The Australian
April 06, 2006

The states must pay up to help fix the mental health crisis

FIXING Australia's woefully inadequate and neglected mental health system is not going to be easy by any measure. For decades the mentally ill have languished in a political wilderness as successive federal and state governments engaged in buck-passing and empty rhetoric. In the meantime, the failed policy of deinstitutionalisation has seen the country's prison population explode as homeless, disturbed and sometimes dangerous mentally ill people with nowhere else to turn are swept up by the criminal justice system. Nationally, the number of beds in psychiatric hospitals has declined by 60 per cent since the 1980s as seriously sick people have been ejected in line with the orthodoxy that they will do better in a community which, tragically, often has nothing to offer.

Whichever way you look at it, as The Australian has often pointed out, it's a national shame and needs a solution. John Howard recognised this yesterday when he announced $1.8 billion in new federal funds to back a five-year mental health action plan. As John Howard made plain, the money will be directed towards practical solutions in areas of severe need that fall within the borders of commonwealth responsibility. Importantly, the new funds are aimed at making it easier and more affordable for people suffering a mental illness to seek early help from a psychologist or psychiatrist. They will provide more respite places to give thousands more families a break from the stressful job of looking after a relative suffering a mental illness, set up new programs to help keep young people with a mental illness at school or in the workforce, and others to increase community awareness about the links between drug abuse and psychosis.

The commonwealth plan will be meaningless, however, unless the states also finally bite the bullet on mental health funding. By releasing the details of his spending program ahead of the review of mental health services set up by the Council of Australian Governments earlier this year and due to report back in June, Mr Howard is pressuring the states to deliver both cash and a real strategy to tackle the psychiatric accommodation crisis. They could start by coughing up the $72.5 million they promised in 2004 to match commonwealth spending on a new respite care program for elderly carers. Every state except NSW signed up to the scheme. Two years later, according to Mr Howard, they have come up with only a pitiful $10 million between them.

Welcoming the new national consensus on the need to fix the system at the COAG meeting in February, NSW Premier Morris Iemma observed that "at long last" there was real hope for the mentally ill and their families. Mr Iemma now has the opportunity to put his money where his mouth is. NSW is by repute the worst performer in the country when it comes to caring for the mentally ill. The rot began in earnest following the implementation of the 1983 Richmond report which recommended replacing many beds in psychiatric hospitals with community facilities. The policy failed when governments in effect banked the savings from closures and the new facilities failed to materialise. A Mental Health Council of Australia and Human Rights Commission report published in October last year set out the vast dimensions of the resulting crisis, noting that while total expenditure on mental health makes up only 6.4 per cent of recurrent spending, mental illness accounts for 15 per cent of what the report called the "total health burden". In the two decades following the Richmond report's release, the number of patients in psychiatric institutions fell by more than half from around 15,000 to 6000. The prison population in NSW doubled in the 15 years from 1986 to more than 24,000.