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Budget Cuts at the Core of Mental Health Support
1 / 07 / 2016
By Esther Levy-Fenner
Each year, one in five Australians will experience a mental illness. Disorders such as depression, anxiety and substance abuse are key contributors to morbidity, and mental and behavioural disorders are responsible for 13.6% of the nation’s total burden of disease, after only cancer and cardiovascular disease.
The Australian Institute of Health and Welfare states since the last National Survey of Mental Health and Wellbeing in 2007, evidence suggests treatment rates have increased ‘markedly, due primarily to the introduction of government subsidised mental health treatment items to medicare’.
Yet despite the prevalence and impact of mental illness, in 2016 it seems the Federal Government has decided that targeted care for mental illness should now be ‘streamlined’.
Australia’s only national eating disorder foundation, The Butterfly Foundation, is likely to lose funding for its 1800 ED HOPE support line which helps over 1000 people a month. ED HOPE is run by counsellors who are able to provide guidance and referrals for treatment. They understand every person’s experience of an eating disorder is unique, and also provide assistance to family, friends and carers of those living with an eating disorder.
Cuts are also proposed to 1800RESPECT. The service provides online and phone counselling for individuals experiencing domestic and family violence, and sexual assault. Support is offered to those across the gender and age spectrums, and provides both translation and AUSLAN services. With 1 in 4 women experiencing violence by someone close to them, services like 1800RESPECT must not be ignored.
In March, Former Australian of the Year and domestic violence campaigner, Rosie Batty spoke to the ABC about Victoria’s Royal Commission into Family Violence. With the State’s Premier Daniel Andrews promising to implement all the commission’s recommendations, more than 100 organisations called for the Federal Government to fully fund domestic violence services at the 2016 Budget.
Image from 1800Respect.org.au
Despite this, the Federal Government decided, from July 1, callers will not have direct access to experienced trauma counsellors, instead having to go through a triage service – like 000 – who will make a brief judgment as to how they should be directed. One option according to the Canberra Times, is simply to be directed to an information website.
Streamlining these services has many likely negative consequences for those living with mental illness or experiencing violence. Most pertinently, those experiencing violence or abuse, either self- or other-inflicted, could be at risk of losing their lives. Mental illness is not a choice and individuals in such a state must not be turned away due to lack of funding, or triaged through to an inadequate service response for their needs.
Victims of domestic violence may also experience cumulative psychological effects of their abuse. An analysis of Australian Bureau of Statistics data suggests women who experienced gender-based violence ‘reported a higher level of severity and co-morbidity of mental disorders…and higher rates of past suicide attempts’. Perpetrators can similarly experience ongoing mental health issues and suicidal ideation.
Melbourne creative and mental health advocate, Honor Eastly, sees mental health ‘moving out of being a “trendy” political issue.’ To Eastly, the National service headspace, is a key marker of this change. In previous cycles, ‘headspace has been at the forefront of many [election] promises’, said Eastly, and it seems mental health ‘is no longer a hot enough topic, despite the fact that suicide is still the leading cause of death for Australians under 44 [with] over seven Australians [dying] each day by suicide.’
All of these issues and examples point to why we need dedicated support lines and services for their respective clientele experiencing particular illness or abuse. It is virtually impossible for any skilled professional to know the intricacies of every mental illness and be able to advise and refer all callers or patients appropriately, yet this is what the Federal Government envisages.
CEO of Mental Health Australia, Frank Quinlan, has called for a cross-party commitment to key objectives for mental health reform including reducing the suicide rate, improving employment rates for those living with mental illness, and to protect the current investment in mental health without reducing services. Under this, cuts to certain areas of mental health would be redistributed to other areas within the mental health sphere.
And on June 9, Professor Pat McGorry, another former Australian of the Year and leading expert in youth mental health, addressed the National Press Club saying ‘You cannot cap funding and just disperse it around the place without it being based on things that work’. While this applies across the mental health care spectrum, Professor McGorry was specifically referencing the redirection of funding from the Early Psychosis Youth Service run directly by headspace, towards oversight by Primary Health Networks.
From July, Primary Health Networks – local regional processes – will assume all funding from the Federal Health Department to continue or reform these services. While assessment and planning is currently ongoing, the complexities of developing such a wide ranging network of professional and services seem likely to pale in comparison to the intensity and quality offered by already existing services. This problem is exacerbated by the rapid rollout of new services that are unlikely to meet the needs of those currently receiving support through established pathways such as headspace and the Early Psychosis Youth Service.
Image from Networking Health Victoria
The Labor Party has said they will continue funding these services, and both the ALP and The Greens have committed to a reduction in the national suicide rate by 50% in the next 10 years.
On Sunday, it was announced that a re-elected Turnbull government would invest $192 million in mental health, including securing funding for new headspace centres and the Early Psychosis Centre. But there has been little commitment to adopting specific targets, and a Turnbull government will continue to push access to services through PHNs.
Having nowhere to go or seek help is already too common for those living with mental illness. Social stigma of mental ill health is still widespread and whilst it may be diminishing through advocacy and conversation regarding certain illnesses, others are still left well and truly in the dark. This is particularly a concern for those in regional and remote areas, where hotlines such as ED HOPE and 1800 RESPECT may be the only targeted service to which they have access.
The reach of mental illness goes way beyond the individual. Symptoms impact families, friends, schools, workplaces and communities. And the longer a person lives in certain forms of ill health, the more complex treatment can be, while physical, mental or social impacts, worsen.
Increased cuts to welfare recipients accessing pensions such as the Disability Support Pension and Carer Payment will also further strain the budgets and pressure of individuals and families living with mental illness or abuse as a companion. Recipients of the DSP have already been undergoing reassessment for years, which can be particularly hard on those with silent or invisible illnesses.
Despite all the difficulties in asking for, accessing and receiving support and mental health treatment, approximately only 7% of State and Federal health budgets are dedicated to mental health. The Federal Government needs to stand by existing, evidence-based services that are currently helping those in need, and channel funding into further research and service coverage.
Funding should also be put into education and preventative services, following in the footsteps of the Andrews Government recent funding of ‘How far is too far?’, an information and support site for the awareness of eating disorders.
Mental health is a complex arena, but no one is immune to developing mental illness. We need more people speaking out about their lived experiences, more awareness, and ultimately more funding, to reduce stigma and work towards a healthier Australia.
Esther Levy-Fenner is a writer from Melbourne currently based in Berlin, Germany. Esther writes on social and cultural issues, and is an advocate for the rights of those experiencing mental illness.