Health reform debate ignores non-vote winning mental health issues
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We all know that unfortunately mental health is not a vote winner. The users of mental health services include people such as me who are relatively affluent and educated, but they also include some of the most marginalised and vulnerable people in our community. It is this group of Australians who are being left out of Prime Minister Rudd’s and the state premiers’ health reform debate. The focus is on the sexy, headline-grabbing and vote-changing issues of aged care, hospital beds, waiting times for surgery and access to physical health services. In other words, the health package is tailored by politicians with an eye to their futures. Yet on June 12, 2008, when Nicola Roxon was the newly minted health minister, The Sydney Morning Herald reported her as saying:
Now, less than two years later Roxon is having to defend herself against the reality that the Rudd government’s health reform package ignores mental health, and inexplicably so, given that mental health and physical health are so closely intertwined. This is not only tragic, but scandalous. Because as it stands, even if Rudd gets his way with the premiers next week, nothing will change for most users of public mental health services, and particularly those in the public system. They will still face acute-care bed shortages; a silo-like approach to services, which means that they are shunted from service provider to service provider, private hospital mental health care will still remain out of reach except for those who can afford it; and the police and correctional services will be forced to warehouse people with mental illness because they cannot secure scarce bed places in emergency wards. Yet more than three million Australians experience mental illness each year. The AMA says that about one in 10 sessions a GP has with a patient is mental health-related and in 2008 the ABS found that more than two million Australians did not access help for their mental health needs, despite them acknowledging they need to do so. One major reason for this frightening ABS number is that there is a lack of facilities available to patients. As Professor Vaughan Carr, a psychiatrist from the University of New South Wales and head of the Schizophrenia Research Institute, noted recently,
Yet despite all this, our political leaders are not making mental health reform a key part of Australia’s healthy future. Greg Barns lives with bipolar depression and is a regular user of the mental health system. |
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10 Comments
Can we have more pics of the girl on the main page link to this please?
Why has Rudd left mental health out of his package to the States? It simply makes no sense.
As a user of private mental health services I found it difficult to access acute care when required last year. It was an agonosing 28 hour wait for a bed to become available. For me and my family, already feeling helpless, those hours were terrifying.
But as Greg points out, the situation is far, far worse for those relying on the public health system. I was lucky, I had great supports who kept the pressure up to find me a bed and ensure I received treament. But what about those who, when they are in crisis and incredibly vulnerable, have no one to be their voice, their advocate? They get lost in a seriously under-staffed and under-resourced health system. And the consequences - well, they can be fatal.
Mental Health needs to be front and centre of the federal government’s suite of measures, anything less is immoral.
Aged-care is sexy? Well, I never!
One in four Australians will experience difficulties with their mental health in their lifetime. It is the most under resourced area of the health sector and our over populated gaols are a direct result. Rudd has been dripping out one package after another during this exercise and I hope the next one will be about mental health. If not we should all be writing to Bill Shorten.
What do people mean by mental health, perfectly happy? It has become such an all encompassing term that it no longer means anything. If we really gave a shit, we would limit alcohol usage (that’s included in a mental health diagnosis), redirect the almost billion dollars going to private psychologists and GPs through care plans to public mental health services, authorise more nurse practitioners who can get down and dirty with the people who really need the care who don’t go to GPs and rebirth community mental health centres. Ta da .
Golly! I never realised how simple the answer was. Praise the Right. Just introduce Prohibition. It worked in the US didn’t it.
One of the things the mental health field has in common with other areas of health care is that it is medically and clinically dominated thus the focus is on bio-medical treatment at the acute end while prevention and early intervention suffer. I don’t mean early intervention in terms of giving dangerous psyciatric drugs to people who have possible early indicators of mental illness - that can cause more problems than it solves. I mean real prevention.
Many moons ago when I was a Lifeline counsellor the phones would run hot from 5pm - 2m when people got home from work, took off their “masks” of being happy little workers and fell in a heap being depressed and often suicidal. After talking to scores of such people the consistent pattern I found was that the vast majority had a history of childhood neglect and/or sexual abuse.
I think it is only this generation which is coming to realise and acknowledge the long term psychological damage that childhood abuse, particularly sexual abuse, causes. I suspect if child abuse stopped tomorow the rate of adult depression 20 years from now would be only a fraction of what it is now.
Obviously there are myriad causes and factors for depression, anxiety and other mental health issues, but this has got to be the biggest one and yet it goes on and on and child protection workers remain shockingly underresourced.
I am no longer a Lifeline counsellor but do donate regularly to child abuse prevention and victim support organisations. That and lobbying governments to take the issue more seriously is all I can think to do. Unfortunately like consumers of mental health services, children do not have a strong voice - and like prisoners and asylum seekers they don’t vote so their mental health needs don’t seem to matter.
Of course effective responses to mental illness aren’t just ‘health business’—it’s a classic whole of government responsibility. Nevertheless, with so much talk and so much money on the table for ‘health reform’, the current news (or lack of it) is a powerful wake-up call to all of us in the sector. We can never assume we’re included.
Last week I attended a briefing on the reforms by Mark Butler, Parliamentary Secretary for Health. After listening to a talk that was 95% about hospital administration and funding, I asked what the implications for community mental health services might be. The response: ‘Each state has very different arrangements, so we won’t be imposing any top-down solutions’. That was it. That does not sound like front-of-mind status; in fact it doesn’t sound like new money is coming to people affected by mental illness. Maybe that’s too pessimistic, but with such a thundering silence on the details, what else are we supposed to think? Several hundred thousand people with mental illness and their families are still waiting for some good news from this whole process.
Mental health is the sole responsibility of the states (as is aged care, so Rudd’s offer in that area is irrelevant, not that the media has noticed).
Green-Orange Many NGOs working in this field recieve commonwealth funding chanelled through DADHC I think. It’s all very convoluted and confusing but you’re right that the coverage of this issue by the media is pathetic.