It is estimated that one in five people will be affected at some stage by a mental health problem or illness. The increasing prevalence of mental illness means that at some point in time most of us will either be affected or we will know of someone who is.

Although most people with mental illness can be treated in the community, at times some may require emergency treatment or admission to hospital for shortterm intensive therapy.

Not only are more mental health patients presenting to an emergency department for treatment than ever before, they are reportedly sicker and a greater number require admission to a hospital bed for further treatment. And, because of its very nature, those suffering from acute mental illness may not understand what is wrong or be able to communicate their problems clearly.

This makes access to emergency mental health services a significant issue for government that requires continuing attention.

The focus of this report is on the provision of 24-hour crisis services to adults. Emergency mental health services play a vital role in providing timely and appropriate care. Without proper treatment the severity of the illness may escalate, increasing the risk of self-harm or harm to others.

There have been many changes to mental health services over the last decade to deal with increasing demand. Much has been done to improve access to, and the quality of emergency services through significant increases in funding, the opening of new beds and the employment of more mental health staff.

Yet recent reviews have highlighted problems with accessing mental health beds and inadequate levels of psychiatric support in rural areas.

I believe that our report will provide valuable assistance to area health services on alternative models of emergency mental health care that better manage patient risk and further improve service quality.

Parliamentary reference - Report number #136 - released 26 May 2005

Periodically we review the extent to which agencies have implemented the recommendations they accept from our earlier audits. This gives Parliament
and the public an update on the extent of progress made.

Intellectual property (IP) can have value to the agency concerned and may have the potential for wider commercial use. Poor management of IP can impose risks, including the risk of lost opportunities. Because it is not ‘tangible’ like a building or plant and equipment, the need for properly managing IP may be overlooked.

In this follow-up audit, we examine changes following our October 2001 report on how well public sector agencies were managing intellectual property.

Parliamentary reference - Report number #133 - released 30 March 2005

The purpose of this document is to assist agencies in meeting the challenges of exploiting the benefits and managing the risks which e-government presents. Being 'e-ready' and managing the transition to e-government will not happen by chance. It is difficult and requires a careful and concerted effort. This guide draws from the research assembled in the performance audit, e-government - Use of the Internet and related technologies to improve public sector performance (September 2001). It addresses issues at the agency level, in a self-help guide format.

Parliamentary reference - Report number #88 - released 19 September 2001

Notwithstanding the considerable effort, it is not apparent that the Government's vision can be fully achieved without increased efforts. Based on the current position, to ensure that the Government's vision can be achieved the Audit Office is of the view that the following key issues need to be urgently addressed: 

• more robust mechanisms are needed to monitor, review and report publicly on progress and benefits

• a greater emphasis should be placed on central coordination to ensure that agencies act in a more uniform and integrated manner  

• the achievement of significant reform of business processes will require a substantial strengthening of accountability mechanisms and more comprehensive, rigorous and systematic approaches to e-government project and risk management. 

• despite an array of guidance material and support provided by central agencies, line agency needs for assistance do not seem to be being met to sufficiently advance matters across the sector at the pace and scope desired

• the Government’s e-government aspirations and funding are not always effectively harmonised. Agencies typically have limited resources available to trial or experience new technologies, and display an aversion to the associated risks.

Parliamentary reference - Report number #87 - released 19 September 2001

This performance audit indicates that the Service has considerable work to do to reach its aspirations of being recognised amongst leading examples of best practice services. The commitment of the Service to serving the community and the professionalism of the Service's officers is not in question. It is, however, apparent that a number of barriers to performance will need to be overcome for the Service to perform as well as it would wish.

Parliamentary reference - Report number #80 - released 7 March 2001

Volume One: Corporate Governance in Principle, considers relations between the Government and boards, and the extent to which boards add value. Various public sector governance models are examined, including those currently operating within NSW and those from five other jurisdictions.

It found the role of boards should be clearly defined, and specific criteria developed, so that boards can be clearly classified as either governing or advisory. Legislation should be reviewed targeting priority areas and policies developed to clarify and strengthen the respective role and functions for governing and advisory boards.

Governance models, legislation, policies and practices should be based on principles of simplicity, clarity and consistency in approach; provide boards with sufficient and clearly defined powers and authority for them to carry out their statutory role and there should be a corresponding appropriate level of public accountability.

Parliamentary reference - Report number #39 - released 17 June 1997

This Report, Volume Two: Corporate Governance in Practice reports upon how actual corporate governance practices by NSW public sector boards compare with “better practice”.

It found criteria and processes for appointing directors to boards are not always transparent. It also found a more systematic and rigorous approach to the range of corporate governance issues is required across the public sector if it is to approach "better practice", there is a lack of accountability for board decision making and board performance and where boards are to serve a governance role, then a basic framework needs to be created to ensure they can operate efficiently and effectively.

Parliamentary reference - Report number #39 - released 17 June 1997

A Supplement to Volume Two: Survey Findings has also been prepared, presenting The Audit Office’s survey findings in detail. This may serve as a useful benchmark for governance in the NSW public sector.

It found that, supporting/enabling legislation, governance structures and boards creation processes should facilitate better governance practice. It also found boards and management should understand their roles, responsibilities and duties and that these should be clearly articulated in legislation, board directors should possess appropriate qualifications and expertise to fulfil their responsibilities, boards need to ensure that adequate systems are in place to be able to oversight on the activity of the agency and boards must be accountable to those whose interests they represent.

Parliamentary reference - Report number #39 - released 17 June 1997