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.