Mental health system in urgent need of overhaul

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In 2009, a strategy was released in Victoria called Because Mental Health Matters: Victorian Mental Health Reform Strategy 2009-2019. It set out a vision and agenda for a new era of mental health reform, with high aspirations for a holistic approach to mental health across the board.

Unfortunately, this impetus was eclipsed by the Black Saturday bushfire disaster, and the anticipated funding for it quickly dissipated from a river to a trickle. It was never restored. In the years that followed, ministers from both sides of politics made further attempts to develop a more modestly funded mental health strategy, but these were successively thwarted, even in their reduced ambition.

For too long Treasury has seen mental health reform as a ‘nice to have’ rather than a must-have. Doing so has completely underestimated the impact mental ill-health has on people’s lives, the economy and on the larger community – every bit as much as cancer or heart disease.

This impact has been compounded by long-term systematic policy and funding neglect. When advocates of policy reform are constantly overlooked they come to know their place, eventually lose ambition and their aspirations are diminished.

The Productivity Commission has now quantified the economic cost of not addressing mental health reform and the Royal Commission has laid bare the undeniable human cost of Victoria’s broken mental health system.

I am fortunate to be leading a mental health organisation at this moment when the Victorian government has committed to implementing the Commission’s recommendations and there is renewed energy and opportunity for real change.

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The Royal Commission’s recommendations for changing the architecture of the system for a more holistic and community-focused mental health system are a potential game-changer. Supporting people to maintain or rebuild their connections with employment, education and the community provides hope and the opportunity to sustain long-term recovery and full citizenship. Similarly, a new statewide trauma service will be instrumental in addressing the critical impact that trauma has on people’s mental health.

Nothing we do will matter if at-risk Victorians don’t have secure housing. The Royal Commission has found, like Mind Australia’s own ‘Trajectories’ research in partnership with the Australian Housing and Urban Research Institute, that housing security is one of the most essential requirements for mental health.

The Victorian government’s recent commitment to 2000 homes for people with mental ill-health was a welcome head start and the Commission’s recommendation for a further 500 supported housing places for young people will create the much-needed foundations for a meaningful life.

The Royal Commission has now done its job and the government has said it will provide the required policy leadership and funding capability. The next step is for the complex array of people and organisations across the clinical health and community sectors to bring reform to life. Central to this must be those with lived experience and their families.

Our challenge is to create the system, service innovations, and the evidence for improved outcomes that will enable us to realise a reformed mental health system that changes people’s lives is good for our economy and strengthens our community.

It won’t always be easy. In my experience, service sectors are never more united than when arguing to the government that reforms are needed and never more divided than when arguing over the details of reform implementation. While robust debate in implementing new systems is healthy, there is no time for this to bog down real progress. We must work together to realise this once-in-a-generation opportunity.

We owe it to the people we support, who have waited through all those other strategies only to be disappointed time and time again. The pathway is here and the clock is ticking.

Gill Callister PSM is the chief executive of Mind Australia and Adjunct Professor (Practice) in politics at Monash University.