Towards a 21st century system of mental health care - an Australian approach

Some of these measures, such as the scaling up of headspace from the current 30 centres nationally to a total of 90 centres, and the first stage of a national rollout of the EPPIC model of care, are groundbreaking and will deliver better health, social and economic outcomes as well as radically changing the culture and design of Australia’s mental health system. Hard research evidence shows these programs will greatly reduce the numbers of young people ending up on disability support.

However, care needs to be taken to ensure that this new funding is focused where it has optimal prospects for improving lives and achieving significant changes in culture and practice. Much is riding on the successful rollout of the EPPIC model, so it is imperative that these new services have full fidelity to the EPPIC model, and that they are led by enthusiastic, capable change agents and are given mandates appropriate to the level of funding they are allocated. This will require specific governance, as was achieved with the national rollout of headspace. The result there has been rapid scaling up of a model with benefit to tens of thousands of Australians, and this long-overdue creation of a nationwide stream of mental health care specifically designed for young people will benefit many thousands more.

More broadly, to close the huge gap in access and quality compared with physical health care, the government’s investment package must be the first instalment of a 10-year program of scaling up of capacity in Australia’s system of mental health care. The ball is now in the court of the state and territory governments. The federal government’s package is targeted at strengthening primary and community-based care - action from the premiers is still required if acute and hospital-based care are also to get the urgent attention they need. A credible national reform and investment plan that adds state and territory investment to the federal mental health package is now crucial to successful reform.

Australia’s mental health professionals should embrace the opportunity to become change agents by engaging positively and creatively with these new measures. We should be ready to partner with government and the community in sharing the responsibility and accountability for achieving real outcomes. Success for this round of funding will help secure future investment, and as the fiscal climate improves, to comprehensively fix Australia’s mental health system. As a sector, we need to unite and work cohesively to achieve the changes our chosen field so desperately needs.

At the community level, we can all challenge and defeat stigma whenever we encounter it. It’s vital that every person who has been touched by mental ill-health share these experiences in an open and unashamed way - that’s the first step. We can all talk openly about both mental health and mental ill-health with family members, friends and colleagues. Consider doing a mental health first aid course to increase your skills and confidence about responding to the mental health needs of the people around you. We can also donate: philanthropists large and small can support mental health research, innovation and advocacy. And all of us who have been let down by our current system can let people know why they insist on a 21st century approach to mental health for all age groups by writing to the newspapers, ringing talkback radio, arranging to meet their local MP, or forming a local action group. We need to make our message heard - Australians deserve a better deal, and the community has a critical role to play in continuing to express strong support for mental health reform as one of our most pressing national priorities.

Finally, it is heartening to see how our community’s concerns and our increasing expectation that we should have access to the same quality of care for our minds as we do for our bodies has now been reflected by government action. Mental health reform now has champions across the Australian parliament, with politicians of all parties and, notably, all the leaders and the key independents committed to tackling this long neglected but vitally important challenge. Australians applaud this tri-partisan political leadership, which puts mental health above politics. I sense we have passed the tipping point; our calls for action have been heard, and our need for a new approach to mental health is now matched by our determination and the first steps towards a new capacity to deliver it. If all of us play our parts in this reform agenda, together we have every chance of creating the 21st century system of care that we so desperately need.