SSWAHS = SWSLHN + SLHN and the Medicare Locals - 35

The danger in the following media statement possibly best demonstrates the potential for nepotism in the fund-holding arrangements planned for the Medicare Locals to be rolled out by the Federal Government from July 1st 2011.

We already have a situation when the Southern Highlands Division of General Practice can determine who should (or should not) be recruited to provide mental health services to those patients with a diagnosed mental illness. This has already been demonstrated with the Better Outcomes for Mental Health initiative (BOMHi) and the Mental Health Nurse Incentive Program (MHNIP) which were both funded by Medicare Australia. The funds for the BOMHi program are held by the Division and are used to pay for patients of GPs to have sessions with private psychologists. Those psychologists selected for the program will tell you that invariably the money "ran out" before the end of the grant period.

In the case of the MHNIP, the Division endeavoured to divert patients from the GP practices to the RN they had recruited to run the program from their Division's rooms. Eventually, they had to cease that activity due to the fact that their RN did not gain the necessary accreditation to be able to carry out the functions required. From all reports, the Division then did nothing to support the implementation and extension of the program among their GP members and so, a useful and viable mental health service that could have been of benefit to many, has withered away.

Govt pledges $59m for mental health

15th April 2011

By: Australian Doctor

The new wave of Medicare Locals will be given $59 million to provide care packages to support people with severe mental illness.

The money will allow the new organisations being rolled out from July this year to buy bundles of services to support people in the community and keep them out of hospital.

Clinical services will include therapy from psychologists and social workers who, according to the Federal Government, will be "encouraged to link patients to other services in the community for people with severe illness".

The move follows national consultation on the funding plan.

The government claimed there was strong support from GPs, who will be central to "supporting and finding referral pathways" to other services.

The first 15 Medicare Locals will be eligible to access the funding.

AGPN CEO David Butt said the timing of the pledge was "a glimpse into the government’s vision" for primary mental health services.

"It’s encouraging to have these flexible care packages available to the first 15 Medicare Locals and indicative of a government that wants to see a fundamental change in the delivery of mental health services, in which there is a shift towards the primary healthcare sector rather than a reliance upon the acute sector.

"These packages will also enable interventions at different levels of intensity.

Depending on the patient’s needs, the care may need to step up’ to more intensive interventions, such as specialist care with a psychiatrist or psychologist, or the care may step down’ to services like community connectedness programs." Paul Smith

SWS Health Coalition in action - this how it can (should) be done!

Meet Your Neighbour - Bankstown GP Division

The Mental Health Coordinating Council’s initiative to encourage organisations to meet, learn more about each other and find ways to work better together. Come and learn more about Bankstown GP Division and how NGOs and GP Divisions can work together.

When:

Monday, 18 April 2011

Duration:

2.00pm to 4.30pm

Where:

Bankstown GP Division, Bankstown Civic Tower, Level 7, 66-72 Rickard Rd, Bankstown

Contact:

For more information Rod West 02 9555 8388 ext 110 rod@mhcc.org.au

RSVP for catering purposes: Carrie Stone 02 9555 8388 ext 0 meetyourneighbour@mhcc.org.au

More about the Meet Your Neighbour - Bankstown GP Division

SSWAHS = SWSLHN and mental health in the Southern Highlands - 12

Mental health: a continuing history of neglect

April 12, 2011 – 11:01 pm, by Melissa Sweet

Chronic disease prevention is gathering increasing steam, at a national and international level. So why is mental health not part of this agenda? Richard Eckersley argues that the importance of mental health continues to be neglected, and not only in Australia.

Richard Eckersley writes:

Physical and mental health are closely interwoven and deeply interdependent, the result of a complex interaction of biological, psychological and social factors. Medicine, however, continues to focus on the biological and neglect the psychosocial, despite the growing recognition of its importance to population health.

This artificial separation has been a formidable obstacle to understanding mental health; as a consequence, its importance to the wellbeing of individuals, communities and societies has been underestimated. Both developing and developed countries show this bias towards physical health, and especially mortality.

Developing countries tend to give priority in health to infectious disease and reproductive and child health; developed countries prioritise non-communicable diseases that cause early death (such as cancer and heart disease) over those that cause years lived with disability (such as mental disorders).

The relative neglect of mental health is seen in the growing efforts in disease prevention and health promotion, both internationally and nationally. These include: the WHO global strategy for the prevention and control of non-communicable diseases; the Oxford Health Alliance; the Trust for America’s Health (in a report, ‘Prevention for a healthier America’); and the Australian National Preventative Health Taskforce (in its strategy paper, ‘Australia: the healthiest country by 2020’).

All imply a wide health perspective, but focus on the physical diseases that contribute most to premature mortality, notably cardiovascular diseases, cancer, chronic respiratory diseases and diabetes. These diseases account for about 60% of all deaths globally.

The efforts will culminate in the United Nations’ first high-level meeting of the General Assembly on chronic non-communicable diseases in September 2011, billed in Lancet as ‘a once in a generation opportunity to put chronic diseases on the global and national agendas’. These diseases have been ‘surprisingly neglected elements of the global-health agenda’. Mental illnesses, while also chronic, non-communicable diseases, are not part of this agenda, but are acknowledged to be ‘similarly ignored’.

About 450 million people worldwide are suffering mental illness; only a small minority receives treatment. Worldwide, community-based studies have estimated the lifetime prevalence of mental disorders at 12%-49%, and 12-month prevalence at 8%-29%. In 2004, neuropsychiatric conditions as a group accounted globally for 13.1% of the total burden of disease, measured as both death and disability (disability-adjusted life years or DALYs), the second largest contributor after infectious and parasitic diseases. They account for about a third of the burden of disability, making them the most important source. Depressive disorders are the third largest specific cause of death and disability (and the largest in high- and middle-income countries), and are projected to become the leading cause by 2030. Yet the median allocation of the total health budget of nations to mental health is only 3.8%.

The ‘global burden of disease’ study has played a seminal part in exposing the importance of mental health to overall population health. However, its estimates of the burden of mental illness may still understate its significance for several reasons:

• mental disorders might affect many more people than the burden of disease estimates suggest, especially in middle- and low-income countries.
• the estimates do not include the growing burden of suicide and self-inflicted injuries, which is counted under injuries.
• the burden of mental disorders (in sharp contrast to chronic, physical diseases) falls mostly on those under 60, so increasing the personal, social and economic costs.
• mental disorders increase the risk of physical diseases and injuries, with one estimate that depressive disorders raise the risk of all-cause mortality by about 70%, and affect adherence to treatment for other diseases.

Aspects of this picture of mental health have been contested. For example, it has been argued that the high prevalence of mental disorders reflects changed DSM diagnostic criteria and the medicalisation of normal human emotions. This is part of a wider concern about the medicalising of life itself, and ‘disease mongering’: the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments, including the medicalisation of health problems previously regarded as ‘troublesome inconveniences’.

While medicalisation is undoubtedly occurring in the sense that new treatments are being developed for new conditions, this does not negate the core argument here that mental illness has been neglected relative to physical illness. The charge of ‘disease mongering’ applies to both physical and mental health, and is directed particularly at treatment provision. Indeed, it has been specifically associated with a policy priority of market-based economic development at the expense of more equitable social policies, such as public-health strategies. (Ironically, the medicalisation of mental health has contributed to greater awareness of its importance.)

Questions of definition, diagnosis and treatment aside, the disability associated with mental health problems is generally higher than for other chronic conditions. Even mild cases cause levels of impairment equivalent to those associated with clinically significant, chronic physical disorders.

People attribute higher disability to mental disorders than to commonly occurring physical disorders, especially with respect to their ‘social and personal role functioning’ (with ‘productive role functioning’, the disability of mental and physical disorders is comparable). A comparison of the disability of 15 disease stages found severe depression ranked third behind quadriplegia and being in the final year of a terminal illness, and ahead of stroke and acute myocardial infarction.

• This is an edited extract from:
Eckersley R. 2011. The science and politics of population health: giving health a greater role in public policy. WebmedCentral PUBLIC HEALTH 2011; 2(3):WMC001697.

• Richard Eckersley is a director of Australia21 Ltd, an independent, non-profit research company and a visiting fellow at the Australian National University.

One Comment

1. carolinestorm@iinet.net.au
   Posted April 13, 2011 at 11:33 pm

   “… focus is on the physical diseases that contribute most to premature mortality.”
   So, are the seriously mentally ill to be allowed slowly to become more deprived of treatment and hospital care? Already only a third receive these when in crisis, according to the MHCA. Are they still to be deprived of psychotherapy, essential to to their well-being; are they further to be deprived of social therapies, and more and more descend into homelessnness and complete social exclusion? Why does focussing on the diseases which contribute most to premature mortality exclude the seriously mentally who, in Australia, have a life expectancy of some 55 years.
   More and more suicides will occur as the seriously mentally ill realise, finally, the greatest stigma of all: this is too hard; we’ll just leave it and see what happens.
   What can be done? How can we help? Many people care, but how do we become a force for change?
   But even hope lessens as Richard Eckersley cites the WHO as excluding mental illness from its global strategy of prevention and control of non-communicable diseases.
   The Australian Budget, 2011, is to be made public tomorrow…and little hope there.

SSWAHS = SWSLHN and mental health in the Southern Highlands - 11

‘ECG for the mind’ wins invention award

Professor Jayashri Kulkarni and Brian Lithgow receiving the New Inventors Invention of the Year Award. Photo supplied courtesy of ABC New Inventors

16th Nov 2010

Chris Brooker all articles by this author

VIEWERS of ABC TV’s popular New Inventors program have voted a ground-breaking diagnostic technique for detecting mental and neurological illness as this year’s winner.

The EVestG, is a new diagnostic technique that measures the patterns of electrical activity in the brain’s vestibular (balance) system, fast-tracking the detection of illness.

It was voted the winner by both the program’s expert panel and the People’s Choice.

The developer, Brian Lithgow, is a senior lecturer in electrical and computer systems engineering at Monash University, with research interests in neurological, neurodegenerative and vestibular diagnostics. He saw “the diagnostic potential of measuring and comparing different patterns of electrovestibular activity because the brain’s vestibular system is closelyconnected to the regions of the brain that relate to emotions and behaviour”.

By measuring the patterns of electrical activity in the brain’s vestibular system against distinct response patterns found in depression, schizophrenia and other central nervous system disorders, he was able to develop electrovestibulography – or EVestG for short.

“[It’s] sort of like an ECG for the mind,” he said.

An artist’s impression of the final format of the technology when it goes to market in two to three years.

Working with Professor Jayashri Kulkarni (PhD) and other researchers from Monash University’s Alfred Psychiatry Research Centre, they further tested volunteers to find distinct biomarkers to distinguish the different conditions from each other, and from regular electrovestibular activity. The product measures electrical activity in the brain before and after stimulation of the vestibular system through use of sensors placed within each ear canal, while the patient sits in a tilt chair.

Measurement takes 30 minutes, and has been found to be painless, and comfortable for patients. Tests to date have found it to be 90% accurate.

Diseases for which it has been tested also include Parkinson’s disease, Meniere’s disease, positional vertigo and Asperger’s, said Dr Roger Edwards, CEO of Neural Diagnostics, the company developing the product.

He said it had secured federal funding to continue the research, which had reached proof-of-concept trials. “If current results continue and statistical robustness holds up we are confident we have something quite transformational for medical practice.”

Comments:

ondocfarm

17th Nov 2010
5:15pm

Psychiatry has been 95% labeling based on groups of symptoms and signs which everyone can interpret differently.
Now psychiatry enters the objective testing era of scientific medicine and not before time!
Well done!

NEXT step objective measurement of "Pain, ache, sore and hurt":- for which there are no shared lexical elements and only guess work at play!

If a doctor has not personally suffered them, they have no real idea of what the patients in chronic pain are talking about!

Clement

17th Nov 2010
7:32pm

Good way to go! Please to hear more breakthrough in improvement in diagnosis using technology. I hope government will continue to invest more money for research in creating new ideas and technologies.

Sniper

18th Nov 2010
10:13am

At last Psychiatry can move away from the Consensus paradigm and into the Enlightenment of science. Gone are the days of "Protest Psychosis" and " I can't say what the diagnosis really is, whether it is late onset Schizophrenia of Dementia, but there is certainly something wrong". Now the murkiness is dissipating and we can all work together.

SSWAHS = SWSLHN and mental health in the Southern Highlands - 8

What will it cost to move beyond “60 years of band-aids” for mental health?

April 6, 2011 – 1:41 am, by Melissa Sweet

Continuing the theme of recent Croakey posts on mental heath and the federal budget, John Mendoza argues that it’s well past time we moved past band-aid solutions. Instead, Australia needs to spend about $9-10 billion per annum on mental health services, or around 12% of current health care spending, he says.

John Mendoza writes:

In the past week there has been another round of calls from a variety of groups for major investments in mental health. These have in part being timed to influence the framing of the May Federal Budget. These have included calls for an extra $5 billion over five years from the Australian Medical Association and others.

A Blueprint to Transform Mental Health Services was also released and called for an investment of $3.5 billion over the same period. This came from an “independent mental health reform group” lead by Professors Pat McGorry and Ian Hickie and Monsignor David Cappo.

The latter are all members of the expert advisory group announced by Minister for Mental Health and Ageing, Mark Butler and the Prime Minister late in 2010 after a year of mounting calls for action on mental health. Minister Butler chairs both this group and the National Advisory Council on Mental Health.

Federal Labor knows that it must deliver a substantial boost to mental health funding come the May Budget after the chorus of criticism in 2010 and its oft stated pledges to make “mental health a second term priority”.

The “Blueprint” document released by McGorry and co has been largely positively received. Some criticisms – including the Croakey piece from Alan Rosen – from within the mental health sector have focused on the government’s piecemeal and confused approach to consultation (not the fault of the Blueprint authors I would have thought).

Rosen’s criticisms point to the omission of some evidence-based services including assertive community treatment teams, better forensic mental health care for the vast numbers of people with mental illness in corrections systems and the inadequate size of the investment.

Criticisms were also voiced by consumers at the ACOSS conference last week on the failure to advocate for the re-establishment of a national consumer representative body following defunding of the body by the Department of Health and Ageing in 2008.

In their defense, McGorry and colleagues say the 30 initiatives in the Blueprint are areas where the Commonwealth can act with or without state government cooperation and with a large dose of realism given the “tight Budget” rhetoric of the Government. They also believe that if the Commonwealth can get its act together, as it did under the leadership of Howard in 2006, then a commensurate investment could be forthcoming from the states and territories.

This would be a massive $7 billion over five years building on the $5 billion flowing from the 2006 COAG action plan.

The Australian public are entitled I would have thought for someone to tell them what amount of new funding is required to fix the seemingly contiguous crisis in mental health services.

Firstly, it’s important to understand no presently serving politician in either Federal or state governments created the shambles we now see in mental health in Australia. But all those First Ministers (i.e. PM, Premiers and Chief Ministers) and the respective state and territory Ministers have an opportunity to join a very small group of politicians who have taken bold and effective action in this area. To succeed, they will need to respect history in mental health reform efforts.

Australia has had a long history of responding to crises within mental health services. Indeed Prime Minister Menzies was forced to act following widespread and continuous public concern about the state of services in 1954. Somewhat reluctantly, Menzies and his Health Minister, Earle Page, appointed a Melbourne psychiatrist Allan Stoller, to review mental health care. Stoller was “shocked” by what he found – inhuman conditions, overcrowding, little or no therapeutic care, abuse and neglect. Menzies responded with a capital grants program to modernize the facilities. While some work was done, within six years, again public concerns forced the NSW Government to set up a Royal Commission into mental health services.

This cycle of crisis, review, government action and then within a decade another full cycle, has now characterized mental health reform in this country for close to 60 years.

There are a number of reasons for this, but a consistent one has been a failure by both state and Federal governments to ever undertake a systematic assessment of service requirements. No one has even taken up the challenge to fully scope requirements: the range of services based on available evidence, the scale of services to meet demands and then commit the funds to the development.

The consequence is that we have had 60 years of bandaids applied to mental health. We see dozens of excellent programs or small scale programs all round the country that have never been scaled up or linked with a spectrum of care to support recovery in the community.

The implementation of the policy of deinstitutionalisation from the 1960s to the so-called community based services of today, represents arguably the greatest failure of public policy in the post-war period.

The calls in the last week for major new investments in mental health, while they will improve the access to services and quality of some services, they will fall far short of providing people with mental illness with equality of care when compared with those experiencing physical health problems.

Both Pat McGorry and colleagues and the AMA have presented pragmatic proposals – proposals that take account of the political context. That’s fair enough, but it runs the risk that again we have another band aid – albeit maybe a full size plaster!

The question remains how much do we need to invest in mental health to end this terrible history of neglect? The Senate in 2006 argued that between 9-12% of health expenditure was required. The Mental Health Council of Australia has long argued for the 12% figure. Rosen is his Croakey article refers to 13% of health spending up from the current 7%. All of these are simply sound estimates.

Two health economists, Darrell Doessel and Ruth Williams have attempted to take a more analytical approach and they find that current resources and structures meet about 35% of the mental health needs of the community. They also find that significant resources go to those without a mental health need – in essence a wasteful use of scarce resources. Using their analysis and assuming one could significantly reduce the resources going to ‘non-needs’ as they define them, the funding required to provide for the mental health needs of the Australian community is in the order of $9-10 billion per annum. Maybe coincidentally, this is close to the 12% of current health care spending that many have called for and is almost double the current combined spending of all Australian governments.

This is an enormous challenge and one which will only be solved through a more strategic and sustained 10-15 year reform agenda. We also need to put in place as a first step, an appropriately empowered Commonwealth statutory authority to drive the restructuring of services and report to the Australian community on the progress and the outcomes from this investment.

• John Mendoza is Director, ConNetica , and Adjunct Professor, Health Science, University of the Sunshine Coast, and Adjunct Associate Professor, Medicine, University of Sydney

Comments

1. Shooba
   Posted April 6, 2011 at 9:24 am

   I don’t want to hijack the conversation here, because I think “what portion of the budget should go to health” is a conversation worth having… but… surely bowel cancer screening is priority one? Croakey’s fixation on mental health and physician assistants recently has kind of duopolised discussion at the expense of topics like the FOB test and its glaring need for a full national program

2. Shooba
   Posted April 6, 2011 at 10:08 am

   Awww shucks Croakey… you DO listen!

3. Melissa Sweet
   Posted April 6, 2011 at 10:10 am

   Shooba, I was just about to comment and say: your wish is my command (well, at least sometimes).
   But you got in first…

SSWAHS = SWSLHN and mental health in the Southern Highlands - 7

Explaining the new blueprint to transform mental health services

April 4, 2011 – 12:09 pm, by Melissa Sweet

This post is responding to a recent Croakey article, “So you’re wondering what’s happening with mental health at a federal level?”, by Professor Alan Rosen.

Sebastian Rosenberg and Professor Ian Hickie write:

Alan Rosen’s recent article raises some important points and the need to clarify a couple of issues.

He is certainly right that the recently released Blueprint to Transform Mental Health Services in Australia is not the whole solution to fixing mental health. There are evidence-based services apart from those specified that would indeed merit ongoing investment, including assertive community treatment, mobile acute teams etc. However, as services largely provided by states and territories currently, they were simply out of scope in terms of providing a budget submission to the Commonwealth.

The crazed determination to deliver a budget surplus is now forcing Prime Minister Gillard and her Ministers to seriously lower expectations about the budget, wet the ground for the traditional horror-budget which typifies the first year of most administrations. As reported in countless parliamentary and other inquiries, mental health is so far behind the game that it cannot afford to be caught up in this.

The Independent Mental Health Reform Group which prepared the Blueprint was an informal group which got together for a few weeks specifically to keep some blowtorch of pressure on the Federal Government to make good its promise to make mental health a second term agenda priority.

The Group was comprised of the usual suspects in some ways, people with a long track record of cajoling governments into greater action and investment in mental health. The Blueprint merely reflects the views of the Group, which never intended and was never resourced to undertake broad public consultation.

Unlike the impression given by Professor Rosen, the Group was not constructed, mandated or authorised by Minister Butler or anybody else and had no relationship to any existing committee or body. Minister Butler did not commission the Blueprint. The presence of Monsignor David Cappo meant that the group did have an excellent insight into how best to shape and present its advice to government however there were others on the group with an excellent understanding of the federal budget process.

The Blueprint is one of no doubt myriad budget submissions made by different professional and community groups, attempting to influence the direction and scale of Federal Budget decisions. It is certainly true that key health professional groups have already made formal budget submissions, such as the Australian Medical Association and the Australian Psychological Society. It is less clear the extent to which community sector organisations have made submissions.

Professor Rosen is correct in that the Blueprint really focuses on clearly listing actions the Federal Government is able to take autonomously, without reference to state or territory jurisdictions. This inherently limits the scope of the Blueprint but fits with the imperative to provide urgent advice about intelligent Federal spending options in the upcoming Budget.

As far as we know, there has been no commitment to establish a second National CoAG Action Plan on Mental Health, to replace the first plan which lapses this year. If a second plan is proposed, then the Blueprint lists a series of vital areas of state responsibility where their contribution to a new CoAG plan should be directed. These areas do not include continued mindless investment in new acute hospital beds.

The Blueprint also clearly states the need to ensure that mental health’s share of the promised new 1300 sub-acute beds is not allowed to create new hospital-based warehouses to catch the overflow from psychiatric wards.

Professor Rosen is correct in asserting that CoAG-type intergovernmental agreements seem to fail more often than succeed. However, should a second CoAG Action Plan be agreed, we would strongly suggest the establishment of a clear set of Commonwealth incentives and sanctions to persuade the states and territories to purposively fund the areas identified as priorities in the Blueprint, particular the type of evidence-based community services described by Professor Rosen, or other community-based innovative services. This type of approach to incentives was actually successful in the First National Mental Health Plan and really not attempted since.

While this type of coordinated action is important for holistic reform investment in mental health in the future, the Blueprint represents the vital contribution the Commonwealth can make right now. So let’s get on with it.

• Sebastian Rosenberg and Professor Hickie are from the Brain and Mind Research Institute at the University of Sydney

Comments

1. skipjack
   Posted April 4, 2011 at 4:39 pm

   The closing of institutions has let to people being thrown onto the street and at the mercy of for profit providers of accommodation where there are no nurses or mental care at all. They call them hostels but they are really flea pits. And this was meant to be an improvement on institutional care.
   I have a mother in a mental health ward, and I just want to say that we need to bring back the word ‘insane’ to differentiate the truly sick, who need full time care, from those with temporary mental illnesses and illnesses not requiring full time care.
   Bring back care for the insane, and stop throwing them onto the street – or into the hands of private sector jocks who rip them off in flea infested hostels.

2. Tully Rosen
   Posted April 5, 2011 at 11:26 am

   Yes let’s!

   Those pushing for mental health reform may not always agree point-to-point, but we’re harmonising like never before on the basic problem – we need billions invested in the mental health system – and it must be community-integrated and ongoing!

3. Tully Rosen
   Posted April 5, 2011 at 11:27 am

   And congratulations by the way for taking the initiative.

SSWAHS = SWSLHN and mental health in the Southern Highlands - 5

Self-harm videos a growing online trend

22nd Feb 2011

Kirrilly Burton all articles by this author

2 comments

HUNDREDS of graphic YouTube videos promoting self-harm as normal and glamorous are prompting growing concern among mental health experts.

The dangerous trend was revealed when Canadian researchers analysed 100 of the most popular 2009 YouTube videos containing non-suicidal self-harm themes.

Self-harm viral videos were commonly uploaded by young women, they found.

Those selected for study were viewed more than two million times by a general audience and were rated favourably, suggesting they may be identified with, and accepted by, viewers, the researchers said.

Despite the videos predominantly being factual or educational, over one-half expressed a "hopeless" or "melancholic" message, and few actively discouraged self-harm acts.

The majority depicted graphic images of self-harm such as photographs or live enactments typically showing cutting of arms or wrists of moderate severity, the researchers said.

Other depictions included self-embedding, burning and, less frequently, hitting, biting, skin pricking and wound interference.

"The depiction of self-harm on YouTube represents an alarming new trend among youth and young adults and a significant issue for researchers and mental health workers," the authors said.

"These videos may foster communities of youth in which self-harm is encouraged, normalised and sensationalised, which may reinforce and exacerbate the risk for self-harm."

For example, the use of text, photography and music may make self-harm more attractive and glamorise self-harm for youth who self-injure, they said.

The authors believed awareness of self-harm videos was vital and encouraged doctors working with youth who self-harm to enquire about their Internet use.

Pediatrics 2011; 127:e552-e557

Tags: self-harm, YouTube, cutting, mental health

Comments:

drjgelb

22nd Feb 2011
8:08pm

After recently receiving a spam email touting hundreds of links to "gruesome" sites of murder, corpses, autopsy specimens & numerous other horrors, this new You Tube trend hardly surprises. The disturbed, the alienated, the attention seekers & those who love to shock have all found a niche online. Of course they have to share cyberspace with the bigots, the white supremacists, the kooks & the predators. The Internet is an equal opportunity entity!!!

JD
23rd Feb 2011
2:36pm

A few years ago I came across a website with live footage of a young man shooting himself in the head. The site included disturbing images of suicides and attempted suicides. I reported it to various authorities. I don't know what happened because my emails were never acknowledged and I had no wish to visit the site again.
As an aside - You Tube banned a video narrated by Paul McCartney about the horrors of factory farming yet self-harm videos are allowed flourish(!). Something is very wrong here.

SSWAHS = SWSLHN and mental health in the Southern Highlands - 2

Mental health findings prompt call for Govt action

15th Mar 2011

Mark O’Brien all articles by this author

1 comment

NEW research revealing anxiety and depressive disorders as the leading cause of disability in young Australians has fuelled fresh calls for the Federal Government to deliver on its election pledge to make mental health a priority.

The study, published in the MJA, found disability prevalence rates increased by almost 50% from younger adolescence to young adulthood, with mental health identified as the most common factor.

According to the research, carried out by the University of Queensland, eating disorders made a “significant contribution” to mental disability in young women, while ADHD and autism caused more disability in younger adolescents than in older adolescents and young adults.

In response, the Mental Health Council of Australia has urged the Federal Government to fulfil its election commitment to “make mental health a major second term agenda”.

Council spokesperson Simon Tatz requested the government ensure appropriate attention be given to the disability-related effects of mental illness during discussions about a future no-fault disability care and support scheme.

“This latest research highlighting the impact of anxiety and depression in young people adds to the weight of evidence that government action is urgently needed to address the chronic under-funding in mental health services,” he said.

MJA 2011; 194:232-35

Comments:

asdcarer

29th Mar 2011
8:52am

The article does not mention that the number of children diagnosed with autism doubled since 2003 so the burden due to autism has increased substantially.
Nor does it mention that many in the health sector do not regard autism as a mental illness so is some places no treatment is offered and few services are available to address the burden of disease due to autism.
The Government should compare the burden of disease to the proportions of its spending and to the training effort in the health sector.

SSWAHS = SWSLHN + SLHN and mental health services in the Southern Highlands - 1

So you’re wondering what’s happening with mental health at a federal level?

April 1, 2011 – 6:08 pm, by Melissa Sweet

Note to readers: Please see author’s correction at bottom of the post.

At this time of year, there is always a lot of pre-budget jockeying. This year there is great expectation and also great apprehension about what the Federal Budget might hold for mental health.

Mental health advocate Professor Alan Rosen has been watching recent developments closely, and his analysis follows below (at the bottom of the post you will find an invitation to provide feedback to the Federal Government’s mental health advisors).

Professor Alan Rosen writes:

"The bookies seem to know what every election result will be. So why did we bother having Saturday’s NSW election? Couldn’t we just extrapolate from where the odds stand at midnight on election day?

"Then we could spend the Electoral Commission’s budget on our run-down mental health services. Maybe, on past disappointing form, we should not even wager our lunch on having much of a boost for mental health on budget night, despite Julia Gillard’s insistence that it is a 2^nd term priority. (Perhaps it should be called budget-smugglers’ night, to celebrate that dark art of sleight of the contents of taxpayers’ pockets?).

"But the longer the Government keeps postponing the crying need to reform Mental Health Services, the more that the growing affected community will keep raising the stakes. It is a dead-cert that it won’t just go away as an issue if ignored. In an international survey last year, foremost among all countries, the Australian public placed mental health services as one of its top 3 concerns, alongside the global financial crisis and climate change.

"Sensing the disquiet and impatience of the burgeoning Australian mental health constituency, Mark Butler, the federal Minister for Mental Health, recently put out an update letter about his deliberations with his expert committee, which said next to nothing about what they might be proposing in their advice to him, about which they were all sworn to secrecy.

"It may be that he is engaged in a delicate negotiating process to squeeze something substantial out of the tightening federal budget, but for what purpose?

"It is a bad move not to take this seasoned network into your confidence on your way. It is laudable that early in his tenure, Mr Butler did a whistle-stop tour around Australia, running brief group consultations in urban and regional centres.

"But that was before he installed his expert panel to develop these proposals. The fact is that he does not seem to have foreshadowed any wider consultation process, on any actual proposals. He has commissioned a separate kitchen committee, derived partially from his expert group, to develop a “blueprint”, published not as a draft out there for consultation, but as time is of the essence in the budget build up process, as a finished submission to be taken urgently to Treasury, hopefully for funding*.

"There is a lot to commend in its striving for a transformative approach, and its shopping list of “evidence based best buys” for different age groups. So far so good.

"However, many of its proposed structures for adults though possibly promising, are substantially untested. We need time to produce some evidence that they work, because we don’t want to repeat the blatant wastage caused under Howard’s CoAG initiatives like Better Access, perpetuated by Nicola Roxon.

"Even more concerning is that the real firmly “evidence-based best buys” for adults with severe and persistent mental illnesses, especially with forensic, drug and alcohol comorbidities, have been left out. These include (acute) 7 day and night mobile crisis and continuity of care teams, assertive community treatment (rehabilitation) teams, and 24 hour residential respite households as an alternative to many admissions.

"The Blueprint group can’t back this trifecta, we are told, because their riding instructions stated that these are viewed federally to be state responsibilities, particularly since the states wouldn’t relinquish that 30% share of GST. This could almost be construed as a washing of hands in retaliation.

"At whose expense? These proven service delivery systems will become orphans, and many severely disabled clientele will continue to be clinically abandoned.

"Most states squandered the resources allocated for them long ago, by diverting them to medical and surgical procedures, and by failing to complete the disgorging of stand-alone institutions, preventing the shift of some of their resources to community care. With few exceptions, this has resulted in stunted development or dismemberment of such evidence-based mobile community-based mental health services, and often the retraction of their rumps back onto hospital sites.

"A little under $2 billion over 5 years is required to provide firmly tied funding to the states to restore these key teams, including rural adaptations of them Australia-wide, and to monitor, this time around, their outcomes and fidelity to evidence via a national mental health commission.

"Either that or they will need a contractual arrangement with the states to meet them half way if they want the money, not just via another CoAG agreement, which is bound to be broken.

"The AMA is completely right that we need at least a commitment of $5 billion over 4 years, partly to make up for lost time and lost people. Most in the mental health community would differ with some of the AMA priorities for this funding, however. By my rough reckoning we need at least $5.5 billion over 5 years to kick-start a national mental health program with reasonable expectations of success.

"Professors McGorry and Hickie are overly modest in their estimates of what is required to deliver an effective transformation of the mental health service system, saying they will settle for around $3.5 billion over 5 years.

"This government also needs to commit resources to:

• a widely consultative process, arriving at a rough consensus inside a few months, about priorities and a framework for a national mental health reform program for the next 10 years, integrating public, non-government and private, including fee-for-service sectors. By now, this national mental health taskforce should be out there seeking a broad consensus for this national mental health program. It must overarch the superficial revamps of the national mental health policy, plan and standards, all devoid of practical goals and timelines, which have been diluted and downgraded in political compromises between state and federal bureaucracies. Gillard & Butler & co, need to hunt the money, but they also should not waste this build-up of expectation, momentum and opportunity for really consultation leading to transformative reform. If we are really into social inclusion, we need to practice what we preach.

• a National Mental Health Commission, as also proposed in “the Blueprint” like New Zealand, Canada, and now Western Australia, and soon NSW too, which promotes the resourcing and monitors the implementation of the reform agenda at arm’s length from government, while constantly consulting with all stakeholder groups, and reporting on an all-of-government scorecard basis to the Prime Minister, Health ministers and parliament.(Link to Rosen et al 2010, International Mental Health Commission review).

• Regional integrative budget-holding commissioning authorities ( as established in New Zealand, the UK and now on a statewide basis in WA, and soon to be formed in NSW ) ensuring integration of all mental health and support services, by being able to purchase flexibly from all funding streams, public, non-government communally managed, and private health organizations if need be (Link to AHHA paper on Funding Methodologies 2008).

• We need government to find new resources to bring the mental health proportion of health budget, currently sinking from 8% to 6%, up to 13%, closer to the proportion of health burden due to mental ill-health, as most other developed countries have done.

"As clinicians, we need to follow the form and play the system squarely in the interests of our clientele and their families, in every age group and phase of care.

"And we don’t need yet another policy shoot-out between the parties to entertain the political punters.

"We need a consistent tripartisan commitment to integrated collaborative mental health care for the whole Australian community.

"So while we can’t yet bet safely on the fate of mental health in the federal budget, either way, let’s hope it romps home.

"*However, the authors have placed it in the public domain, and Professor Ian Hickie of the Brain & Mind Research Institute, Sydney, has now undertaken to invite and collate comments by email. Contact: Ian Hickie

TAMHSS (Transforming Australia’s Mental Health Service System, tamhssATyahoo.com.au) will take and list comments publically on its blog from Monday 4^th April 2011.

• Professor Alan Rosen holds positions with the Brain & Mind Research Institute, University of Sydney, and School of Public Health, University of Wollongong.

2 Comments

1. achimova1
   Posted April 1, 2011 at 7:35 pm

   Interesting that the RANZCP was not asked to field a delegate.

2. Melissa Sweet
   Posted April 1, 2011 at 9:59 pm

   Correction from Alan Rosen:

   Note: It has been drawn to my attention that there is an error of fact
   in the 2nd part of the 7th paragraph. It should read:

   “The fact is that he does not seem to have foreshadowed any wider consultation process, on any actual proposals. Meanwhile, a separate little committee, derived partially from the minister’s expert group, and including his designated deputy, Monsignor David Cappo, convened to develop a “blueprint”.

SSWAHS = SWSLHN + SLHN and the Medicare Locals - 18

Socrates says: "Almost one year on! This is still relevant, still do-able, and still to be done!"

Gillard can fix shattered mental health services

25th Jun 2010

Professor Patrick McGorry all articles by this author

2 comments

PRIME Minister Julia Gillard starts her new job faced with many challenges, but also with many opportunities. One of those opportunities is a unique set of circumstances that can enable profound change in mental health.

On Friday 18 June, then Prime Minister Kevin Rudd explicitly stated that mental health and aged care were the two next priority actions in healthcare. Less than a week later, at the exact time he was due to meet with the mental health sector to discuss ways of achieving progress in mental health, he was voted out of office.

But although mental health’s face time with the PM was gazumped by the ALP leadership battle, there is still momentum gathering for action on mental health reform.

Firstly, it helps that Julia Gillard is one of the politicians who “gets it” about mental health – something I observed first hand on her visits to the Orygen youth mental health service for which I work. But more importantly there are now political dynamics in play that are enablers of meaningful reform in mental health. Those enabling dynamics are greater sectoral unity, increased community support and “cut-through” to the national debate.

On the day that Julia Gillard replaced Kevin Rudd, leaders of the mental health sector presented the Government she will now lead with an agreed, common position. More than 60 signatories – virtually every key mental health body, including representatives of doctors, psychiatrists, psychologists, mental health nurses and social workers – made it clear to Government as to what needs to happen next.

Julia Gillard’s Government now has an unprecedented opportunity to work with a unified sector and can seize this opportunity by orienting policy around ending unequal access to quality care between mental and physical health.

Also on the same day that Julia Gillard was voted in to become Australia’s first female Prime Minister, her office was presented with a petition from 80,000 Australians asking her to take urgent action on mental health. These signatories were mobilised in just 48 hours and are an early expression of growing community awareness and concern about mental health.

GetUp!, which organised the petition, also published an Auspoll last month showing 83% of Australians would support a $500m p.a. package of investment to begin implementing the 12 mental health recommendations of the National Health and Hospitals Reform Commission.

Such an investment could be made immediately as a confidence-building measure by Government before working to develop the national reform program in mental health that is one of the core recommendations of the sector to Government.

That wider package of reform will involve a lot more money – probably a doubling of mental health’s share of the health budget (now 6%) to bring it close to or equal to its share of the health burden (13 per cent). This involves several billion dollars a year of public money and can only be accomplished with public support.

However, the national conversation on mental health as reflected in recent media coverage reflects a growing understanding that services are severely underfunded, that this is discriminatory and detrimental to Australian families and that sustained action to address these failings is needed.
Whisper it softly, but we may be close to a tipping point on mental health reform.

Comments:

Shikha

25th Jun 2010
5:49pm

The stumbling block, rate limiting step and bottle-neck to any such health reforms would certainly be the health minister, overlooked in this article. It was this very government and this cabinet and Madam Roxon's department that have deemed only qualified psychologists dish out mental health care under the Mental Health Plan guidelines. They have undermined and side-lined other workers in this area already carrying a large burden and caring for a great many patients, risking fragmentation of care and more burden on the already over-stretched system. Rearranging the proverbial deck chairs won't save this sinking ship under this governance. When the Minister won't listen to legitimate arguments about the flaws in the direction of health reform what difference does it make who's at the top and who she reports to? Nurse prescribing, nurse practitioners setting up next to GP's, midwife indemnity fiasco, superclinics, diabetes budget-holding and so on. Damage already done.

sickofpoliticians

5th Jul 2010
1:40pm

Its just such a pity that it takes a change in Prime Minister to forge us toward a so-called 'tipping point'. Realistically, whoever is in government, the system will still stink until someone with some sort of experience of the mental health system, reforms it. The first question we need to answer is 'How can the mental health system sustain itself when the need clearly outweighs what is given?'.

My name was one of the 80,000 handed to parliament. I did so because I have seen the system at work, I have experienced the frustration, the never-ending cycle because patients are over medicated and dependent. I have experienced the heart ache of carers who struggle to get their person a diagnosis, just so they will be eligible for the hundreds of badly planned out "programs" that the goverment has presented us with.

Spend some money on therapy, spend some money on more staff and start paying the people that work the hardest the money they need to be able to sustain the jobs they face on a daily basis. Spend some more money on research, and put Australia in the running to be best practice for mental health. Spend money to ensure that those who are caring for someone living with a mental illness feels supported. Spend some money to ensure that the person living with the illness can obtain a diagnosis quickly, and without mistake. Train the clinicians, careworkers and stop spening money without doing your research - if you have a spare $1.1 billion dollars lying around somehwere, before you spend the money, ask youself... Where do people need to money the most?

We are a nation of over-weight people already, lets not add increased rates of mental illness to that as well. Stop spending money on opening up Australia to other nations, fix the situation we have here, first! People are taking their own lives everyday, and we are all sitting here arguing about what to do next. Get is right Julia, get it done!