Mental Health reform

Michaelmas Cay

1:30 pm - 1:50 pm

Stream 1: Social determinants of health

Who’s agenda for change?

Mental health service delivery has been the target of reform for as long as I can remember, and I have been working and studying in the field of mental health for 32 years.

Across the western world, health departments have struggled with the desire and impetus for change but have ultimately failed to impact upon the way people who have mental ill-health, access and experience health services. All too often a mental health diagnosis leads to inadequate treatment and monitoring of other health domains [1].

Without doubt there has been significant progression over the previous decades in the treatments available for people who experience mental ill-health. System reform has seen treatment move from institutional models of care to community based models, new and improved medication is available reducing the requirement for prolonged hospital based treatment, and the dialogue surrounding mental health has moved away from whispering behind closed doors to people openly discussing their own diagnoses.

However the overall health outcomes for people experiencing mental illness remain amongst the poorest in the population, with the general life expectancy being 10 and 32 years less than the general population [2].

The challenge of transformation within the context of the public health service is to choose who’s needs are being addressed; all too often these are highlighted as being the needs of the service system and the providers within it [3].

The mental health reform agenda which the Primary Health Networks have been given carriage of, will not be able to deliver upon the mandate of reform unless we start to think differently, seek alternate solutions, and lead the debate from a different perspective.

[1] Keeping Mind and Body Together, Improving the physical health and life expectancy of people with serious mental illness, RANZCP 2015

[2] Keeping Mind and Body Together, Improving the physical health and life expectancy of people with serious mental illness, RANZCP 2015

[3] Reform, revolution and disruption in mental health care: a consumer’s perspective; Jackie Crowe, National Mental health Commission 2017

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