators17

  • NT has 15 times the national average rate of homelessness.
  • 7.3% of all people in the NT are experiencing homelessness.
  • Nationally 0.05% of the population is homeless.
  • 1 in 4 Aboriginal people in the NT are experiencing homelessness.
  • 10% of all Territorians under the age of 18 are experiencing homelessness.
  • 85% of people defined as homeless in the NT live in severely crowded dwellings.
  • The NT has 13 times the national rate of people sleeping rough.
  • 10% of all people sleeping rough in the NT are under the age of 18 Page | 9 FEBRUARY 2017

psychosocial disabilities related to a mental health condition

The following strategies, frameworks and approaches are recommended to inform NDIS services provision for people with psychosocial disabilities related to a mental health condition.

  1. A National framework for recovery-oriented mental health services: guide for practitioners and providers18

  2. Fourth national mental health plan: an agenda for collaborative government action in mental health 2009-201419

  3. Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing

Principles and Practice20

  1. Ways Forward: National Aboriginal and Torres Strait Islander Mental Health Policy National

Consultancy Report21

  1. United Nations Declaration on the Rights of Indigenous Peoples22

  2. United Nations Convention on the Rights of the Child23

  3. United Nations Convention on the Rights of Persons with Disabilities24

  4. Principles of Aboriginal Community Control Health Organisations25

  5. Kimberley Indigenous Cognitive Assessment Cognitive Assessment26

  6. The National Institute for Health and Care Excellence (NICE) Mental health and wellbeing guidance and advice27

  7. A model for integrating alcohol and other drugs, community mental health and primary health care in Aboriginal Medical Services in the Northern Territory. Aboriginal Medical Services Alliance of the Northern Territory (AMSANT), 2008 (Revised 2011)28

  8. Northern Territory Aboriginal Health Forum. Core functions of primary health care: a framework for the Northern Territory. Prepared for the NTAHF by Edward Tilton (Edward

Tilton Consulting) and David Thomas (the Lowitja Institute) October 2011.29

13. Central  Australian  Aboriginal Congress  (Congress):   Submission  to the  Productivity

Commission’s Preliminary Findings Report: Introducing Competition and Informed User

Choice into Human Services: Identifying Sectors for Reform.30

  1. AIMhi Stay Strong App: wellbeing App for use with Indigenous clients by Aboriginal Health Workers, nurses, GPs, allied health professionals, community workers and others within clinical and community settings.31

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REFERENCES

1 A National framework for recovery-oriented mental health services: guide for practitioners and providers http://www.health.gov.au/internet/main/publishing.nsf/content/mental-pubs-n-recovgde

2 Fourth national mental health plan: an agenda for collaborative government action in mental health 2009 2014 http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-pubs-f-plan09

3 Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice

Editors: Nola Purdie, Pat Dudgeon and Roz Walker

http://nceta.flinders.edu.au/files/2113/5891/4630/working_together_full_book.pdf

4 United Nations (2008). United Nations Declaration on the Rights of Indigenous Peoples. United Nations. Articles 3 and 4. http://www.un.org/esa/socdev/unpfii/documents/DRIPS_en.pdf

5 National Aboriginal Community Controlled Health Organisation (2016) NACCHO Submission to Inquiry into

Human Services: Identifying Sectors for Reform, Sub227 into Human Services: Identifying Sectors for Reform. Productivity Commission, Melbourne. p. 3. http://www.pc.gov.au/__data/assets/pdf_file/0007/204964/sub227-human-services-identifying-reform.pdf

6 Australian Government Department of Health National Mental Health Reform 2011-12 Strengthening

primary mental health care services http://www.health.gov.au/internet/publications/publishing.nsf/Content/nmhr11-12~nmhr11-12 priorities~Strengthening

7 Australian Bureau of Statistics 2007 National Survey of Mental Health and Wellbeing http://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/4326.0Main%20Features32007?opendocument& tabname=Summary&prodno=4326.0&issue=2007&num=&view= 8 Aboriginal Interpreter Service https://nt.gov.au/community/interpreting-and-translating services/aboriginal-interpreter-service/about-the-aboriginal-interpreting-service

9 Interpreting-and Translating Service NT https://nt.gov.au/community/interpreting-and-translating-

services/interpreting-and-translating-service-nt/about-interpreting-and-translating-service-nt

10 Web update: Hospitalisations for mental health conditions and intentional self-harm in 2014–15. Age standardised rates of mental health overnight hospitalisations per 100,000 people, by Primary Health Network area, 2014–15 http://www.myhealthycommunities.gov.au/Content/publications/reports/hc30/resources/Mental%20Health _BarGraph_MHOH%20and%20bed%20days%20by%20PHN.pdf

11 Web update: Hospitalisations for mental health conditions and intentional self-harm in 2014–15. Age standardised rates of mental health overnight hospitalisations per 100,000 people, by Primary Health Network area, 2014–15 http://www.myhealthycommunities.gov.au/Content/publications/reports/hc30/resources/Mental%20Health _BarGraph_MHOH%20and%20bed%20days%20by%20PHN.pdf

12 Aboriginal and Torres Strait Islander Health Performance Framework 2014 report. Northern Territory. Australian Institute of Health and Welfare. Canberra. Cat. no. IHW 159 http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129553239

13 Northern Territory Department of Health Annual Report 2015-16

http://digitallibrary.health.nt.gov.au/prodjspui/bitstream/10137/723/3/DoH_Annual%20Report_2015-16.pdf

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14 Northern Territory Department of Education Annual Report 2015-16

https://education.nt.gov.au/__data/assets/pdf_file/0011/379397/DOE_Annual-Report-2015-16_web.pdf

15 Northern Territory Department of Corrections Annual Report 2015-16

https://correctionalservices.nt.gov.au/__data/assets/pdf_file/0007/379771/Corrections-Annual-Report 2015-16.pdf

16 Northern Territory Department of Children and Families Annual Report 2015-16 https://territoryfamilies.nt.gov.au/__data/assets/pdf_file/0010/379594/Department-of-Children-and

Families-annual-report-2015-16.pdf

17 NT Shelter: Homelessness in the Northern Territory https://ntshelter.org.au/documents/?mdocs cat=mdocs-cat-5&att=null 18 A National framework for recovery-oriented mental health services: guide for practitioners and providers http://www.health.gov.au/internet/main/publishing.nsf/content/mental-pubs-n-recovgde

19 Fourth national mental health plan: an agenda for collaborative government action in mental health 2009 2014 http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-pubs-f-plan09

20 Working Together: Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and

Practice Editors: Nola Purdie, Pat Dudgeon and Roz Walker

http://nceta.flinders.edu.au/files/2113/5891/4630/working_together_full_book.pdf

21 Ways Forward: National Aboriginal and Torres Strait Islander Mental Health Policy National Consultancy

Report by P. Swan and B. Raphael 1995 http://library.bsl.org.au/jspui/bitstream/123456789/353/1/Ways%20forward_vol.1%20%26%202%20_1995. pdf

22 United Nations (2008). United Nations Declaration on the Rights of Indigenous Peoples. United Nations. http://www.un.org/esa/socdev/unpfii/documents/DRIPS_en.pdf

23 United Nations Convention on the Rights of the Child http://www.ohchr.org/EN/ProfessionalInterest/Pages/CRC.aspx

24 United Nations Convention on the Rights of Persons with Disabilities http://www.ohchr.org/EN/HRBodies/CRPD/Pages/ConventionRightsPersonsWithDisabilities.aspx

25 National Aboriginal Community Controlled Health Organisation (2016) NACCHO Submission to Inquiry into

Human Services: Identifying Sectors for Reform, Sub227 into Human Services: Identifying Sectors for Reform. Productivity Commission, Melbourne. p. 3.

26 Kimberley Indigenous Cognitive Assessment Cognitive Assessment

https://www.perkins.org.au/resources/wacha-resources/kica/KICA-Tool.pdf

27 The National Institute for Health and Care Excellence (NICE) Mental health and wellbeing guidance and advice. Guidancehttps://www.nice.org.uk/guidance/lifestyle-and-wellbeing/mental-health-and-wellbeing

28 A model for integrating alcohol and other drugs, community mental health and primary health care in

Aboriginal Medical Services in the Northern Territory. Aboriginal Medical Services Alliance of the Northern

Territory (AMSANT), 2008 (Revised 2011) http://www.amsant.org.au/wp content/uploads/2014/10/AMSANT-Policy-AOD-and-Mental-Health-2008-reviewed-2011-Final.pdf

29 Northern Territory Aboriginal Health Forum. Core functions of primary health care: a framework for the

Northern Territory. Prepared for the NTAHF by Edward Tilton (Edward Tilton Consulting) and David Thomas

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(the Lowitja Institute) October 2011 http://www.amsant.org.au/wp-content/uploads/2014/10/111001 NTAHF-ET-External-Core_PHC_Functions_Framework_FINAL.pdf

30 Central Australian Aboriginal Congress (Congress): Submission to the Productivity Commission’s Preliminary Findings Report: Introducing Competition and Informed User Choice into Human Services: Identifying Sectors for Reform. http://www.caac.org.au/uploads/pdfs/2016_Congress-response-to-PC review-of-Human-Services-Nov.pdf

31 AIMhi Stay Strong App: wellbeing app for use with Indigenous clients by Aboriginal Health Workers, nurses, GPs, allied health professionals, community workers and others within clinical and community settings. http://www.menzies.edu.au/page/Research/Projects/Mental_Health_and_wellbeing/Development_of_the_

Stay_Strong_iPad_App/

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