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Mental health services deserve better deal

While welcoming any new investment, most believe there is still a long way to go for mental health, writes Annie May.

One out if every five people in Australia will experience mental illness each year. Of those, about two-thirds don’t receive any treatment in a 12-month period.

Nine per cent of the nation’s children have a long-term mental health problem – most don’t receive treatment. Poor mental health increases the incidence of heart disease, stroke and cancer.
These are the facts that those working in the field already know. Politicians have also been made aware of them, but mental health groups still hold concerns that they aren’t giving them the attention and action they deserve.

It’s past time to give people experiencing mental illness a “fair deal”, the groups say, and both political parties need to stop “picking winners” and make a comprehensive investment in mental health that improves access for all – not just some.

This has been the majority response on the election mental health promises that are being made.

The coalition was the first to show its hand – a $1.5 billion mental health package for early intervention. This includes the promise to fund 20 new early psychosis prevention and intervention centres, 60 additional youth headspace sites and 800 acute and sub acute early intervention beds.

An injection of this level of funding will help many Australian families whose young people are experiencing mental health problems,” says Kim Ryan, Australian College of Mental Health Nurses CEO.

But, she says, mental health problems affect the whole population, not just those under 25.

“There are people who battle to access services for their mental illness right now.
They and their carers need more than an investment in early intervention youth services.”

“The Opposition has ignored the other faces of mental illness - people who struggle with drug and alcohol problems, people who are homeless, older Australians with mental illness.”

According to latest figures, 75 per cent of people presenting with alcohol and drug problems also have additional mental health problems.

Supporting mental health reform based on the recommendations of the National Hospital and Health Reform, Ryan says the Opposition investment also comes at the price of several key health platforms.

“For many Australians with mental illness, their GP is the gateway to all mental health services. Reducing access to after hours GPs will just increase the pressure on emergency departments – from people with physical illnesses and those with mental illness,” Ryan says.

ANF federal secretary Lee Thomas says Coalition plans to expand frontline services in mental health must not undermine measures outlined in the May budget which provide a boost of $7.3 billion to the nation’s health care system.

Workforce issues must also be addressed as part of a broader health reform agenda with a focus on primary health care, she says.

“Nurses work on the frontline in providing care to people with mental illness and part of the current government’s pledge in the May budget was to provide more nurses, more doctors and more beds for our communities. These initiatives will benefit people in all areas of health care need.”

Mental health services need to be improved within a national health reform framework that identifies the vital issues of workforce and national consistency, she says.

“We can’t afford to make this issue a political football. It is far too important and requires a nationally consistent and considered approach that is part of the whole reform process,” Thomas says.

“It is not just about announcing new sites where people can access services but boosting the numbers of health professionals available to offer care to people with mental health issues.”

Next it was Prime Minister Julia Gillard, admitting that a lot needed to be done to improve mental health services around the country.

Labor’s $277 million package is being promoted as a “comprehensive range of measures to tackle suicide and promote better mental health in our community”. It includes $22.9m for psychological counselling services for about 12,500 people each year, $18.1 million for Lifeline Australia’s support hotlines, $9 million to improve safety at suicide hotspots and $9 million for targeted campaigns on depression for men.

Like the Coalition’s package, parts Labour’s package were well received, but was criticised for not being comprehensive enough.

David Crosbie, Mental Health Council of Australia CEO, says the measures are real steps forward, particularly in relation to increased accountability for mental health services through a national mental health report card, and increased investment in anti-suicide measures.
The increased focus on the experiences of mental health consumers and carers as critical measures of mental health service provision was particularly welcomed, he says.

But, he is disappointed that it didn’t go further.

“There is a desperate need to address decades of neglect from all levels of government. The reality is that mental health needs a massive investment and this package falls short of what most experts, including the NHHRC, see as necessary to address the major service gaps currently experienced by mental health consumers and carers.’

Anglicare Australia, The Salvation Army, Catholic Social Services Australia and Uniting Care Australia have expressed reservations about the federal government’s $50 billion health reform plan.

The agencies said in a statement: “We are concerned that the Labor government isn’t committed to acting with the urgency needed on community mental health, nor in the spirit of collaboration that we would wish.”

They also criticised the opposition’s $1.5 billion mental health package for early intervention.

“The opposition is prepared to invest in treatment but has not expressed any commitment to community mental health support such as secure supported housing and support for employment participation,” the statement said.

Australian of the Year Patrick McGorry joined the church groups in slamming the mental health policies of both major parties.

McGorry says he backs the churches’ call for extra mental health funding, even though they didn’t nominate a figure.

“I fully endorse the call to action issued to all political parties to commit to investing in community mental health,” he says.

“All we need is political will and funding.”

In July, McGorry called on Gillard to commit an extra $640 million a year to mental health from 2011. The call was made after Professor John Mendoza resigned from the government’s National Advisory Council on Mental Health.

A system that responds better to the needs of those with mental illness and one that reduces the burden of mental health problems is long overdue, says the Royal Australian and New Zealand College of Psychiatrists.

“They don’t get a fair deal. They face funding shortages, limited access to services, discrimination and services struggling to cope with demand,” says Professor Louise Newman, RANZCP president.
In a blueprint for improving the lives of those affected by mental illness, released last week, RANZCP called for a “plan that is based around the needs of consumers, carers and families”.

To achieve this, there needs to be an increase in funding, improvement in treatment and better support for mental health staff, says the blueprint.

“Funding for mental health services and research needs to increase to reflect the cost of mental health problems to society and the need for improved knowledge of mental disorders. Mental health is the third major contributor to burden of disease, but receives only 8 per cent of the health budget and 3 per cent of the research budget.
Mental health needs 12 per cent of the health budget to get its fair share,” says Newman.

The government also needs to resource, extend and support mental health centres and staff better.

“A broadened range of community mental health service initiatives to provide psychological therapy in clinical settings, better integration to primary care, effective clinical governance regimes and an expanded range of service linkage programs are needed. We need assertive community treatment in the areas of intellectual disability, ante and post natal depression, relational and personality disorders,” says Newman.

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