2019–2021 royal commission in Victoria, Australia
The Royal Commission into Victoria's Mental Health System, more widely known as the Mental Health Royal Commission, is a royal commission in Victoria, Australia. It was established on 22 February 2019 to investigate deficiencies in the state's mental health system and the broader prevalence of mental illnesses and suicides in the state. The commission published and delivered its interim report to the Governor on 27 November 2019 and tabled in Parliament on the same day. The Commission delivered its final report on 3 February 2021 and it was tabled on 2 March 2021 during a special sitting of the Legislative Assembly at the Royal Exhibition Building in Melbourne.
Establishment and process of the Royal Commission.
During the 2018 state election Labor Premier Daniel Andrews promised that a re-elected government would establish a royal commission to inquire into a "broken" mental health system. 
On 22 February 2019 the Governor of Victoria issued the letters patent, appointing Ms Penny Armytage to Chair the Royal Commission, supported by former Australian Competition and Consumer Commission chief and carer of someone with a mental health issue, Allan Fels; psychiatrist and Associate Professor of the University of Melbourne's Department of Psychiatry, Alex Cockram; Professor of law specialising in mental health law and criminal law, Professor Bernadette McSherry. The peak body for people with lived experience, the Victorian Mental Illness Awareness Council, expressed concern that absent the appointed commissioners was someone with lived experience of using the mental health system.
In 11 weeks between 17 April 2019 and 15 July 2019, the Royal Commission called for submissions from the public, receiving 3 267 responses. An interim report was released, making nine interim recommendations. In May 2020 the Victorian Government confirmed providing an extension to the Royal Commission to complete its work until February 2021, noting the delays caused by the COVID-19 pandemic. Further witness statements were received throughout 2020, as well as 8 community panel hearings. Commissioners deliberated in the final stages of 2020 before the final report was delivered to the Victorian Government on 1 February 2021. The final report was released to the public in a special sitting of the Victorian Parliament on 2 March 2021, with significant media coverage and attention.
Findings.
Among the themes from the Royal Commission's findings were that:
These findings informed the development of a suite of recommendations in the Interim and Final Report.
Recommendations.
The Royal Commission's final report includes 65 recommendations in addition to the nine interim report recommendations.
The recommendations set out a 10-year vision for a future mental health system in Victoria where people can access treatment close to their homes and in their communities. Importantly, people with lived experience of mental illness or psychological distress will be central to the design and delivery of this new mental health and wellbeing system being implemented as a result of this Royal Commission.
The Royal Commission's recommendations are grouped around four key features of the future mental health and wellbeing system:
1) A responsive and integrated system with community at its heart
2) A system attuned to promoting inclusion and addressing inequities
3) Re-established public confidence through prioritisation and collaboration
4) Contemporary and adaptable services.
The Government of Victoria has committed to implementing all recommendations, establishing Mental Health Reform Victoria for this purpose. In July 2021, its staff and functions moved to the new Mental Health and Wellbeing Division within the Department of Health (Victoria).
The 2021-22 Victorian State Budget responded to the recommendations of the Royal Commission into Victoria's Mental Health System, with the Victorian Government announcing a record $3.8 billion investment in mental health and wellbeing. 
Among the recommendations was the development of a new Lived Experience Agency to support innovation in the mental health sector.
A new Mental Health and Wellbeing Act for Victoria.
The Royal Commission found that implementation of the "Mental Health Act 2014" (Vic) had not lived up to expectation. Originally, that legislation was lauded as making Victoria a "leader" in mental health reform in Australia. The Royal Commission's interim report concluded that the least restrictive means possible were not being used by mental health services. The final report found that because mental health services do not routinely record whether and how they seek informed consent to treatment, it is 'unclear to what extent authorised psychiatrists consider these provisions before administering treatment.'
Other issues identified in the final report were regarding quality and safety as well as oversight processes to give effect to legal obligations. The final report spoke to evidence that:'it is difficult to see what actions are being taken to hold services to account for quality and safety or human rights failings. Transparency about these activities allows consumers and their advocates to engage in a more meaningful way with the various oversight and improvement arrangements, and hold those charged with these functions to—in turn—be held to account. In contrast, the lack of information about how the Department of Health, the Chief Psychiatrist and other bodies are responding to quality and safety concerns can leave consumers feeling disempowered and distrustful.'As part of its recommendations, the Royal Commission recommended the repeal of the current Mental Health Act 2014 and enactment of a new Mental Health and Wellbeing Act for the state of Victoria.
This new Act aimed to:
The Royal Commission has recommended that the new Mental Health and Wellbeing Act be passed no later than mid-2022.
The Department of Health ran public engagement to help with the drafting of the Mental Health and Wellbeing Bill from June to August 2021. The department will work with consumers, families, carers, supporters, workers and providers to develop guidelines, regulations and processes to support the new Act once it has been passed by the Victorian Parliament. The new Act also provided for the replacement of the previous Mental Health Complaints Commissioner that had been criticised for under-enforcement of human rights. However, the new Mental Health and Wellbeing Commission has also been criticised for similar issues and for a lack of transparency.
2024-2025 Budget Commitments and the Royal Commission Recommendations.
In the 2024-2025 budget, the Victorian Government committed to key elements associated with the Royal Commission recommendations, while highlighting questions about others. The Victorian Government continued to provide funding for youth mental health services, such as those provided by Orygen Youth Mental Health. However, the following recommendations have now remained behind the schedule provided by the Royal Commission:
Timeframes for these recommendations is indicated in Volume 5 of the Royal Commission reports. Three weeks after the release of the budget, the Mental Health and Wellbeing Commission released a statement acknowledging the disappointment in the rollout of the Royal Commission recommendations. In August 2024, the Mental Health and Wellbeing Commission, with the statutory functions to monitor the government's implementation of the Royal Commission recommendations and powers to conduct own-motion inquiries, stated it was still seeking further information and briefings from government.
References and further reading.
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