Since 2006, Australian governments have committed to spending about $8 billion of new money on mental health.

Given the huge burden of mental illness and the unmet needs for mental health services, proper accountability for this expenditure is crucial to ensure that it is targeted at the areas of greatest need and is delivering better outcomes for people with mental illness.

As outlined in a paper published this week by MJA , my colleagues Sebastian Rosenberg and John Mendoza and I found that establishing this accountability is not easy.

Federal and state budget announcements (and re-announcements) and the lack of publicly available reports perpetuate an environment characterised by opacity rather than transparency.

Despite dozens of plans and policies, spending between jurisdictions continues to be unco-ordinated, lacking  accountability and a focus on patients’ needs.  It is impossible to verify whether jurisdictions really did spend what they reported.

There is little evidence to show that new mental health investments are driving improved health outcomes. For people with mental illness, the spectrum, capacity and quality of services available depends on where they live, and the quality of care goes largely unassessed.

We argue that for real accountability, the new National Mental Health Commission must begin with a robust plan to co-ordinate national efforts to address agreed priorities, identify and close service gaps based on evidence-based models of care, and require nationally consistent definitions and accounting processes.

This should be accompanied by a national report card that includes nationally validated data of the experience of care, quality of life, and rates of homelessness, education and employment for people with a mental illness.

Without this, no one will know if mental health funding is well targeted or just well meant.

*Dr Lesley Russell is a research associate at the Menzies Centre for Health Policy, University of Sydney

Peter Fray

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