Last week the ABC published leaked sections the National Review of Mental Health Programmes and Services which was undertaken by the National Mental Health Commission and completed last year.  Two days after the initial leaks Croakey was first to release the full report to the public. While the review has now been released, Health Minister Sussan Ley has suggested that the government are still considering some recommendations and has announced an Expert Reference Group and a range of advisory committees.  

In this post Professor Allan Fels, Chair of the National Mental Health Commission shares his thoughts on why now is the time for action and warns of the potential barriers that must not be allowed to hijack the process.

Professor Fels writes:

Now that the National Review of Mental Health Programmes and Services that the National Mental Health Commission provided to the Australian Government has been made public, we must overcome two potential barriers to meaningful reform that have thwarted the best efforts of others in the past.

The first is barrier would be to lose sight of the fact that this is about people with lived experiences of mental illness and their families and carers. Yes, it is about ‘the system’, but it is about a system being reoriented to focus on the need of individuals, families and communities, rather than supply as determined by funders and providers. Certainly it’s not about debating the merits of one service provider over another and it’s not about robbing Peter to pay Paul.

Millions of Australians are being let down by the current state of affairs in mental health. Individuals, their families and support people, indeed whole communities, are paying a heavy price. There’s no single answer to this problem, no silver bullet to fix it all in an instant.

The recommendations contained within the Commission’s report are significant and detailed, incorporating advice from more than 2,000 submissions and the results of ten months of comprehensive work.

We know that worthwhile, productive reform will take time, and consultation and a collaborative approach between federal and state and territory governments, and NGO and community organisations is essential. But we should not be daunted by this process.

Every day that reform is delayed is another day that we are letting everyday Australians down. People are falling through the cracks, people are being left to a life of unemployment and poverty, and people are dying. We cannot afford to delay any longer. Our priority must be to meet the urgent needs of individuals, their families and support people.

We are not the first to say this. When it comes to mental health programmes and services, we’ve had more than 20 years of national planning, almost a decade of COAG planning and dozens of major inquiries. It’s widely understood that Australia can and must do better when it comes to mental health and suicide prevention.

The second barrier we must overcome is the temptation for individuals and sectional interests to commandeer debate to pursue their own agendas. This issue is bigger than any one group, and it requires a cohesive, integrated response. The Minister for Health, The Hon Sussan Ley MP has identified this, noting: “We cannot continue to place Band-Aids on the mental health system and expect it to heal itself.”

“Solutions” that serve the interests of a small section of service providers without care or consideration for the bigger picture are Band-Aids, and they are no solutions at all. We simply cannot afford to allow the discussion to be hijacked by those who are prepared to put self-interest ahead of the collective good and lose our chance to achieve sustainable, effective change.

Meaningful reform is achievable. The Commission has offered 25 deliberate, integrated recommendations across nine strategic directions that will work together to transform Australia’s mental health system over the next ten years.

A central theme underpinning these recommendations is a move to a model of person-centred care, where the system is designed to fit around the needs of people, not around what service providers have to offer, with funding aligned to outcomes, rather than activity. Far from advocating for a reduction in services we are calling for better services that are, in fact, improving people’s lives.

We are also proposing a regional approach to improve equity of access to services, and to engage and empower communities in identifying priorities and developing local solutions – not having cookie-cutter models imposed on them from afar.

Those of us in the sector have an obligation to show leadership and work constructively together, and with government, to achieve better outcomes for individuals and their families and support people. If we pledge to work constructively and cooperatively to achieve the very best outcomes for those Australians who need our help, then we can final take advantage of the opportunity for meaningful, lasting reform.

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