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Ambitious program of reform but the challenges lie in its implementation

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Ambitious program of reform but the challenges lie in its implementation

Last week was a momentous one for those of us advocating for change across the mental health landscape. On Monday the Federal Government released the Productivity Commission’s inquiry into mental health final report and the Prime Minister Scott Morrison gave a keynote address underscoring his government’s commitment to mental health reform.

The National Suicide Prevention Adviser’s Interim Advice and a roadmap for reform as set out within the National Mental Health Commission’s Vision 2030 were also made available for consultation.

The team and I have been working through this 1600-page report to digest the Commission’s findings and evaluate the proposed agenda for change.

The Commission was tasked with weighing the economic cost of an underperforming mental health system and building the case for reform. It is estimated that mental ill health and suicide cost the Australian economy approximately $200 billion per year. We know that the true cost to individuals, families and communities is impossible to quantify.

SANE agrees with the Productivity Commission’s assertion that far too many of us suffer preventable mental distress. Further, when people experiencing complex mental health issues are met with stigma, discrimination and inadequate and inappropriate care, this can lead to disruptions in education and employment, relationship breakdown and loss of life satisfaction and opportunities.

Whilst it is true that radical reform will bring significant fiscal benefits, our primary focus needs to be to ensure that people living with complex mental health issues experience rich and fulfilling lives unlimited by systemic and social barriers.

We believe the Commission strikes the right note in terms of its aim to ensure that people have real choices in managing their own mental health and feel empowered to choose the treatment and supports that are right for them, their families and carers.

SANE wholeheartedly endorses the proposition that community treatments and supports should be expanded to support recovery within the community. Stronger liaison between hospitals and community care is also identified as a key priority for people recovering from a suicide attempt, as is reducing the life expectancy gap for people living with co-occurring complex mental and physical health issues. Both objectives are important facets of our own advocacy work. 

Bolstering community mental healthcare services is a key component of avoiding hospital inpatient care and we endorse the expansion of these services to provide quality, therapeutic community-based care for people living with complex mental health issues.

The impact of suicide on our community is profound. SANE welcomes the Commission’s recommendation to improve suicide prevention interventions and establish a whole-of-government approach. We urge governments to ensure such initiatives are informed by those with a lived experience of suicidality or those bereaved by suicide. SANE’s Better Off With You (BOWY) initiative demonstrates the power of peer to peer storytelling to reach people within our communities who may be contemplating suicide.

The recommendations that, in the words of the PM, address “the bewildering array of unpredictable gateways” are encouraging. But this must go beyond merely equipping people to navigate the current, broken, system. Mental health system architecture needs fundamental redesign to optimise the engagement of people living with mental health issues, particularly those living with low prevalence, poorly understood mental health issues. People affected by complex mental health issues need access to alternative and holistic models of care, including peer support.

SANE applauds the Productivity Commission’s recognition of the detrimental effect of stigma on help-seeking and recovery and need to eliminate stigma. The proposed development of a national stigma reduction strategy is consistent with the Recommendations for Action that flowed from our very own National Stigma Report Card project.

Ending stigma and discrimination is key to achieving social inclusion, participation and better health outcomes for people experiencing mental health issues. SANE will advocate for the prioritisation of the needs of people affected by complex mental health issues who, as the National Stigma Report Card demonstrates, experience stigma in a significant and harmful way.

We support the premise both within the Commission’s final report and highlighted by the PM that the best mental health system is one that is person-centred. In particular, we celebrate the acknowledgement that providing resources for people to better direct and make decisions about their own care is vital to a robust mental health system.

SANE will advocate on behalf of the community we serve to ensure that people with lived experience of complex mental health issues play a central role in training, service planning and ongoing oversight for health and social services.

SANE endorses the recommendation to increase online support, including awareness campaigns promoting availability. SANE’s own digital mental health services – including our 1800 Helpline, Peer Support Forums, webchat and psychoeducational resources – provide integrated, holistic, person-centred and specialised online support from both professionals and peers. It is critical whilst we continue to deal with the challenges of COVID-19 and well beyond, that such services are both valued and well resourced.

SANE congratulates the Commission on the breadth of the final report and scale of its ambition. Reading the report inevitably brings up regret as we reflect on the failings of the current system, but there is cause for optimism and hope.

The current unprecedented focus on improving the mental health of all Australians is to be celebrated. That said, there is much to be done and the challenge lies in the implementation of these recommendations.

SANE looks forward to working with the government in prioritising these reforms to make a real difference in the lives of people affected by complex mental health issues.

Last updated: 24 November 2020