Mental health funding “a long way from where it needs to be”

In the wake of the Federal election, mental health experts are concerned that Australia’s major political parties are failing to respond to the seriousness of mental health in this country.

Professor Patrick McGorry AO, Psychiatrist and executive director of Orygen Youth Health, says political allocation of funding in mental health is a long way from where it needs to be.

“Even though their [politicians] rhetoric is supportive to mental health… they haven’t responded to the scale of the problem,” says McGorry.

Currently, mental health funding appears to make up less than four percent of Australia’s total health budget, however according to The Australian Institute of Health and Welfare, Mental health actually represents around 12 percent of the total “burden of disease”.

“We’re probably spending about half as much, in Australia, on mental healthcare as it really needs, so you’re bound to have high suicide rates, you’re bound to have a lot of people on the DSP for mental illness, if you’re not actually treating people effectively,” says McGorry.

Publicly mental health is perceived differently to other serious health conditions and therefore the public tolerates substantially lower funding in this field, says McGorry.

“Look at the NDIS. They managed to get $22 billion a year for 400,000 people [460,000 according to NDIS website]. There are 4 million people with mental illness and something like $6 billion is spent on them,” says McGorry. “But [the NDIS] manage to get the sympathy vote because you parade out these people with cerebral palsy into parliament house and everyone feels sorry for them, so it’s a visible thing… but you bring out people with mental illness and it’s a bigger leap. People think ‘oh yes it’s a sad story, but shouldn’t they have been a bit stronger’.”

Melbourne-based student and mental health advocate, Lucy Williams, says that while there is now strong encouragement for people to reach out for assistance, there are limited resources.

“There is a lot of focus on ‘getting help’ and often that health isn’t there. There are certainly issues with stigma, shame, ill-informed health professionals and other barriers that play into these difficulties but ultimately there is lack of services to deal with enormous numbers of people seeking assistance,” says Williams.

To respond to this, a program called Australians for Mental Health has been launched, with the hope of achieving “fundamental, systemic reform”.

“We’ve got to build the army… and organize the movement. I’m not blaming the politicians… but they won’t feel compelled to act, or empowered to act, unless the public make it very clear what they want,” says McGorry.

Following its election victory, the Liberal party, as part of its Youth Mental Health and Suicide Prevention (YMHSP) plan, committed to an additional $503.1 million investment to mental health, with an emphasis on high risk groups.

In particular, this involves consolidating the existing Headspace network and opening new centres. Headspace is designed for young people aged 12-25, among whom suicide is the highest leading cause of death, according to Lifeline.

McGorry, board member of Headspace, says the organisation plays an important role in providing an “acceptable entry point for people into the system which wasn’t there before”, facilitating “greatly improved access” and “greatly improved satisfaction in young people and their families”.

However, Headspace is a primary care service and is not designed to cater to more complex mental health conditions. For a large number of people this leaves them with nowhere else to go.

“Forty percent of the young people who come into Headspace don’t improve and that’s because they’ve got more complex enduring conditions. They’re currently stuck in Headspace with a limited model and they can’t get into the state funded specialist services because they’re so poorly funded and they turn away three out of four people,” says McGorry.

Rebecca Johansen, host of 3CR’s mental health radio show Brainwaves, agrees that the current system isn’t catering to the full range of people’s needs.

“From the people I’ve spoken to over the years, not a lot of people go through Headspace. A lot go through psychologists and private clinics because Headspace is good, but they can’t treat serious mental conditions,” says Johansen.

However, going private can be prohibitive for many people and means many don’t get the support they need.

“If you don’t have the privilege of being supported by family members it can be difficult.… A lot of the time the people that I speak to really struggle getting help because they don’t have the money to finance sessions,” says Johansen.

A serious investment is required into, what Professor McGorry terms, the “missing middle”.

“I think this missing middle approach is the big thing both for young people and adult, because you’ve got a primary care system which deals with mild problems and you’ve got a state system that is broken and in the middle you’ve got large numbers of people, you know hundreds of thousands of people, who need expert care and they’re just not getting it. That’s the top priority and we’ve been developing models in that, both in youth and adult,” says McGorry.

Had the Labor party been successful, it was going to fund a program called Headspace Plus. This program would have addressed some of this more complex “missing middle”, says McGorry.

The other major area of funding outlined in the YMHSP plan was the investment of $53.7 million “to strengthen Indigenous youth suicide prevention”.

The rate of suicide among Aboriginal and Torres Straight Islanders is more than double the national average and five times higher between the ages of 15-24, according to Lifeline.

Scott Morrison’s government outlined in the plan an intention to create “culturally appropriate, trauma-informed care as well as services that recognise the value of community, cultural artistic traditions and protective social factors”.

A hanging from a classroom in Ngukurr, an aboriginal community in Arnhem Land, NT. Photo Freya Fajgman.

But there is concern that the government’s decision to invest in mental health must be considered as a bigger picture within the landscape of Indigenous rights and wellbeing. Currently this appears mis-aligned with other policy decisions.

“I don’t think these deaths occur in a vacuum and I think more funding is necessary beyond health, and in other policy areas, in obvious addition to consultation with the Indigenous community themselves. Frankly, when a government is seeking to assist a community while simultaneously acting against them in other policy areas it feels deeply hypocritical,” says Williams.

The rejection, in 2018, of the Uluru Statement of the Heart, is an example of this contradictory behaviour.

Dr Andrew Peters, a descendant of the Wurundjeri and Yorta Yorta people, believes the issue extends far beyond directing funds towards this particular issue, to a lack of broader understanding and respect for cultural and historic factors at play.

“We have a clear, fundamental lack of understanding and knowledge of our Aboriginal culture and history, and as a result have a severe lack of appreciation for it,” says Peters.

Peters, lecturer in Indigenous studies and tourism at Swinburne University, doesn’t feel that the Liberal Party broadly represent the best interest of Indigenous Australians effected by mental health challenges, though he admits that “I certainly feel that they think they do”.

“History has shown us, in my view, that pushing funding at problems of culture don’t produce the desired results, unless we have the right people making the right decisions.… Until this happens, we keep handing the reins to people who don’t understand, and make the same neo-colonial assumptions about Aboriginal people and culture and lead to the same outcomes we’ve seen for over 50 years,” says Peters.

We have to be empowering First Nations to make decisions and changes on their own behalf, says Australian historian, Dr Julie Kimber.

“The importance of the provision of power, respect and recognition can’t be underestimated. Asking First Nations what they think/need is central to this (hopefully healing) process,” says Kimber.

Both Coalition and Opposition Health Ministers were unavailable to provide comment.

If you or anyone you know needs help or support, you can call Lifeline on 13 11 14.