While it feels like we have only just voted in our State Election, we now have a date for the 2022 Federal Election. Once again we are calling for good policy and investments in mental health and this time our focus is on the Commonwealth contribution.
Recovery is ongoing, it’s not finite. It doesn’t finish, but it’s a spectrum. There are ups and sometimes downs. I think people need to understand that with recovery there’s hope, hope for change.
The Commonwealth plays a vital role in funding our mental health services. In 2019-20 $11bn was spent on mental health related services across Australia.
While this seems substantial, many of our national colleagues point out that this is underwhelming. This is often done in partnership programs which allows for services such as the Urgent Mental Health Care Centre to be created.
In our latest partnership agreement $127.8m was committed to mental health which comprised $66.1 million from the Commonwealth and $61.8 million from the South Australian Government.
Suicide prevention and mental health programs were promised along with $101.1 million to establish a network of Adult Mental Health Centres (Head to Health) in Northern Adelaide and Mount Barker which will be co-located with new state-funded services including a Crisis Stabilisation Centre, and two additional Head to Health satellite centres.
Partnerships like this are welcome however we need to keep our eye on the bigger picture this Federal Election. We need to make sure that programs and partnerships have the scale and focus that we need.
We will always have people who are extremely unwell and will need hospital based support, but we are still not giving enough money or attention to keeping people well at home, not just in the city, but in the country as well.
The mental health historians amongst would note with interest that 2022 marks the 30 year anniversary of national mental health policy which prioritised investment in community support as a key area for mental health reform.
The Productivity Commission Inquiry into Mental Health delivered its final report in November 2020 and in the midst of the pandemic fundamental recommendations have not been progressed.
Recommendation 17 identified the enormous gap in community psychosocial services delivered by the non-government sector and specifically addressed the need to invest in it. The Productivity Commission recognised that this investment played a vital role in the recovery for people living with acute mental health challenges.
When we invest in psychosocial services people are supported to manage their self-care, improve social and relationship skills. This creates an improved quality of life in physical health, social inclusion, secure accommodation, education and employment. The evidence is clear that psychosocial support also helps people to reduce reliance on other mental health services such as hospitals making our mental health system more cost efficient as well as more effective.
The Productivity Commission estimated up to 154,000 Australians would significantly benefit from psychosocial support services that are currently not receiving them. However making this happen would require changes to governance, funding, and the workforce.
Federal Election Ask 1;
Commit to implementation of Productivity Commission Recommendation 17 and specifically commit to a timeframe to reduce the unmet demand for community psychosocial support by 50% within 3 years.
The Productivity Commission also recognised the importance of housing and its connection to maintaining mental health. The Report stated: “Suitable housing — that is secure, affordable, of reasonable quality and of enduring tenure — is a particularly important factor in preventing mental ill-health and a first step in promoting long-term recovery for people experiencing mental illness. Some 16% of people with mental illness live in unsuitable accommodation.”
We have people who are discharged from emergency departments and the hospitals don’t even let the person’s GP know, they don’t let their family know. You know, people are still sent home to nothing or to nobody or without support.
Housing was highlighted by the Productivity Commission as a ‘priority reform’ arguing every State and the Federal Government; “should commit to, monitor and report on, a nationally consistent policy of not discharging people with mental illness from hospitals, correctional facilities and institutional care into a situation of homelessness.”
By implementing this reform we create significant improvements in quality of life for people and we argue that it not just be for those at risk of homelessness but any unstable accommodation.
Federal Election Ask 2;
Commit to the mental health reform priority of access to suitable, sustainable, affordable housing with a goal of no exits from hospitals, mental health services, institutional care and correctional facilities into homelessness or inadequate housing.
We already know that South Australians with mental illness currently spend more time in emergency departments and other hospital-based services than they would need to if there was adequate access to psychosocial supports. Investing in psychosocial support services will reduce Emergency Department admissions for a mental health crisis by 39%.
The Productivity Commission also recognised the “cycling of people in and out of hospital (is) at great personal cost and cost to taxpayers”. Their report identified that over the past 15 years Emergency Department admissions have increased by 70%.
What’s a bed going to do when you’re already in there being guilt tripped out of it? You’re not even going to take your shoes off, put your bag down.
Here in South Australia 15% of people who are discharged from hospital will be readmitted within 28 days. The Productivity Commission has identified a priority reform as alternatives to emergency departments that are designed for people with mental health challenges.
“Adequate aftercare could reduce the number of people who are in hospital emergency departments, having attempted suicide, by about 20%, and all suicide deaths by 1%. This is equivalent to preventing 35 people per year from dying by suicide, and a further 6100 people from attempting suicide that results in some level of incapacity for them.”
Federal Election Ask 3;
Fund psychosocial support services and invest in alternatives (such as the Urgent Mental Health Care Centre) to eliminate avoidable Emergency Department presentations.
People have qualities beyond the diagnosis of a mental health issue. People are members of the community. They’re the neighbour that gives you a wave as you’re walking out the gate. They’re like anyone else, they are members of the community.
This Federal Election we need to remember that every vote counts. On our Fund Mental Health Page you will find resources to help you advocate for mental health when your local candidates are out campaigning. The MHCSA will continue its election advocacy this May because we need to get our heads around mental health.