State of the Nation’s Mental Health.
Any serious discussion of the key public policy issues in Australia over the last five years cannot overlook the almost continuous discourse surrounding mental health services, public funding and service delivery. There are several reasons for this. First, Australians are now more informed on mental illnesses and the consequences of falling to provide services for those with a medical need. The work of beyondblue, headspace, SANE Australia and The Inspire Foundation (to name a critical few) has significantly increased awareness and understanding. Second, on an almost daily basis there are national media reports of mental health service failures and inadequacies. This combined with regular adverse reports from credible sources including Ombudsman’s Offices, Auditor Generals, providers, researchers and so on, paint a picture of a system in perpetual crisis. This in turn feeds the public discourse and drives the political engagement around policy responses. Responding to this, the Rudd Opposition in 2007 and later Government committed itself on numerous occasions to reform: “we are committed to meaningful reform that will improve outcomes for people who have a mental illness or are at risk of mental illness, their families, carers and the community”. Australians appear to rate the provision of mental health services as a major challenge for the nation. An international survey conducted by Kings College London in late 2010  showed the utmost importance placed on the issue of mental health by Australians, who went as far as to rank the issue as the third most significant challenging facing this country, well ahead of other nations and second only to the economy and global warming. As we enter the last year of the second term of the Rudd-Gillard Governments, mental health remains very much ‘unfinished policy business’. This is despite Prime Minister Julia Gillard’s bold commitment in the election campaign in 2010 to make “mental health a second term priority for the government” and a major funding package of $2.2 billion announced in the 2011 Federal Budget. So then, what has happened in the past five years? Is there real progress and what are the priorities for mental health reform going forward? Continuing a ‘Sara Lee’ Approach to Policy
This year, 2013, will mark 30 years since the Richmond Report in NSW which set out the directions for formally closing the old stand-alone psychiatric institutions in that state – the policy of de-institutionalisation. This year also marks twenty years since Brian Burdekin’s damming assessment of the services provided to the mentally ill in community care – many the former patients of the psychiatric hospitals. Indeed, the Federal Parliament’s Hansard records debates about the Dickensian state of our mental health facilities and what reforms were necessary as far back as 1954. In response to Human Rights Commission (Burdekin) report and the community’s concern about the state of services, all Australian Government’s agreed to a national mental health policy and five year plan. Since then Australian government’s have collectively endorsed: * Two National Mental Health Policy documents (1992 and 2008) * Four, Five-Year National Mental Health Plans
* Three, possibly four, National Suicide Prevention Strategies (1995, 1999, 2005 and 2010), and * One COAG (Council of Australian Governments) National Action Plan (2006). In 2012, the Gillard Government developed the “Ten Year Roadmap for Mental Health Reform” and this was endorsed at the last COAG meeting of that year. In addition, there have been hundreds of other sub-ordinate planning documents including separate implementation plans issued in every state and territory. In effect ‘layer upon layer’ of policy as Ms Sara Lee might say – without diligent planning, deployment and evaluation. Hence, the implementation of a community model of care in mental health has become a seemingly...
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