| Uniya - Jesuit Social Justice Centre | CONTENTS | Spring 1995 |
In June, the second National Mental Health Report slipped out
without fanfare. This was hardly surprising. The report, designed to
detail progress in the second year of a new National Mental Health
Strategy, contained little to celebrate. The Strategy adopted in April
1992 defined directions for reform in the mental health sector. It
included a framework for a state and commonwealth response over a six
year period. The annual Mental Health Report was to be published to
allow public scrutiny of the reform process. However, it was released
quietly, with consumer and non-governmental organisations yet to run a
finger across its broad pages.
A key component of the National Mental Health Strategy is Schedule F of the Medicare agreement. This requires states to maintain expenditure on mental health services during the downsizing of institutions and mainstreaming of mental health care. Victoria has managed to disregard this agreement, making a saving of $18.4 million during the year 1993/94.
On a per capitas basis Victoria and Queensland have reduced mental health expenditure. Queensland and NSW are now competing for the lowest per capita expenditure at $45 and $46 respectively. An additional $55 million would be needed to bring them into line with other states' spending. Significantly, up to 55 per cent of those with a serious mental illness presently go untreated. Half of the mentally ill in Australia (currently estimated to be 250,000 people) receive no treatment from a public mental health service, from a private psychiatrist or from a general practitioner.
This high level of unmet need indicates that current funding arrangements are inadequate. This is so despite the efforts of the Australian Health Ministers' Working Party to bring about an increase in the number of people with a serious mental illness receiving treatment. For those who fall through loopholes in the guidelines that determine eligibility for existing services, such as those with a dual disability, rising expenditure levels are cold comfort.
| Indicators of change are important, especially those that provide structural support to state and commonwealth commitments. Keys to the reform process are intersectoral links, such as those between the Departments of Housing, Community Services and Police, together with legislative reform regarding the rights of the mentally ill, initiatives for those with special needs (such as Aborigines, women and youth) and relevant workforce reform. In all of these areas there is evidence of good intentions but little action. One state, Western Australia, is yet to publish a state policy on mental health. | Consumers have some right to be cynical. Significant structural changes are in place to oversee a reallocation of resources from institutional to community based care, but there is little evidence of actual change. |
What is needed urgently is a commitment by state governments to ensure a flow of funds to community care for the mentally ill. State action must go beyond closing institutional beds and issuing flimsy policy statements purporting to be government initiatives. Australia's track record of closing beds without transferring resources to the community is well documented. This year's Mental Health Report shows that New South Wales, Victoria and South Australia closed 203, 190 and 60 beds respectively. Closing beds without implementing alternative inpatient services denies those who need the most care.
Catholic agencies working in the field point to a staggering increase in numbers of people with mental illness seeking assistance. Sydney's Matthew Talbot Hostel claims that 70 per cent of those being served have a psychiatric illness. Planning documents full of glossy pictures and good intentions are not enough. Commonwealth and state and governments must take seriously their duty to protect the rights of those with a mental illness.
Above material is from the Uniya Newsletter: used with permission.
The Cardoner,
© Copyright 1995 by Jack Otto.