Band-Aid for broken mental health system
29 July 2010
The PM's policy is the same tired old approach that's failed for decades.
On taking office, Julia Gillard was quick to announce the government had "lost its way" on several issues. We in the mental health community were excited about the prospect of her leadership - as the daughter of a psychiatric nurse and as a former shadow minister for health, she has a strong background on the issue.
The Labor government, under Gillard and Kevin Rudd, was given more advice on mental health than any previous government. Gillard surely knows the challenges faced every day by Australians when it comes to mental health and wellbeing. Yet, following her first speech on the topic and Labor's announcement on Tuesday, there is still no clear vision - only a token commitment to a sadly mistreated sector.
In 1993, then federal human rights commissioner Brian Burdekin launched the National Inquiry into the Human Rights of People with Mental Illness. The landmark report described a deplorable state of mental health services, affecting more of the Australian community than most of us could imagine. Sadly, these conditions are all still prevalent.
Today, mental ill-health is the leading cause of death for all Australians under 45. More than car accidents. More than binge drinking. More than anything else. It is the leading cause of disability in Australia across all demographics. It affects more than four million Australians every year and is estimated to cost the Australian economy about $30 billion each year.
This means that every day, 330 Australians who present to emergency departments with serious mental illnesses are turned away. Fewer than one in 15 are referred to any other service. Every day more than 1200 Australians are refused admission to public or private psychiatric units. Every day, at least seven people die as a result of suicide, with more than a third involving people discharged too early and/or without care following hospitalisation.
Despite knowing this, the Labor government cut a total of $354.6 million from mental health programs. This means mental health funding remains at about 6 percent of healthcare funding, despite representing 14 percent of the system's burden.
On Tuesday, the Prime Minister delivered her first mental health policy address - a grab bag of modest investments in several worthy initiatives. This is not reform, just more of the same failed approach we have seen for decades. Patches hastily attached to a broken system. This will not change the access to care or the outcomes for the millions of Australians missing out on quality mental health services.
The $9 million over four years pledged for a men's mental health promotion campaign is enough money to buy no more than a single advertising run in every airport urinal in the country. By comparison, we spend $100 million annually on tobacco prevention.
Gillard also committed to the "expansion of youth mental health networks and this will need to be scaled up over time". The government pledged $25.5 million over the next four years, when it knows that each site for the early psychosis program will cost $13 million a year in operational costs and that we require 20 such sites for an effective national program.
The Prime Minister also announced $9 million for a suicide "hot spot" program, akin to the road safety "Black Spot" campaign launched by the Howard government a decade ago. The hot-spot program is a good initiative, built on the evidence that safety measures in known areas can prevent suicide happening. But the funding pledged is only enough for three sites. Astonishingly, despite Gillard referencing the site, it does not guarantee funds for ''The Gap'' - a cliff-face in Sydney where, on average, 50 people take their life annually.
Meanwhile, Health Minister Nicola Roxon has argued that mental health will have to wait its turn; that she will not take money out of other areas for more mental healthcare. But when she and Rudd proudly announced the establishment of regional cancer treatment centres, beefed up the treatment of diabetes and funding for elective surgery, she did not say the money was coming at the expense of something else. For those big and sexy policy announcements, there was allegedly no trade-off.
Roxon, in effect, said that those services are warranted, but sees fit to further stigmatise mental ill-health by saying that there is no money for it without someone else missing out. This direct attack on mental health consumers and their families by a health minister is unprecedented.
This marginalisation will no longer work politically because people are starting to pay real attention. A recent Auspoll of 1500 respondents showed 35 per cent of Australians were more likely to vote for the Coalition following their $1.5 billion mental health plan, and 22 per cent of soft Labor voters more likely to vote for the Coalition.
Gillard, Roxon and Tony Abbott need to take note. They may not be responsible for the dire circumstances that Australians face in trying to access mental health services, but they have an opportunity to end the cycle. No one expects a transformation overnight, but we need our leaders to acknowledge the problem and provide a real blueprint for change and for new investment.
John Mendoza resigned as chairman of the National Advisory Council on Mental Health last month. He is an adjunct professor at the University of the Sunshine Coast and adjunct associate professor at the University of Sydney.
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