SSWAHS - Dr Victor Storm - The Federal Government's not the only one to ignore a significant need!

Socrates found this piece of spin by Dr Victor Storm, the SSWAHS Executive member who seems more interested in protecting his poor performing senior staff members who fail in their duty towards the consumers of their mental health services. Instead of decrying the lower Federal budget commitment to mental health, perhaps Dr Storm should be less committed to building his SSWAHS empire's infrastructure (his Concord Centre for Mental Health Services) and for machines that go "ping" he should use some of funds his Area Health Service gets from the State and Federal governments on those integrated specialist community-based mental health services that he suggests will be championed by the likes of Morris Iemma.

Socrates finds it somewhat prophetic of Drs Storm and O'Connor seemed to pre-empt the choice of the current NSW Premier in the recent selection of Morris Iemma to one of the key positions in the NSW Local Health Networks.

Budget has ignored a significant health need

Nick O'Connor and Victor Storm

May 14, 2010

Have Kevin Rudd and Nicola Roxon forgotten about mental health? You are certainly left with this impression after the budget and health reform announcements.

There is nothing in the budget for mental health. Little came out of the Council of Australian Governments negotiations except for some important but hardly central enhancements for youth mental health and expanded access to psychological services for people suffering anxiety and other high-prevalence disorders.

Mental health represents more than 10 per cent of community morbidity, yet it received only 2 per cent of the health reform funding increases.

The Senate select committee inquiry into mental health called for its budget to be 9 to 12 per cent of the health budget by 2012. This now looks impossible.

Even more concerning is the split of community services from acute hospital services and the dismantling of area health services. This could break up the integrated mental health services it has taken decades to build. That would be a catastrophe for mental health, which at federal and state levels has seen opportunities for real improvement slip away.

The COAG meeting asked for a report on mental health next year, seemingly because at the last minute the Commonwealth realised its schema for the health system - which included acute hospitals, primary and community care and a sub-acute sector - failed to acknowledge the pivotal importance of specialist community mental health services.

These clinicians care for a large number of people living with serious mental illnesses such as schizophrenia. Some work in inpatient and community settings, some do intensive follow-up and treat people in their homes and community centres.

Despite growing need in most states, and NSW in particular, these services have not been improved for decades. They are the backbone that supports young people who need continuing care and they are at breaking point.

How could this omission happen? How could some of the most marginalised in our society be ignored? Every politician in our parliaments - state or federal - knows someone who needs specialist mental healthcare. Too many don't get it.

Several steps are necessary if Australia's mental health services are not to become a disaster - a champion, a plan and three enabling conditions.

We need a champion, much like Morris Iemma was on this issue when dealing with the Commonwealth as premier in 2006.

We need agreement on the mental health priorities. Nationally, it is a complex jigsaw of human services - disability, employment, housing, GPs, hospitals, services for children, youth and older people, prevention - all have a role.

Central to it are integrated specialist community mental health services. To date, there have been four national mental health plans and still we have no coherent national plan for delivering specialist mental healthcare.

The general principles and core requirements are generally understood by consumers, carers and clinicians. We need to increase community understanding of mental health problems, and do more prevention. We need more services for younger and older Australians and recovery programs to provide intensive treatment in the community, with secure housing and employment to sustain that recovery.

The states and territories need to articulate these priorities in a 10-year plan, and implement it. And we need to manage three barriers to such a plan.

Specialist mental healthcare is best delivered when integrated, including local community services, hospitals and specialty programs. These can be aligned with the new local hospital networks but need co-ordination at state level and to be administered regionally - where tertiary services cover a cluster of local networks. There appears to be sufficient wriggle room in the COAG communique to allow for this sort of arrangement.

Mental health funding needs to be quarantined to stop its being siphoned off and the shortage of mental health nurses and doctors needs to be reversed.

Mental health is dressed up ready to go to the big health ball. She is just waiting for a strong and courageous partner.

Dr Nick O'Connor and Associate Professor Victor Storm are Sydney psychiatrists, representing the NSW branch of the Royal Australian and New Zealand College of Psychiatrists.