A life worth living

Improved housing, education and employment opportunities are critical if we are to help as many Australians as possible with a mental illness stay well and have a life worth living opines Executive Director Barbara Hocking in The Weekend Australian, 17-18 September, 2011.

PEOPLE with mental illness want the same things as everyone else: a home, a job, a sense of belonging - a life worth living. Everyone recognises these needs but for people with a mental illness, it's not always easy. Building a mental health system that provides effective treatment and support, as early as possible and for as long as needed, is not an end in itself. Rather it's a means to achieving this life worth living.

Take Joe, who has schizophrenia. Being  “warehoused'' for years in a run-down boarding house with no friends, no job, and nothing to do, is not a “successful outcome''. Just because he hasn't needed to go into hospital, doesn't mean he's faring well.

The Mental Health Reform package announced in the 2011 budget featured programs costing $2.2 billion over five years. These measures, overdue and welcome, are largely focused on improvements to clinical services. But areas of major neglect remain for people with mental illness beyond clinical services and the mental health portfolio. Improved housing, education, and employment opportunities are critical if we are to help as many Australians as possible with mental illness stay well and have a life worth living.
People with mental illness want to live and be treated in their local communities.

The old asylums are long gone fortunately, although they did provide a roof over patients' heads and some companionship that we are still struggling to replace. So how much better is life for people with mental illness these days?

Almost half the respondents (45 per cent) to The Australian's Health of the Nation series Newspoll said they would not be confident that a family member would receive an acceptable level of care if they developed a mental illness.

Good clinical treatment is vitally important, of course, providing the cornerstone of care. So, while ensuring that we have enough specialist health workers, hospital beds, and mental health clinics, we must also make sure that a range of community services and supports are readily available to help people take their place in the community.

A home. Decent housing is fundamental to good care  - without that it's difficult to manage treatment, get and keep a job or maintain friendships. Yet SANE research with almost 400 Australians living with a mental illness found that nearly half  (47 per cent) of the respondents were in unsatisfactory accommodation and looking for somewhere else to live.

A recent ACOSS Community Sector survey reported that 135 people were turned away from homelessness and housing services on any given day in 2009-10. The same survey reported that unmet need was most acute in the area of mental health. So while there are some growing programs in the NGO mental health sector, these are still too few and far between.

A job. Meaningful and productive work requires education and training something that is often disrupted by mental illness as well as help getting and keeping a job. Returning to education and vocational training therefore needs to be a routine part of treatment and rehabilitation for many people.

Schemes to help increase the number of part-time jobs are also important as a lack of these is cited as the main barrier to finding work. And of course, we also know that having workplace education to improve managers' and co-workers' understanding of mental illness will also have the good business advantage of retaining experienced staff.

A sense of belonging. Many people with mental illness are lonely and isolated, often having no partner or friends to share their lives. SANE research found that almost half (49 per cent) of people surveyed were not in a relationship and almost as many (43 per cent) did not have a close friend.

Continuing support for the Personal Helpers and Mentors scheme and new investment in flexible care packages demonstrate that the government does acknowledge the need for ongoing care and support for people with more disabling mental illness. Having someone to chat to, go for a walk with or share a meal with can really help with recovery.

Minister for Mental Health, Mark Butler, has announced the establishment of a National Mental Health Commission and a 10-year roadmap for mental health reform is now on the drawing board. Elements of the roadmap that may well have the biggest impact for many people are not the huge new clinical programs that get media attention but day-to-day work happening on the ground in local communities with people with mental illness and their families.

How different will Joe's life really be in 10 years? Our real challenge is to help ensure he has a life worth living.


SANE Australia offers a wide range of resources to assist people diagnosed with mental illness and their families. Call the SANE Helpline on 1800 18 SANE (7263) or visit sane.org for more information.