Political courage needed to lead genuine mental health reform and end entrenched disadvantage
27 November 2013
Professor Allan Fels, Chair of the National Mental Health Commission, has used the launch of the second National Report Card on Mental Health and Suicide Prevention to call for political courage in reforming mental health and providing better outcomes for the 45% of Australians who will experience a mental health problem in their lifetime.
Prof. Fels said: “We speak about Australia as the lucky country, but mental health is a weak point in our society as well as our health system.
“For example, it’s scandalous that only seven per cent of the 340,000 people who have co-existing mental illness and substance use disorders each year are estimated to receive treatment for both problems. These people have their lives cut short by an average of between 20 and 30 years, they are more likely to be in prison or homeless, and they are more likely to take their own lives.
“The Commission is also highly concerned about how we as a society criminalise people who live with a mental health difficulty. People living with mental illness are over-represented in our prisons, in the number of police incidents and in the number of police shootings. We believe that each stage of the justice system needs significant reform.
“In 2012, 38 per cent of all people entering our prison system reported being told they have a mental illness, and 87 per cent of young people in the juvenile justice system in NSW alone were found to have at least one psychological disorder. “Compared to other prison entrants, people with poor mental health have more extensive and early imprisonment histories, poorer school attainment, higher unemployment rates and higher rates of substance abuse. Incarceration and their treatment in prison often makes their mental illness worse and rarely treats their illness appropriately. “The warehousing of people with mental health and drug and alcohol problems is inhumane and makes no economic sense. Each person with a mental health problem or a cognitive impairment who comes into frequent contact with the justice system costs taxpayers $1 million each year.
“When we look at the issues from a high level we see that there is a cycle of vulnerability that crosses generations, and current mental health systems and supports are not generally designed with the needs of people and families at its core.
“Only 25% of young people and 15% of boys and young men with mental health problems receive treatment of any kind. Meanwhile, 44 Australians, on average take their own lives each week and Aboriginal and Torres Strait Islander peoples are two times more likely to die by suicide than non-Indigenous people. “There is a growing divide between those of us who are empowered to live a contributing life – and those of us who are disempowered by issues like unemployment, homelessness, social exclusion as well as a lack of the right support ”, Prof. Fels said.
A Contributing Life: The 2013 National Report Card on Mental Health and Suicide Prevention shines a light on the lives of people who are the most disadvantaged in society - economically, socially and because of the impacts of their mental illness. It contains personal accounts from people and families who have experienced mental illness through the prism of prison, homelessness, unemployment, discrimination and grief following a suicide.
The Report Card highlights the need to increase investment in early intervention across a range of areas and across people’s lives.
“As a country, we can’t afford the personal, community and productivity costs that too often accompany poor mental health. People want to live a Contributing Life. We do not choose to live a harder life than we need to. A lack of early intervention cements disadvantage, while discrimination adds to people’s exclusion from society. As a society, and as individuals, we must stop blaming people for their mental illness. And we must find the courage to call out those who do”, Prof Fels said. The Report Card also tracks progress against the four priority areas for ongoing reform and ten specific recommendations for action the Commission made last year. The Council of Australian Government’s (COAG) response – received by the Commission just a few days ago – agrees with eight of these ten recommendations and supports the four priority areas.
Prof. Fels said: “Many of the recommendations we made last year relate to systemic reform that we know takes time. We need to make a start. This is about us – our family, friends and colleagues – and we are impatient for action on behalf of the millions of people and families we know are tired of struggling on.
“We still have no public reporting on the number of people who are discharged from hospitals, custodial care, mental health or drug and alcohol related services into homelessness even though this issue has been named as a national commitment since 2008. “We observe a concerning trend of services retreating from their roles and governments retreating from funding commitments to support people in the community. Last year, we called on governments to ensure that mental health funding they publically announce is spent on mental health as promised, but we’ve seen no independent and transparent reporting on this. “Courage will also be needed to avoid tinkering with a disjointed collection of linear services and systems that have long been shown not to produce the outcomes people need. Success will rely on all levels of government, community agencies, and public and private services working together to make people’s lives better”, he said.
However, the Commission stressed that the news is not all bad. Professor Fels cited the public release of the first ever national data on seclusion by states and territories as a highlight of the year and a key step in achieving real reductions in this practice, which is not in line with human rights. The Commission is also pleased that psychosocial disability has been included in the NDIS, and applauded the work that non-government sector, the business sector and first responders such as Police have taken to address issues the Report Card and its broader work has raised.
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