Fundamental rights to healthcare and justice are at risk in elections, from Queensland to the United States. Meanwhile, the “horse race” approach to political reporting undermines the community’s rights to an informed policy debate and public sphere.
The column this week also brings COVID updates, including a new study suggesting RAT tests often give false negative results. “So don’t rely on one RAT as ruling out COVID,” says Professor Paul Glasziou.
The quotable?
Globally, e-waste is an enormous problem. In 2022, humans discarded about 62 million tons of used electronics, enough to fill a line of trucks that spans the equator.”
Mental healthcare in Ukraine
Amidst the traumas and disruption of war, can Ukraine’s mental health systems be transformed and improved for the future?
This is the hope, and the vision of a group of international experts who have put forward recommendations for improving mental health in the war-torn country.
Forty experts in mental health, health economics, law, science, and epidemiology, together with people with lived experience of mental illness, joined to create The Lancet Psychiatry Commission on mental health in Ukraine, which recently published findings. The group includes at least three Australian academics: Dr Paul Gerard Robertson (University of Melbourne), Professor James G Scott (University of Queensland), and Professor Cathy Mihalopoulos (Monash University).
The Russian invasion and annexation of eastern Ukraine and Crimea in 2014, along with the ongoing war since February 2022, have inflicted incalculable damage, with many deaths and injuries, massive population displacement, and extensive physical and emotional trauma, notes the Commission. As well, the country’s mental healthcare system has traditionally been dominated by large psychiatric hospitals and residential institutions, and known for neglect, abuse, and human rights violations.
While coping with the current stressors, Ukraine is also looking ahead to the future with recovery plans that aspire to transform Ukraine’s many systems to meet or exceed international standards, says the Commission.
Interestingly, the experts suggest that system transformation is often easier to implement in the context of a nation-wide effort to recover from major societal changes, such as the transition from conflict to peace, as long as the resources needed for transformation are available.
“Although wartime might not seem to be an optimal time to reform a country’s mental health system, especially its legal and regulatory elements, it might in fact be just the right moment for Ukraine,” they write.
“The war is and will continue to affect the entirety of the Ukrainian population, leading to the higher prevalence of mental symptoms and disorders, especially among people most proximal to the carnage, military personnel, veterans, first responders, and individuals with physical and emotional trauma. The high levels of concern given to these victims, especially veterans, provides just the impetus necessary for difficult changes.
“This leverage can be used to transform the entire mental health system, including reform in advocacy and the legal principles underpinning mental health.”
The Commission put forward recommendations in five areas:
- Community-based mental health care and a vision for a new network of Ukrainian mental health-care services
- Training and education of the mental health workforce
- Rebuilding mental health research capacity and infrastructure
- Law reform to support human rights and to decriminalise mental health conditions.
- Resourcing the future of mental health
Not only is the total financial support for Ukrainian mental health care disproportionately low relative to the needs of the population, but a major share of resources is allocated to institutional care rather than evidence-based community services, says the report.
Infographics are here.
Other global health news
#AusPol
Queensland election (26 October)
ACT election (19 October)
Public health leader Adjunct Professor Michael Moore provided this reflection on the ACT election: “In the ACT healthcare has gone backwards over 23 years of Labor on a comparative basis. Most indicators such as elective surgery waiting times, emergency dept and beds have moved from amongst the leading jurisdictions to now being at the lowest level.
“On public health issues the ACT is doing relatively well. One indicator is the first COVID vaccination rate at over 98 percent. Amongst the best in the world.
“However, key factors in the ACT are socio-economics and education, along with a long-term positive approach to population health.”
Media matters
As federal election fever builds in Australia, the critique below of media coverage of the United States election will become increasingly relevant. Read more about odds vs stakes coverage in this recent article by Marie McInerney.
First Nations health
COVID updates
Health policy news
Three reviews have been released (and Croakey will report more in coming days):
- Review of General Practice Incentives
- Review of After-hours Primary Care Programs and Policy
- Working Better for Medicare Review (examining how effective our current health workforce ‘distribution levers’ are. These levers consist of policies and geographic classifications that are intended to distribute health workforce across areas that need them most.)
The Australian College of Rural and Remote Medicine submission on health checks for late career doctors is here.
On 8 October, Health and Aged Care Minister Mark Butler announced the retirement of Chief Medical Officer Professor Paul Kelly, whose last day in the Department will be 21 October. Arrangements to fill the roles of CMO and head of the interim Australian CDC “will be confirmed in due course”.
Prizes
Details of the 2024 Nobel Prizes are here.
Conference Watch
Events