Related Articles


  1. 1

    Dr Tim Smyth

    While not disagreeing at all with Dr Rosenberg that we have not got mental health “right” in Australia, and not disagreeing that better resourcing is required, I am not sure funding is the No 1 problem.

    After many years of running health services, senior executive roles in health departments and now chairing a Primary Health Network, I’d suggest that we need to tackle the following and get these right to facilitate better services, better outcomes and a mentally healthier Australia, along with additional resourcing:

    1. Reintegrating mental health into the health system. The separation, which was driven by a misguided assumption that this would “protect” mental health, has allowed the rest of the health system (primary, secondary and tertiary) to leave mental health to mental health.
    2. Getting a consensus on evidence based service models appropriate to Australian society. The wide disparity of approaches in suicide prevention, stepped mental health care, “crisis” services, early intervention and shared care is a big barrier to progress.
    3. Sorting out the interfaces with NDIS, My Aged Care and Centrelink/housing and social services for people with chronic mental illness, their families and carers.
    4. Adoption of culturally safe, evidence based services for Aboriginal people and communities.
    5. A commitment from the RANZCPsych to private sector psychiatry working again in the public sector.
    6. Adoption of the National Mental Health Service Planning Framework by all players (recognising that further work is required to apply the model to smaller populations, rural areas and Aboriginal communities).
    7. An agreement between the Commonwealth, States, Territories and mental health peak bodies on the roles of state/territory public sector mental health services, Primary Health Network commissioned mental health services, NDIS and My Aged Care funded care packages, private sector, the NGO sector and the health and human services government agencies.
    8. Moving very slowly and carefully on expanding Activity Based Funding into the community and ambulatory care settings.
    9. Transparent independent public reporting of KPIs and outcomes for all mental health services (including private providers).
    10. Ensuring that every person living with a chronic mental illness has a really good GP or case manager who also looks after their physical health.

  2. 2

    Sebastian Rosenberg

    Hi Tim and thanks a lot for your excellent comments. Where do I sign up to these 10? I agree that there are organisational issues to sort out as well as funding issues. You are right. It is not all about funding.

    Of all the ten most apposite suggestions you list above, it seems number seven would be the most elusive. So many silos and bunkers, so little time….Despite calls from experienced people like you, or even Nat MH Commissions, this kind of leadership to drive a more organised response to mental illness seems as far away today as ever. Even where regional leaders across state and fed boundaries might choose to pursue reform (very much the exception rather than the rule), they need national authority, permission and support to proceed. Simply putting more money into our broken system would probably perpetuate fragmentation rather than lead to systemic improvements.

    Really important that you added the aged care sector into this discussion in relation to mental health support. A. Black. Hole. Recent reports regarding the rate of suicidality in aged care homes alarming.

    Thanks again for your comments.


Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

© 2015 – 2021 Croakey | Website: Rock Lily Design


Follow Croakey