There can be few areas of public policy more fundamental to the wellbeing of the citizenry than healthcare. Tenets of good public policy include effectiveness and efficiency, and when it comes to healthcare, the difference between decent and poor policy is measured in needless deaths. So it should be of widespread concern, but not surprise, that a comprehensive independent report has found Australia’s mental health system is fundamentally failing, with billions of taxpayers’ dollars being poorly spent in an uncoordinated system that focuses too much on emergency, hospital-based responses rather than on prevention and support.
The 2014 Review of Mental Health Programmes and Services was done by the National Mental Health Commission, following terms of reference from the federal government. That its findings, which were reached after extensive research and examining more than 2000 submissions from organisations and individuals, are highly negative is not a surprise because a number of investigations into the system in recent years have reached similar conclusions.
Getting mental health policy right is hugely important, and the various national plans and policies of the past decade or more clearly leave lamentable room for improvement. As many as 4 million Australians have a mental health problem in any given year. But research shows that only a third of the population has access to treatment and that almost two-thirds of those with mental ill-health get no treatment.
Total spending on the mental healthcare system by all levels of government each year is about $14billion. And then there is the multibillion-dollar cost of lost productivity. Almost 90 per cent of the federal government’s share of $9.6billion goes on demand-driven spending including income support, rather than prevention.
The report says: “Many people do not receive the support they need and governments get poor returns.”
The report makes 25 recommendations, and sets out a 10-year plan for reform, the first steps of which can be taken immediately. The Age believes action is evidently long overdue, and that this report not only demonstrates the duty of our lawmakers to act, but gives them the perfect opportunity to do so. Further, the report says vast improvements, which, again, save lives, can be readily and rapidly engineered without increasing spending. An important element of this, particularly for young people, is incorporating and leveraging digital technology into the mental health system.
There is scope for radical improvement across the system, the report finds, and it says there is particularly acute need in indigenous and rural and remote communities.
There have been sufficient studies, enough reports. The government has had this latest report since late last year. Health Minister Sussan Ley said when the report was finally released this week, having been partially leaked a day earlier to the ABC amid frustration at the delay, that the government had been examining the examination for months. And she said that the government would now establish further committee-based examinations so that its response might be properly considered.
It would be shameful to bureaucratically bungle or shackle this situation. In their letter to the minister upon delivering the report, the commission’s chairman Professor Allan Fels and chief executive David Butt say: “There is an extraordinarily high degree of consensus as to the directions needed to create a system which promotes good mental health and wellbeing and a contributing life. Practical steps now need to be taken.”
This newspaper agrees.