What does this mental health inquiry need to do?

OPINION As someone who has worked in the Mental Health System in Australia for nearly four decades, I really wonder whether this inquiry will be any different from the last, or the one before that, or any of the dozens before that…  I have held senior positions in hospital-based mental health services and within the community sector and with each new role, I have been full of hope that I can make a lasting difference to the experience of people trying to access the service. Each time, despite my best efforts, I have found changing hearts and minds in the large professional culture of health really challenging.

So why do we need another inquiry when the last one, the Productivity Commission Inquiry into Mental Health painted a picture of a fundamentally flawed system and outlined a compelling economic argument for supporting the wellbeing of the nation? Why do we need another report when the past three decades have been flooded with reviews, reports, plans, investigations and roadmaps – all articulating the same issues plaguing our mental health system? It is no secret – the nation has long been facing a mental health emergency and the system is not fit for purpose. This was the case before the pandemic started, and as we enter our third year the mental wellbeing of the nation really is suffering.

So, whilst I commend the state government for wanting to understand what the specific issues are for Queensland, I would encourage the inquiry to consider why haven’t we seen meaningful change after so much review of the mental health system?

People accessing services have cited the stigma they face both in the community and within the system when seeking help. Throughout my career I have heard many stories from individuals and families frustrated by their attempts to access help and feeling the only alternative is to turn up to the Emergency Department once in crisis. We know there is immense pressure on the hospital system and that Emergency Departments are not conducive environments for people in mental distress, but despite this, they remain one of the key entry points to the system. People also describe service experiences which hold low expectations of their recovery, which leads to feelings of hopelessness and powerlessness.

The current system is designed to respond to illness and crisis, when what we really need is a system which swings into action early in distress, preventing a crisis. We need a whole of government approach which actively supports wellbeing within the community. The system needs reimagining.

We need warm entry points within the community that are welcoming, where you can seek advice and/or self-help initiatives, access individual coaching to help re-establish your life beyond illness, as well as access to health professionals if you need them. Entry points that do not require proof of diagnosis or confirmation through a medical process about the severity of illness to determine whether you can walk through the front door. A place where you are understood by people who know what it is like to be in your shoes, having themselves overcome similar issues. These are people with lived experience.

This inquiry must shift the dial and seek to truly understand how people experience care. It must pivot from simply responding to and managing illness to actively supporting the mental wellbeing of all Queenslanders. The risk is that we will not invest enough, and we will simply fund more of the same, tweaking around the edges of a flawed system, rather than making the fundamental changes needed to build mental health and wellbeing for all Queenslanders.

While we wait to hear the Federal commitments through the National Agreement for Mental Health and Suicide Prevention there are some rays of hope. In the last few weeks, we have seen the launch of a new Head to Health service in Townsville which looks like a promising model with unrestricted access to the community. This service is delivered by non-government community managed organisations and has people with lived experience of mental health challenges working in the services. It is these types of services that people in mental distress often say is the most helpful.

The Community Mental Health and Wellbeing Sector has the potential to play a much bigger, and desperately needed role in the broader mental health ecosystem. It could function as a primary entry point for those seeking mental health assistance, providing practical support and help to stay well and/or referral early in distress.

So, my hope, as someone who’s worked in the mental health system for a long time, is that this inquiry sees that need for fundamental change and can synthesise what has already been articulated in the many other inquiries and reports. Any changes it recommends need to benefit all Queenslanders, to encourage everyone to seek help at the earliest point in distress, leaving the scarce clinical resources available to those who need them most.

Jennifer Black
Chief Executive Officer
Queensland Alliance for Mental Health

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QAMH is the peak body for community-managed mental health organisations, representing more than 100 not-for-profit services that work with people experiencing mental health challenges.

QAMH CEO Jennifer Black is available for comment on community mental health and wellbeing matters.

Media contact: Emma Griffiths, QAMH Director – Advocacy and Communications

M: 0439 971 080

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