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The Rudd Govt and mental health: how they’re giftwrapping an empty box

After wading through the waffle of the latest National Mental Health Policy, Australian Doctor’s political editor Paul Smith is less than impressed.

Below is an edited version of his column first published in Australian Doctor. He raises some pointed questions for Rudd and Roxon:

AROUND the  office of Australian Doctor you often hear the phrase “dull but worthy”. It’s  used to describe the mass of policy papers, guidelines, parliamentary reports  and lobby group documents written in a style of prose unlikely to electrify  your day.

I was ready to recycle the words when confronted with  the job of wading through the National Mental Health Policy, endorsed by federal and state health ministers back in March.

Usually by page five  of any policy you have finished with the platitudes describing the reasons why such policy is needed. But halfway into this document it was still rambling  on: “People at risk of developing mental health problems or mental illness can  benefit from preventive or early intervention activities.”

Or this:  “Prevention involves understanding and minimising factors which heighten risk  and enhancing factors which improve resistance to mental health problems,  mental illness and suicide.”

Then by page 19: “In order to respond  effectively to the varying requirements of people with mental health problems  and mental illness, there is a need to develop ways of fostering partnerships  and improving linkages between services provided within and across the primary  care sector.”

Suddenly the document ended and, bleary-eyed from the tedium, I  was hit by an unease born of the realisation that this “national” policy for  mental health in Australia was no policy, no strategy, no plan, and offered no  real clue as to what will be done. It was just 40 pages of mental health  policy clichés.

There is a classic essay written by George Orwell in  1946, called Politics and the English Language, which starts off as Orwell’s writer’s guide for anyone who is going to commit words to paper. As you read  on it becomes much more than this however. Written three years before the  publication of 1984, the essay is talking about the abuse of language in the (moral) corruption of thought.

He writes: “The inflated style  itself is a kind of euphemism. A mass of Latin words falls upon the facts like  soft snow, blurring the outline and covering up all the details. The great  enemy of clear language is insincerity. When there is a gap between one’s real and one’s declared aims, one turns as it were instinctively to long words and  exhausted idioms, like a cuttlefish spurting out ink.”

The policy is  intellectually bankrupt. And it prompts you to ask if the person who sat  before their word processor and tapped out its vacuities was also guilty of a  moral failing: using words to fall on the facts – the facts of what happens to  many of those whose lives are struck by serious mental illness, the reality of  what awaits when the services fail?

Three years ago, a team at Australian Doctor compiled a special report on mental health. I went on a tour  through the rough parts of Sydney with Sister Maria, who was part of the Brown Nurses Ministry. The nuns and brothers of the Brown Nurses are usually the  people the city’s statutory services – the community mental health teams for  instance – turn to for help when they can do no more.

One of Sister  Maria’s clients was John, a middle-aged man with schizophrenia, who was living  alone on the ground floor of a 1970s tower block in Redfern.

We went to  the supermarket to buy him food. He couldn’t go because his appearance alarmed  the checkout staff.

We ended up at his flat, which was stripped of the  usual domestic comforts such as wallpaper, carpet and furniture. It consisted  of a bare concrete floor, a stinking mattress and an office chair he had  salvaged from a skip bin. When John arrived, he walked in with his arms  dancing, his mouth twisting as though gripped by a spasm.

It took  several seconds before I realised the poor bugger was simply trying to say the  word “hello”.

It is four years since the publication of the Not for Service report. It gets described in the literature as a landmark publication,  but is just a compilation of stories about what happens to people when things  go wrong. It runs to 1000 pages. It was enough to prick the conscience of John  Howard who, after 10 years of apparent indifference, began to throw cash at  mental health services.

Under Rudd and Roxon I’m struggling to find one  major speech on mental health. Instead, their civil servants have helped draw up this document.

Psychiatrist Professor Alan Rosen has called it a  “phantom policy”. In a letter sent to the Federal Health Minister earlier this  year (and published here), he wrote: “The whole document is  set out like a discussion paper giving history of the reforms in mental health  over years, but it is almost complacent and self congratulatory about diluted  partial achievements.”

In a world where the history of mental health  reform repeats only as tragedy, I guess many will readily accept that what is  delivered is ‘dull’ provided that is also ‘worthy’. But the policy isn’t worthy. It’s insincere, like those ministers and bureaucrats giftwrapping an empty box.

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Comments 3

  1. Liz45 says:

    It’s worse than insincere, it’s a national disgrace and tragedy. The stats for the incidence of those people who will suffer a mental illness in their lifetime is quite high – 1 in 4?The unnecessary suffering and anguish of those people suffering a mental illness and their families is heart rending. Whenever there’s a tragedy(usually preventable) of the death of a person suffering an illness of this kind, the media wrings its hands, politicians make appropriate noises, and after a couple of days, everybody moves on – until next time. In the past few weeks, 3 people have been killed by police, probably unnecessarily – these people all sounded as though they were in a mental turmoil of some kind.

    We hear much in the media of how the public’s response to mental illness, and most importantly, to the PEOPLE who are suffering, but very little has changed. This is a rich country. There is enough money to care for the health needs of just over 21 million people. It is a damned disgrace that through neglect, the terrible and unnecessary suffering of fellow humans will just remain – business as usual.

    I listened to Ann Deveson (well known Australian journalist) interviewed several years ago about the life and death of her lovely son Jonathan, who suffered from schizophrenia. I was moved to buy the book, and was overwhelmed by the neglect and trauma family members and of course the sufferers have to go through, in order to get adequate medical help. We, all of us, let these people down on a daily basis. I learned a lot about mental illnesss, and while I believed I was a compassionate person, my eyes and awareness were alerted. I hope I’m now a more understanding and caring person to a lovely bloke who lives nearby, and also suffers from a mental illness.

    In the Illawarra in the past few weeks, nursing staff in the Mental Health field at a local hospital, took action over wanting to be placed on 12 hour shifts. I couldn’t believe that this would even be considered. When their present conditions were explained, I could understand the benefits they’d gain by 12 hours on and 12 hours off, but this is a disgrace. A demanding job like nursing, deserves better conditions than this? For over 30 years now, the monies that used to be spent on keeping people locked up and away from the rest of the community, should have gone to providing excellent mental health care, and community support for people to live with dignity and autonomy. Sadly, governments just ‘pocketed’ the money and spent it on usually frivolous other demands – like more freeways and tunnels etc.

    Perhaps we need people to stand at the next State(s) elections on this issue alone. The public must be told the reality of the suffering of people whose ‘crime’ is, they’re sick. If we treated people with a broken leg with the same cruelty we treat people with a mental illness, it would surely change. I like to think so!
    I applaud all those people who diligently, and while overworked and weary, continue to fight for the plight of those with a mental illness!

  2. zayzayem says:

    I think this is a sad state of a lot of Australian politics pushing “phantom policy”. Does anyone actually know what they are doing? (or more importantly, why aren’t people who know what they are doing in politics?)

  3. daeron says:

    Yes it’s worse than insincere, the fact is that Mental Health is mostly used as a verbal weapon in Australia by people seeking control of somebody else’s assets. The Mental Health Acts & Guardianship Acts are aimed at appointing a new financial manager, not the person’s welfare.

    Every day behind closed doors in Guardianship Tribunals, volunteer Australian carers are being accused of mental illness and financial abuse, the allegations are made in secret by people who have refused to help but who are now seeking financial management of their relative’s assets knowing that the Tribunals do not use rules of evidence nor allow the accused to answer the allegations. The more vile the allegation, the more determined the Guardianship Tribunal is to hide the allegation from the accused, and the more bias the Tribunal becomes against the carer.

    Every day thousands of Australians are chemically restrained to subdue their will and to lower staffing costs for nursing homes and public hospitals; at least in the US they have acknowledged the problem : “In February,, California’s attorney general charged three staff members at a nursing home with using Risperdal and Zyprexa to sedate patients and make them easier to manage. In a separate case in January, Lilly agreed to pay the federal government $1.4 billion to settle charges that it illegally marketed Zyprexa for use by the elderly.”

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