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Mental health: Are you sick enough?

Since the first announcement of the Royal Victoria for Mental Health last year in Victoria, its limitations have been clear. The Andrews Labor government has decided that this will not be "fault". Chief Commissioner Penny Armitage explained that it was about "looking into the future, not the past."

One of the most striking things about this committee is the government's determination not to explore the past. But how do you make the necessary changes without first understanding what happened in the past?

The committee received 10,000 applications within 19 days in Melbourne. 96 witnesses summoned. They were recipients of psychiatric care, their families, carers, specialists providing mental health services, bureaucrats and hospital administrators.

Those who testified about ill-treatment in the mental health system have described how extremely difficult it is to get help. Many family members talked about relatives who sought help in suicidal thoughts and were turned away to take their lives later.

The general theme was people's frustration that they were not admitted to hospital because they were not "sick enough". People said they were forced to wait and get worse, or watch their family members feel so bad that they were finally accepted.

Mental health specialists talked about the frustration of working in a system where there are very few options to help people. Maybe they can find a bed in the ward, if one is available, maybe two weeks to visit the community, or maybe people can be sent to the GP who can spend just 8 minutes with them.

The Mental Health Act 2014 imposes great restrictions on mental health workers. Basically, he says that if a person is not "sick enough", he cannot be accepted against his will. Of course, it is best to avoid forced parties where possible, but without proper family support, carers are solely responsible for someone who may be in a serious crisis.

Crisis support may range from appropriate in some metropolitan areas to extremely poor or absent in rural and remote areas. Often, family members are at risk while waiting for support.

Most people know someone who has experience with the system, sometimes positive, but mostly negative. Positive experiences are often the work of individual employees. Mental health workers often work tirelessly to make something out of this broken system.

The Commission will publish an initial report in November and final recommendations will be issued in October 2020. Much has been said about other ways of doing things, such as the model used in places like Trieste in Italy or in the Netherlands where dropped-in centers are provided.

These places are moving away from the hospital model of psychiatric care instead of community-supported care. Drop-in centers are designed to promote a social base and a sense of community and belonging.

In Victoria, currently, 1.5 billion dollars is spent on clinical care, but only 99 million dollars is spent on community care. The number of people who have been diverted from mental health services demonstrates the overall inadequacy of funding in all areas.

But for a real solution to the mental health crisis, we need much more than just increasing funding. While more money is needed, for real lasting change and improvement of mental health, we need a total system change.

Bad mental health is not simply a product of genetics or other biological agents. Our social conditions have a great impact on mental health. It is influenced by everything from housing conditions to education, financial stability, adequate nutrition, social connections, a sense of belonging, experiences related to violence, etc.

A profit-oriented society imposes a huge burden on ordinary people. Of course, the scope of the royal commission's investigations is not about these broader but basic issues. Although the committee can reveal some issues, only changing the system and creating a society that will be a priority for people's needs will lead to a significant improvement in mental health and well-being.

By a public mental health worker

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