It’s time to dig deep for crucial mental health reforms
The recommendations of the Royal Commission into Victoria’s Mental Health System, released this week, push for changes that are nothing short of transformational. They touch on every aspect of what is widely recognised as a broken system in permanent crisis mode.
But as the commission understood, the final report “carries the weight of unrealised hopes and expectations accumulated over decades”. Since the early 1990s, at least 12 Commonwealth or Victorian government “strategic plans” have been formulated for mental health. Each was surely done with good intentions and an expectation of future improvement.
Royal Commission chair Penny Armytage releases the report with the Premier, Daniel Andrews.Credit:Eddie Jim
And yet here we stand, once again, with a blueprint for change freshly published, along with many promises to turn it into a reality.
The report certainly has the right foundations. It understands the need to make services more localised and patient focused, it looks to harness the knowledge and experience of those with “lived experience” of a mental illness, it highlights the need to redistribute resources to ensure disadvantaged populations and vulnerable groups are properly targeted, and, in a long overdue measure, it calls for a reduction in the use of seclusion and restraint in mental health.
And while it maps out in extensive detail many of the changes required, it also calls on the state government to reach out to Victorians “as active partners in designing and delivering services, rather than passive recipients of services designed by someone else”. It may seem an obvious inclusion, but in the area of mental health, where accessing services can be a complex and confusing process, it surely must be an essential aspect of rebuilding the system from the ground up.
Premier Daniel Andrews made the right noises on the day of the report’s launch. He has committed to implementing all 65 recommendations, which he said would “serve as our blueprint for the biggest social reform in a generation”. But he also acknowledged that funding and implementing such large-scale reform will take more than one budget or a year or two of focused action.
In the commission’s words: “Transformation will take strong leadership, courage and collaborative effort from all partners involved in the delivery of reform over many years.” No one would be under any illusion about how difficult that will be. It will require bipartisanship in Victoria, not exactly rife these days, but also cooperation with the Commonwealth.
That is already being tested with the commission’s suggestion of introducing a levy or tax to help fund the changes. While Mr Andrews appears open to the idea (although he accepts that it may be challenging to introduce while the state recovers from the pandemic), Opposition Leader Michael O’Brien is adamant he would not support the idea, instead calling for the extra funding to come from general revenue.
The Age strongly backed the increase in funding when it was first floated in the interim report in late 2019. We acknowledge that reforms of this size might be politically difficult, particularly in the current economic environment. But there is no doubt money, and substantial money, will be required bankroll the infrastructure and human resources needed to get these reforms underway. As always, systems decline in the absence of adequate funding, and fixing them requires fresh commitments of money. This is something that, as a wealthy country, we must make provision for.
When Mr Andrews first floated the idea of a royal commission on the state’s mental health system in November 2018, the world was a very different place. But, if anything, events since then have underscored how essential it is to provide high-quality care for those with a mental illness. The task ahead is enormous. Let the work begin.
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