Other Issues

Addressing Stigma in the Community

Stigma is a big problem in this community – people fear what they don’t understand. I’ve experienced a change in body language of a specialist when they ask you what medications you are on. I’ve been told by a solicitor not to tell anyone that – sometimes our integrity is questioned just because we have a mental illness – we might be unwell but that doesn’t mean we’re stupid.

Consumer, New South Wales, Broken Hill Forum #24, Not for Service, p. 250

It is Time for Service to end the continuing negative attitudes towards people that experience mental illness and their families.

Raising community awareness of mental health issues must be a key priority for future action on mental health. Research conducted by Curtin University for the WA Healthway Foundation, VicHealth and Queensland Health all point to low levels of mental health literacy in the Australian community.

People have a poor understanding of mental illnesses and what they can do individually and together to reduce the likelihood and impact of mental illness. This lack of community understanding also leaves those that experience mental illness isolated and fearful.

To date, there has not been a broad-based national community education campaign on mental health. Relatively small-scale state or locally based programs have been developed in Victoria and most recently in Western Australia and far North Queensland.

Community campaigns can achieve a number of beneficial outcomes including:

• reducing stigmatisation and discrimination experienced by people with mental illnesses and their families;
• promoting good mental health and preventing the development of mental illness through emphasising strategies to help people stay mentally healthy;
• more early intervention for people with mental illnesses by raising everyone’s awareness of the symptoms and where to go for help; and
• promoting appropriate treatment for mental illnesses by raising awareness of various treatment options and how well they work.

Australia needs a national comprehensive mental health campaign - Mentally Healthy Oz – to promote simple strategies to enable people to take control of and improve their mental health.

Expenditure Required: $10m pa

A New Approach to Accountability

It is Time for Service for the community at large to know the truth about the quality of Australia’s mental health system.

A new approach to accountability is required, at all levels – strategic, program, service and individual.

It is strongly recommended that a national accountability mechanism be adopted to report on the implementation of this new approach to mental health in Australia.

The current National Mental Health Plan is largely devoid of specific goals and targets and has failed to deliver good governance of mental health in Australia.

As the Council of Australian Governments’ (COAG) Human Capital report acknowledges, the issue of mental health is broader than health and includes a range of other areas such as employment, education, housing, community services amongst others¹⁴.

These services are provided by federal, state and local governments, as well as community and private sector providers. Any accountability mechanism adopted must have the scope to investigate the effectiveness of Australia’s mental health system across all these levels.

Independence and transparency are critical to robust accountability. The National Reform Council outlined by COAG at its February meeting may be the most suitable body, at least in the short term, to ensure all governments adhere to agreements and to apply sanctions if necessary. We also note the announcement of the Intergovernmental Action Plans (IAPs) and the Individual Implementation Plans (IIPs). We concur with the COAG Human Capital report which emphasises the requirement for clear outcomes to be articulated, monitored and reported routinely.

Consistent with the recognition that improvements in mental health will be dependent on partnerships beyond governments, Time for Service advocates that a taskforce be established, comprising governments, consumers, carers, representatives of the general community and the private sector. The taskforce would work in partnership to oversee accountability in the mental health system for at least the next three years. The goal of the taskforce would provide advice to the National Reform Council on the development and progress of the IAPs. Similar taskforces should be established to assist each state and territory set and meet their obligations under their own IIP.

10-Year Targets for Mental Health

Time for Service recommends adopting the following ten-year targets for mental health outcomes:

1. 60% of those with mental disorders be provided with care in any 12-month period (currently this figure is 38%);
2. national disability costs attributable to mental disorders be reduced from 27% to 20%;
3. national disability costs among 15-34 year olds attributable to mental disorders be reduced from 60% to 40%;
4. participation in work among those on disability support pensions for psychological reasons be increased from 29% to 60%; and
5. national suicide rates be reduced from 11.8 to 8 per 100,000 persons.

These targets are realistic and achievable provided that governments invest in a community based model of mental health care emphasising prevention and early intervention activities now.

As the Senate Inquiry Report states, a further key element of national accountability must be the regular (annual) and systematic monitoring and reporting of the experiences of those receiving care.

The Mental Health Council of Australia would be the most appropriate body to implement this element of a new accountability framework.