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Outcry Against Mental Health Institutions

The report of the Mental Health Council of Australia, last October, which revealed the pathetic state of the country’s mental health system, the Council //of Australian Governments (COAG) commissioned a taskforce to present a report with proposed solutions by July.

However mental health experts now feel that the earlier momentum is being lost. The Mental Health Council of Australia launched a follow-up report called Time for Service that lists particular reforms to be adopted by the governments.

According to MHCA board member and prominent psychiatrist Ian Hickie, the COAG process appeared to be proceeding without a proper planning, goals and intentions.

`We're doing something that the (state and federal) governments haven't done _ we're clearly stating at the outset what we think are the range of services required, the size of the deficits (of unmet need), the targets, and a need to develop a new, independent system of accountability,' Hickie says.

MHCA chairman Rob Knowles said it was ``essential that any new investments by Australian governments are properly targeted and integrated within a national system'', acknowledging what really was their concern.

In April Prime Minister John Howard made a surprise announcement of a five-year, $1.8 billion mental health package, targeting an expansion of Medicare access to psychologists, more mental health nurses, and increases in training places and respite care places.

However what was surprising was the fact that this announcement was made outside the COAG process just like the NSW Government's budget move last week of over $338 million in new money for mental health services, including community-based services. What mental health experts feel is that the COAG would finally be a whole lot of ad-hoc and disjointed programs.

The reported pointed out that the key goals for a functional mental health care system are services designed to preve nt mental illness, or else their identification and early intervention.

Arrangements should be made to assist people to live independently at home, involving support for families and care givers in addition to providing stable and appropriate accommodation, and lead a normal life

Hickie said that this goal setting plan differed from the National Mental Health Plan, written in 2003, which ‘just sets priorities _ it just had broad motherhood statements’.

Early intervention youth mental health service program is one of the early priorities proposed by the report. Setting up such a service on a national scale would cost $300 million in the first year, and $150 million in running costs in subsequent years.

Besides this services to look after patients experiencing their first mental health episode would cost an estimated $500 million in the first year, and $300 million a year thereafter.

According to Hickie, ‘But in the mental health area, often it's a very important part of the health system that the accommodation, the rehabilitation, the return to work actually happens.’

`’Those things are actually health interventions. If people are back at work, back at school, their mental health improves in those situations. We have to get over the notion that you have to get well before you bring into play these social and other services. ‘

The Time for Service report says that early interventions would cost an extra $1.7 to $2 billion every year, from all levels of government. But the federal Government has pledged $1.8 billion over five years, not one, and the MHCA hope that this would be matched jointly by the states. In this situation meeting the target seems to be fraught with difficulties

At the end, getting the priorities right was more important than the sums involved according to Hickie. ‘We've had mental health inquiries and reports every decade for the past five decades,' Hicki e says.

‘We've failed not because politicians have not got interested at each point in time, but because resources have not gone in, and then the implementation has been poor ... and the lack of accountability. Each of those critical junctures that we've had, the accountability hasn't been in place. We're desperately keen that this one, which involves the heads of governments, actually delivers.’ br>

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