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His suicide was tragic, made all the more so because it was preventable, we believe, but for the inadequacy of the public mental health system.  [X] died just two weeks after his first suicide attempt, eight days after his discharge from the Canberra Hospital psychiatric unit, two days after  being refused admission to the psychiatric [unit] following a second suicide attempt and within hours of contact with the mental health crisis team.  On the day of his death, [X] had contact with the mental health system no less than three times. [Suicide occurred early in 2004] (Anonymous, Australian Capital Territory, submission #288 – recorded in ‘Stories of Injustice and Despair’ in Not for Service, 2005)

Beyond belief

Australia’s mental health services urgently need all Australia's Governments to commit to a process of well-resourced reform, according to a mental health specialist who will be one of the speakers at the Mental Health and Human Dignity Conference in Adelaide later this week.

Professor Ian Hickie, Executive Director of the Brain and Mind Institute, and Professor of Psychiatry, at Sydney University, says that Australia’s mental health services reflect disorganised and dislocated health and welfare systems, which lack commitment to the provision of quality mental health care particularly in the public sector.

“When any of us seeks mental health care we run the serious risk that our basic needs will be ignored, trivialised or neglected,” he said.

In writing the foreword to the Not For Service research released late last year, he called for major actions, support for innovation on mental health care and enhanced whole-of-government approaches - for example, in solving accommodation or employment issues.  More than committed individuals were needed for genuine and rapid progress.

“Given the likelihood that every family in Australia will be affected by mental health problems at some stage, it can no longer remain an isolated or marginal concern.”

Professor Hickie said that in the early 1990’s, Australia had occupied an unique position internationally, as the result of a decade of clinical innovations in community-based mental health care.

“Community, political and professional enthusiasm for a major overhaul of mental health was evident. National leadership was clear and major policies and plans were set in place. Innovation was supported directly by national funding and key movements to promote better community understanding were born. It can be argued that a great deal was achieved between 1993 and 1998.

“Services were largely moved out of asylums and the needs and rights of those with mental illness and their families were formally recognised. The development of a broad population-based agenda for both prevention and treatment of common mental disorders was supported. National standards for specialist services were constructed. The national mental health survey detailed the extent of mental disorders in the community. The patterns of health care usage described provided the evidence-base for other major reforms in community education, preventative psychiatry and general practice reform.”

Since the late 1990s, however, there have been “persistent and disturbing reports of fundamental service failures”, he wrote.  “These reflect disorganised and dislocated health and welfare systems and a lack of commitment to the provision of quality mental health care, particularly in the public sector. Community-based care depends not only on organised health services but coordination of welfare, housing, police, justice and emergency care services. Multiple state-based inquiries have been conducted by health departments, coroners, auditor-generals, parliamentary committees and non-government organisations.”

In calling for governments-led reform, he said that what was not needed was “continued blaming of those who use the services, those professionals who provide the services or those independent bodies who report on them. Continuation of this culture of blame will only worsen the workforce crisis in public sector mental health services.”

Professor Hickie will present a paper, The state of play with mental illness in Australia, at the one-day conference at the Adelaide Convention Centre which marks the beginning of the programme of events to mark the 14th World Day of the Sick which is designed to draw attention to the plight of millions of sick people across the world and give support to their carers.  The day is held annually, on the feast of Our Lady of Lourdes. 

Anne Deveson, author and member of the NSW Mental Health Review Tribunal; Garry McDonald, actor and beyondblue board member; Fr Peter Comensoli, Diocese of Wollongong Chancellor; Prue McEvoy, chairwoman of the Child Protection Council of the Archdiocese of Adelaide and Monsignor David Cappo, Archdiocese of Adelaide Vicar General, will also address the conference.  The first speaker will be Cardinal Javier Lozana Barragan, president of the Pontifical Council for the Pastoral Assistance to Health Care Workers.

A pastoral workshop for people interested in health care services, on Friday, will give participants an opportunity to share and reflect on their experiences.  A set of recommendations for Church and Government action is expected.

This year’s theme, mental health and human dignity, will be addressed by Pope Benedict XVI in his message to be read by the Papal Envoy, Cardinal Javier Lozana Barragan, during a Mass in St Francis Xavier Cathedral on Saturday.  More than 1000 people including bishops from across the Asia-Pacific region, clergy from around Australia and the public are expected to attend.

The host for the Adelaide activities, the Archbishop of Adelaide, the Most Rev. Philip Wilson, said the activities were designed to make inroads into what has become one of the biggest health problems in Australia, and world.

“These activities will challenge us to engage with and experience the needs of those who are most vulnerable in our society and is an opportunity for those who work in the health care sector to reflect on their work and how it can be seen as a continuation of the healing mission of Jesus,” he said.

On Friday, the Council of Australian Governments (COAG) meets.  On its agenda is Australia’s mental health crisis.

The dream of closing psychiatric institutions and moving towards community based care has turned into a nightmare. Community care is under resourced and integrated services are lacking. Too many people are denied treatment and slip through the gaps.   (ARAFMI Tasmania , Tasmania , Submission #245 – recorded in ‘Stories of Injustice and Despair’ in Not for Service, 2005)

World Day of the Sick (including a link to the Pope’s message): http://www.worlddayofthesick.org.au/site/page.cfm

Not for Service: http://www.mhca.org.au/notforservice/index.html


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