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A tick for Opposition’s plans to improve employment services for people with mental illness

With mental health in the news, thanks in part to Tony Abbott’s recent funding promises, below is a Q and A piece with Professor John Mendoza, first published by The Conversation on April 21.

Why do so many mentally ill Australians struggle to maintain employment?

This is a critical policy issue for all Australian governments over the next decade. We’re clearly facing a skills shortage and that’s across the board, it’s not just in the mining sector.

We have to get a lot better at engaging people of working age who are not in employment.

Mental illness, often untreated, is one of the primary causes for the situation that we face.

About 28% of all Australians on the disability support pension have a primary mental health-based disability. Of the remaining 70%, around half have mental health problems as a secondary contributor.

The rate of employment for people with mental health conditions in OECD nations is nearly three times the rate of employment than Australia. Needless to say, Australia does very poorly in this area.

There are a number of reasons for this and the announcement by the Federal Opposition starts to address some of these issues.

***

How does the Coalition’s announcement build on existing infrastructure?

We’re already spending a lot of money increasing employment services for people with mental health disorders.

Commonwealth spending on disability support pensions and employment-related programs is around $5 billion. This provides income and support for people on the disability support pension, Newstart allowance and other benefits who are there because of mental health problems. But we’re not getting good outcomes from that spending.

What today’s announcement does is target a couple of specific areas where we know we can do better.

It’s not just a matter of preparing a person with significant mental illness to enter the workplace.

We need to place people in a workplace where they can receive support. A truly supportive work environment is where the culture recognises the way mental illness presents and manifests.

These workplaces support the employer to help keep that person engaged, modify activities, train co-workers on how to deal with mental health episodes and crises if they occur, and retain that person in employment.

The mental health blueprint, released last month, calls for a minimum investment across 30 targeted programs over four years.

We’ve got to lift our current rate of mental health funding as a proportion of total health spending – from around 6% towards 12% to 13%.

That’s a very big ask and no government of any persuasion is going to be able to do that in one or two terms. I think the Coalition is mindful that what was announced today is not enough.

***

Will we see more than just a bidding war from today’s announcements?

I have to be optimistic that this announcement is more than a bidding war. I certainly believe what the Coalition took to the last election and what they’re building on today could bring about real improvements.

The Rudd Government and, to an extent, the Gillard Government are “blowhards” when it comes to mental health. They’ve talked long and hard but they’ve delivered almost nothing.

Suicide prevention was the cornerstone of their mental health policy leading into the last election, with promises of spending $274m over four years.

In the first year, they’ve spent $10m. There’s a bit of a credibility gap when you say you’re going to deal with an issue and in the first year you spend only 2% of the funding that you’ve allocated.

The situation is similar when we look at the Headspace initiatives for increasing early intervention sites around the country.

Labor is spending most of the money not in the second term, but in the third term of government if they’re re-elected. I think that is gilding the lily on this issue.

We need to see the investment flying through fairly evenly, but building up over the four-year budget cycle.

Tony Abbott has basically picked out elements of the blueprint that were released by the working group last month. Many of the working group’s members are advisors to the Federal Mental Health Minister Mark Butler.

These are things members of this group have said privately to the government about what needs to be done.

Tony Abbott has said, very wisely, we know we’ve got a problem with employment participation for people with mental illness and I’m going to target that because it’s one of the areas where investments will produce dividends. The impact on the budget in the longer term will be a positive one.

We know employment participation is critical to people’s recovery, in lifting them out of poverty and helping them regain their sense of self.

Certainly social inclusion is improved dramatically by participating in work. So I think it’s a wise investment, it’s a smart policy, and it won’t cost the budget bottom line in the first instance.

Over the longer term, it will save an enormous amount in terms of the money we’re spending at the moment on disability support pensions and the like.

We’re spending this money now but without getting any movement on people going back to employment.

• John Mendoza is the Director of ConNetica Consulting Pty Ltd. He is the former chair of the the National Advisory Council on Mental Health (appointed by the Rudd Government in June 2008) and resigned in June 2010 citing a lack of vision or commitment to the issue.

Comments 5

  1. Murf says:

    If we’re going to get people who have mental health issues back into the workforce (and most of us who’ve been employed before are really keen to get back to it), we need to start training CentreLink not to send away unemployed females who don’t qualify for a benefit. I haven’t even been able to talk to anyone- just a quick dismissal on the phone, several times over the past 12 years (when I’ve had the occasional part-time job). They say “Use your professional networks- we can’t help people like you. We don’t have the sorts of jobs you’re looking for”. Slam. How can we have networks when we’ve been out of work for months or years? Huh? Will we just happen to bump into an employer who won’t run a mile as soon as we mention mental health issues? Better to keep it to yourself when there’s no one to back you up. Also, no one seems to realise how soul-destroying it is for females who have always been financially independent, to suddenly tie their fate to someone else because there are no supports in the community for them to fall back on. It makes mental health issues worse. Someone has to have a good think. Get back to me when there’s some news.

  2. prunella says:

    We seem to have entered an Orwellian twilight zone-The big ticket mental health item in the upcoming budget is not more dollars to provide and expand mental health services but cuts to welfare dependancy by people with mental health issues.

    I have had similar experiences to the previous commentator. I have been on and off social insecurity for the last thirty years. I have completed 2 degrees and 2 diplomas in that time, at my expense with a HECS debt. I have never received any support to get into a traineeship, or even help to identify a skills shortage. When i went to the careers office at the uni where i am a part-time student they referred me to the counselling services because they had to prioritise and so youth came before ” women returning to the workforce” to use their expression. This career women treated me like something that the cat had brought in. I am still studying at my own expense and the job network provider is trying to get me off their books because there is no funding incentive to have ‘middle aged overeducated women’ to use their phrase hanging around. For some reason they get more money if they get a man or a young person into a job.

    I have been following the mental health debate and can make two observations. One is that Mental health has become a hot issue not because of changing community atttiudes- they are getting worse not better- but because of powerful occupational interests closely associated with the AMA. Namely Allied health professionals like OT’S, psychologists and social workers.Their interest is career pathway to hike up their salaries and benefits, namely pensions up as close to doctors as they can. When people talk about the under-funded mental health system on silly talkfests like the Drum thats what they mean. I worked for a health commission many years ago and was astounded then at the generous contribution from the taxpayer money to individual doctors and psychiatrist who were by no means poorly paid.
    There are plenty of mature people, like nurses for example who could and should be skilled up as Psych nurses or community mental health workers. But no, the government wants to unleash 22 years old with no life experience on people with a history of trauma and precarious day to day existence. I know that i have alluded to a number of different issues here but that is the case with anything to do with the public health system, mental heath in particular. We need to demand a comprehensive health service like the scandinavian one which delivers good health outcomes unlike the profit based one we have where some people actually benefit from other peoples ill-health.

  3. Maggie says:

    ” powerful occupational interests closely associated with the AMA. Namely Allied health professionals like OT’S, psychologists and social workers.Their interest is career pathway to hike up their salaries and benefits” Totally agree with you there. I actually think we (the consumers) would be better off if we dismantled the entire mental health services edifice social workers, administrators, advisors – the lot, and took to neighbourhood houses and existing educational institutions for our services. I talk about all that here:

    http://stopthrashingaround.wordpress.com/2011/06/02/second-opinion-versus-reality-check/

    As far as jobs go the most important thing to do right now is for each hospital mental health team to have a jobs specialist embedded whose sole purpose is to save people’s jobs as they come onto a mental health ward.

    When you enter these wards no one ever asks you if you have a job and what needed to be done to save it. I have seen people who were CEOs and GPs wandering around in the mental health system for years, because no-one tried to save their job when they were first on the ward.

    Getting back to work after 3-6 months off, with no help or assistance, is pretty near impossible. Concentrate on making sure no new arrivals to the mental health system lose their jobs in the first place. Dealing with long-term unemployed people with mental health issues is an entirely different matter and a whole other story.

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