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  1. 1

    Ian Haywood

    Two points:

    d – Such separation is a retrograde step. I think psychiatry has to get over being in ‘hospital on the hill’ and completely cut off from everything else. This is how a low standard of care which would never be tolerated in other parts of the health system flourished and continues to flourish.

    f – Many mental services often cut back to the ‘barebones’ services: prescription of antipsychotics and basic social work focussed around stabilising accommodation. However this is a funding issue and driven by the bureaucracy, it’s not about the extent of ‘medical control’

  2. 2


    I agree with much of Alan Rosen’s commentary however re (d):
    The funding of Community Mental Health Services is just one of a range of issues and is often a furphy, even with existing funding the services could be both more efficient and more responsive to actual community need. Core service mix, at least at a State level, ideally Nationally, must be agreed so the public have consistency and choice, this must include real assertive community treatment teams (ie 24/7 continuous and reactive). In addition Child and Adolescent services (particularly in WA) need to wake up to the needs of 11-17 year olds and shrug off the Fountain House legacy, again its not the money preventing this change although CAMHS are currently massively underfunded.
    The NHHRC is a funding methodology proposal, not a solution to service delivery meeting need, thats for MHS’s to get on with, numerous National Plans and Strategies to date have had minimal impact.

  3. 3

    Jenny Haines

    There is some merit in Alan Rosen’s proposals, but such a Mental Health Commission at Federal Level would need to be an agile, active and responsive organisation to meet the needs for reform in mental health services across Australia, and I doubt if any Canberra bureaucracy can be that responsive.The States have certainly failed their obligations in the provision of mental health services. In ED Departments where patients are mainstreamed due to initiatives several years ago, patients are denied their legal rights under the Mental Health Act to the “least restrictive environment” and expedited processing. Despite the recognition in NSW by a previous Health Minister 5 years ago of the desparate need for more acute beds, the pressure on acute beds remains intense. Community based mental health services struggle along, understaffed and underskilled. Incidents happen, but they are covered up. Politician after politician at State level make promises, which all seem to end up in an intensification of workload for community staff and GPs. Perhaps Federal co-ordination can bring some order, and better standards of care into the mix but I am not convinced that remote Canberra bureaucracies can deliver what is needed on the frontline.


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