Mental health not getting a fair bite of the health dollar

Search the Federal Minister of Health’s website for the words mental health and not much will come up. In fact in the list of 15 portfolio responsibilities mental health does not rate a mention. In the SANE Australia’s Mental health Report released a couple of weeks ago, it was noted that since January this year the Federal Minister for Health Tony Abbott had spoken in the house 400 times on health issues and mentioned mental health just once.

Maybe he is unaware that statistics show that one in five Australians will suffer from some form of mental health problem each year. And while some would argue that the buck stops with the Minister, in our political system, state governments have a considerable leadership role to play both in establishing and funding services, developing important local strategies to deal with local needs and building a care network that responds to the real issues.

So is that it? Is it the Government’s fault that South Australia has the inglorious reputation of having some of the poorest mental health services in the nation? A state, according to SANE where far too many sufferers end up in the prison system instead of receiving treatment, where the 19th century institution of Glenside houses - and sometimes doesn’t - people with extreme or episodic mental illness, and where funding for more progressive programs of community accommodation and community support services has been reduced to 0.4 per cent and 1.9 per cent of the health budget respectively. A state that is home to Baxter Immigration Detention Centre, where mental health issues continue to be deeply embedded in the complex and enduring national issue of how we treat refugees.

We can rail that governments must commit more money to mental health and we should continue to rail. And we can hope, to use a catch cry fresh from the election campaign that in their effort to build a “fair and decent society” the Federal Government will show national co-ordinated leadership and a real intent to rectify the gaping hole in funding for care of the mentally ill.

But on the ground, out there where the care is being provided, the research is being done and the services are being developed and delivered, what can be done to make a difference? As a mental health nurse, a doctor, a social worker, is it enough to grin and bear it, to plod on within the system and hope for the best?

The fact is the crisis in mental health care will benefit from a serious boost in funding but that alone won’t fix the problem. There needs to be permission from the highest levels of Government for mental health professionals to lead within. Leadership is about adequate funding as much as organisational reform. 

That permission would provide the platform for mental health professionals to reflect on what they do and to what extent it is in the best interests of their patients and staff. Adequate funding would allow and support growth in service provision, ensuring the development of flexible, responsive services for vulnerable patients and their families. With adequate funding mental health professionals could begin to differentiate between leadership and management and assess whether they have real opportunities, the right and even an obligation to challenge what is happening in their jurisdiction.

In taking more responsibility as leaders, mental health professionals could begin to establish a framework for excellence in the workplace that appropriately questions conventional wisdom, supports innovation, values and integrates the expertise of non-government agencies and other key services providers. 

Any government that embraces new ways of effective leadership in mental health will grow to understand the dynamics of that leadership and the role it plays in improving services to mentally ill people. If leadership within the industry is not encouraged and adequately funded then progress is an illusion. With whole hearted support for both the mentally ill and the workers who care for them we can build a vibrant, trusting, and dynamic environment to support the kind of care that can make a difference in the lives of some of the most disenfranchised members of society.