I just have returned from community-led meetings/conferences in the Nambucca Valley and Canberra in the past two weeks. The community is becoming increasingly energised by the lack of federal government leadership on the issue of mental health after three years in office.
As my colleague and former senior adviser to Julia Gillard, Dr Lesley Russell said in the Canberra Times earlier this week, federal Labor has only cut funding to mental health programs (all of them started by the Howard government) since elected in 2007. (The article can be downloaded here).
Good programs such as PHaMs, the respite program, the mental health nurse program, headspace and ATAPS are all in need of substantial new investment. Headspace is now nothing like the model of care that was originally envisaged when it was designed in 2005.
Services are now grossly underfunded and having to charge out-of-pocket fees to stay open. This is to meet the government target of 60 sites within the funding allocation. The services will resemble the facades from a Hollywood western — just a shop front and no real service.
The headspace service in the Nambucca Valley has now closed and the community is desperately trying to find ways and means to keep some sort of service operating. The government knows all this and it also knows that it must make reforms to the Better Access program to ensure those in need can afford access to psychology services.
The much-trumpeted suicide prevention funding announced during the federal election campaign last year totaling $277 million will see just $9.1 million spent this year. Again this is symbolic of a government that talks the talk but fails the test of real action.
Mental health and suicide prevention are now red-hot national political issues. This is in part due to the continuing delays on any real reform or action by the federal government despite having more advice than any previous government on what actions are required.
It has had dozens of program-specific advices from the National Advisory Council on Mental Health and overall system reform from NACMH and the National Health and Hospitals Reform Commission — almost all of which it has ignored.
It knows what the priorities for investment are — prevention, early intervention, community support services including supportive accommodation, research and new governance and accountability.
And its only action since the election last August is to appoint a minister (Mark Butler) and another expert panel chaired by the minister (who also now chairs the NACMH). Yet more advice.
To his credit, the minister did undertake 14 community consultations attended by consumers and carers and hear first hand their concerns. I believe he is trying but like many before him, he is running into the same road blocks when it comes to significant new funding.
There is always a reason for delaying real reform and action on mental health it seems.
Almost on a daily basis I receive phone calls and emails from distressed Australians who cannot access care or have dreadful experiences in acute care and then no community support for very ill family members.
In Bowraville last Thursday I assisted an indigenous mother whose son had been placed on a community treatment order six months ago. He committed a crime to gain admission to Port Macquarie Hospital. He has been seen for a psychiatric assessment just once in that time and despite being heavily medicated and suicidal last week and again was refused admission or an assessment. If he had presented with an equally life-threatening case of chest pain, he would have been immediately admitted and received good care.
Recently I have spoken at length with a deeply distressed mother from Queanbeyan who has lost her son to mental illness — or more correctly to the NSW Health system.
Last week it was Wagga with a very public suicide of a young man and several suicides here on the Sunshine Coast; previously six in the small community on the Darling Downs late last year and almost a dozen suicides in the Kimberley in the past few months.
I could go on and on with systemic failures across the nation. With the exception of the events in the Kimberley and action by the WA Mental Health Minister Helen Morton, there has been no response from either state or federal governments to these tragic events and the many systemic failures of care.
While it’s too early to make a judgment on the new Victorian government’s actions on mental health, the Stanhope government in the ACT is tackling the problems of access, care continuity and quality and is increasing investment in community services.
They stand out from other governments in their approach to mental health.
I am optimistic that should a Coalition government be elected in NSW at the end of this month, they too will tackle reform and direct substantial funding into evidence-based community services and not continue the failed hospital-centric approach of the current administration.
*John Mendoza is adjunct professor, health science, University of the Sunshine Coast, and adjunct associate professor, medicine, University of Sydney. Last year, he resigned as chair of the National Advisory Council on Mental Health.