One down, one to go

The latest review of mental healthcare will, fortunately, focus on the consumer; the voice of the care providers should be next. 

Mental health has once again been pushed into the national spotlight.

Time and again it has become evident that mental illness affects people from all walks of life and all levels of society. From Australia’s greatest sportsmen to everyday citizens, no one is immune.

Until now, however, reports into mental illness have largely bypassed the input of two essential voices: the consumer and mental health workers.

So it is timely to see the recent media release from the federal minister for sport and health, Peter Dutton, announcing the terms of reference for the review of mental health services and programs.

Mental health has been a national priority area since 1996 and the impact of mental illness on communities and on the Australian healthcare system is becoming increasingly apparent. Mental illness is the third major cause of burden of disease. One in five Australians are affected and people with a mental illness have a greater risk of premature death. These facts all contribute to the heightened visibility.

To paint a clear picture, in 2010–11, about 1.9 million Australians (9 per cent of the population) received public or private mental health services.

This data does not count the vast number of people who do not seek help for many reasons, not the least of which remains stigma. The figures represent what is known but it is probably the tip of the iceberg.

It is imperative then that, globally and nationally, we strive to make our mental health systems the best they can be.

Australians deserve and expect good care and treatment when they have a physical illness or an accident. People with mental health issues are no less deserving.

A well-educated workforce plays a large part in ensuring good care. Highly trained mental health professionals, who provide evidence-based specialist care to often very marginalised and vulnerable people, are fundamental to a good system.

As a nation we have been in the business of healthcare for a long time. It is about time we got our system right. Why does it seem so hard? To this end, I call for a national, unfragmented approach.

A poignant example of fragmented policy is having different mental health acts in each state and territory. Is this not one country? Having separate acts causes huge logistical and jurisdictional issues and makes consistency of care troublesome. Is there a fundamental reason why people across Australia need to be treated differently?

The National Mental Health Commission will address these issues by conducting a national review of mental health services and programs. This review will examine existing mental health services and programs across the government, private and non-government sectors. The focus will be on assessing the efficiency and effectiveness of programs and services in helping individuals with mental illness – as well as their families and other connected people – lead a contributing life and engage productively in the community.

The review appears to place the consumer at the fore, which is welcome considering the consumer is the reason mental health services exist in the first place. It also appears to value the importance of lived experience.

It’s only right the consumer voice should be heard loudly. But that’s not enough. The other voice that must not be ignored is that of the mental health nurse. Mental health nursing comprises the largest section of the associated workforce. About 18,000 nurses are in this group in Australia, providing care within the 1450 specialist mental health care facilities nationally.

Service provision includes community, private and non-government sectors, as well as primary and tertiary services. As such, the knowledge, opinion and depth of experience of mental health nurses will contribute a profound understanding to what is undeniably a complex area of delivery.

The role mental health nurses will play in informing the review is of the utmost importance and the whole profession will monitor it.

Lorna Moxham is professor of mental health nursing at the University of Wollongong.

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