In February 2006 the Council of Australian Governments had identified mental health as an issue of national significance, but one year down the line, nothing much has happened observers regret.
The Victorian mental health system in the state of Victoria remains in a state of perpetual crisis a year after a Government-commissioned report found half of the state's mentally ill did not receive appropriate treatment, The Age, a prominent newspaper reported Saturday last.
The scale of human need — one in five Victorians experiences some degree of mental illness — suffering and economic costs, estimated at $5.4 billion a year in Victoria, makes the lack of a more urgent response almost unfathomable, it said.
Only 67 per cent of mentally ill patients who presented to an emergency department in the three months to July were admitted to a state-funded mental health bed within eight hours, well short of the state's target of 80 per cent. At some of the biggest public hospitals, on-target admission rates were as low as 38 per cent. At the worst-affected hospital, Maroondah, of 483 people who waited a day or longer in emergency last financial year, nearly 100 had symptoms of acute mental illness.
With psychiatric wards at capacity, only acutely ill people have a hope of getting a bed. The demand creates such pressure to free up beds for new emergencies that at some hospitals as many as one in four patients, and an average of 15 per cent overall, are readmitted within 28 days. The numbers who miss out completely are staggering: in any 12-month period about 44 per cent of the 150,000 people severely disabled by mental illness are not treated.
A much larger group, more than 340,000 people with mild to moderate mental illness in any year, also receive no treatment. This makes a mockery of political promises to focus more on preventive health, it is pointed out. Early intervention is critical for avoiding or at least managing lifelong mental health problems, but fewer than 100 beds are available for mentally ill teenagers.
The state has begun to increase mental health funding, with the May budget providing $69 million for 95 new psychiatric beds and early detection of adolescent psychosis. But that was just a drop in the ocean — total health spending is $1.9 billion. It must be acknowledged that the system is a legacy of past times when governments and the community totally underestimated the breadth and depth of the problems of mental illness.
The entire model, which focuses on patients who have reached crisis point, cries out for reform, so that the pressures at the acute end of the system are alleviated by early detection and treatment in adolescence and early adulthood. The savings would far outweigh the admittedly considerable costs of implementation.
While the Government is adopting a five to 10-year strategy of such reform, the current levels of suffering and neglect are intolerable. The director of Orygen youth mental health service, Patrick McGorry, says: "I think state governments really don't know how short of the mark they are when it comes to mental health. It is really the wider community who need to be outraged by these figures."
The Age stresses, "We all need to lend our voices to those of the few tireless advocates of a more enlightened and caring approach. Mental health has edged up the political agenda, but only when the community clamours for reform will governments act on a scale that matches the dimensions of this public health crisis."