What will the health reform agenda mean for mental health? This was the subject of a seminar recently convened by the Menzies Centre for Health Policy, the first in its Policy Innovations 2010 seminar series.
You can listen to the full recordings here, but the Centre’s Angela Beaton has also provided this summary – which raises some questions for Croakey readers.
She writes:
“Dr Lesley Russell (Menzies Centre for Health Policy), Dr Andrew Pethebridge (St George Hospital), Mr David Crosbie (CEO, Mental Health Council of Australia) and Ms Barbara Hocking (Executive Director, Sane Australia) participated in the panel discussion that was moderated by Professor Gavin Andrews (UNSW at St Vincent’s Hospital).
An engaged discussion at the end of the seminar quickly concluded that there is consensus around a good evidence base about what needs to be done to treat and help those who suffer from mental illness and their carers.
In particular, we know what needs to be done to provide effective early intervention services to young people. But lack of political action means that the resources are not available, and most people with mental health problems go without the treatment they need.
These were some of the questions that were posed by participants:
– Why is mental health so neglected?
– Why has the Rudd Government left mental health off the health care reform agenda?
– Do we need to change tack and reframe mental health disorders as medical conditions of the brain?
– Should mental health be removed from the remit of the health portfolio and made a whole-of-government responsibility within the Office of Prime Minister and Cabinet?
– What sort of grassroots action will make the politicians see mental illness in the same light as other chronic health conditions such as cancer, diabetes and heart disease?
What do Croakey readers think?”
1 – Because people with severe mental illness don’t shout loudly (to politicians). And because severe mental illness is dealt with by (state funded) community health teams who are too busy to breathe let alone draw attention to the problems or the nuances in the system that cause the problems.
2 – Because Better Access means most people’s contact with “funding for mental health” comes in the form of $1200 for psychology (or thereabouts), so the perception is that it’s funded quite well. And there haven’t been any mental health disasters (homicides or suicides) in the media recently.
3 – No. We need to stop the division of health at the neck level and think in terms of overall holistic care of a person.
4 – NO! It’s health. It should be under the health portfolio remit and actually dealt with. Maybe bringing community (including mental) health into the remit of the federal govt might help accountability.
5 – How about some publicity about the health gap between people with mental health disorders and those without? Or maybe a ribbon with psychadelic colours? (joke)
Sorry if my Friday evening cynisism is a bit brash, but thanks for listening all the same.
I had thought that the Convention on the Rights of Persons with Disabilities (CRPD), to which Australia is a signatory, was supposed to usher in a new era of consumer/survivor participation on disability policy and practice. I think that the slogan attributed to that convention, ‘nothing about us, without us,’ was meant to be more than hollow rhetoric. However, from this story I can see that policy-making in mental health remains clustered around the usual old suspects. That a professional bloc with vested interests can easily reach a consensus about which way forward in mental health is hardly surprising, but such machinations should not be confused with objective thinking. Objective thinking, looking toward the empirical evidence, tells us that causation, treatment, and recovery in mental health are highly contested subjects. For example, while those in the professional bloc would argue that ‘early intervention’ means treating young people (usually and solely with psychotropic medication) at or even before the onset of symptoms, the evidence tells us that the best early intervention is positive health promotion across the lifespan. We would fundamentally prevent most mental ill health if we cared for and protected children, ensuring that they grew up safe, loved, and attached. I hear none of that evidence coming from the professional bloc, who remain wedded to that dated belief, that mental ill health follows an inexorable biogenetic path. It does not.