The lucky (for some) Country
It was with some cynicism that I heard the news that there will be a Productivity Commission Inquiry into mental health media release. Those of us who have worked in this space for several decades will have seen many inquiries into mental health, which failed to follow through with effective reform. Maybe my cynicism is misplaced?
As we all know the Productivity Commission Inquiry into disability in 2011 led to significant reform in the form of the NDIS inquiry report.
So assuming there is a real commitment to improve the mental wellbeing of all Australians let us hope that the mistakes of previous reviews and inquiries are not repeated. There have already been calls from within the sector to innovate including the Mental Health Australia and KPMG call to "invest to save".
Now is the time to re-think mental health services and how they are designed to deliver the best health and social outcomes for our community. The Richmond Report in 1983 set out to close the “asylums”. Unfortunately the Richmond Report wasn’t fully implemented and the community supports needed were not and are not available for people with lived experience of mental illness.
So maybe we should change our focus? Shift the paradigm of mental health services? Maybe we should look within our communities for the solutions? Maybe we should re-think how health and social service funding is used within our communities? Maybe it’s time for all of us to take responsibility?
I was struck by Hugh Mackay’s analysis of Australia’s wellbeing trends despite the growing economy in his book Australia Reimagined where he reports how the loss of social cohesion is linked to increasing rates of anxiety and depression. A similar theme is also subscribed by Jonathon Hari in his book Lost Connections where he links social disconnection with addiction, depression and anxiety.
So maybe it’s time to really look at government policy and really test some of the emerging approaches that appear to enhance wellbeing. Rutger Bregman in his book Utopia for Realists makes a strong case for social reform including a universal wage. The Portuguese Government’s radical drugs policy appears to be working so is this the time for Australia to follow the evidence given the impact of drugs and wellbeing?
Of course there are no simple answers and we fail when governments are seduced into believing there is a silver bullet. Mental wellbeing is complex. There is not a simple cause and effect. To have a real impact we need to address the whole system. A medical paradigm in isolation is not the answer. Viewing mental health in the same health paradigm we view physical illness is a mistake, and we keep on making that mistake.
Fingers crossed the inquiry will embrace a whole of system paradigm? Or should we take the opportunity to "seize the day" and advocate for an authentic whole of system approach?
I would love to hear your thoughts.