Friday 21 October 2005

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Mental health problem is clear, so is the solution

Opinion piece

Author: Sev Ozdowski

Publication: The Canberra Times (13,Fri 21 Oct 2005)

THE LAUNCH this week of a new report on Australia 's crumbling mental health system repeats the message that mental health consumers, their carers and their clinicians have been shouting out for years - Australia 's mental health system is in crisis.

Commonwealth, state and territory bureaucrats routinely report that work is underway to improve mental health services, but I have seen little real progress in the past three years in my role as Human Rights Commissioner. It is clear that the current crisis is due to a ' 'culture of denial ' ' that a serious problem exists; a lack of departmental and political leadership; and a lack of funding.

We all know the extent of the problem - mental health care is an enormous social issue. One in five Australians are likely to suffer a mental illness at some point in their lives, which means statistically that almost every family in Australia will need to deal with mental illness at one time or another. But mental health is not just a social issue - it 's a human rights issue.

Australia is a party to several international human rights treaties, two of which explicitly recognise the right of everyone (especially children and youth) to the highest attainable standard of mental health care. Yet despite the fact that mental disorders are the largest single component of Australia 's disease burden, mental health care is still not a priority.

As one submission to pre-report consultations put it: ' 'The dream of closing psychiatric institutions and moving towards community-based care has turned into a nightmare.

Community care is under- resourced and integrated services are lacking. Too many people are denied treatment and slip through the gaps ' '. And it is Australia 's youth who are the biggest victims of this bureaucratic nightmare.

Statistics from the Orygen Institute in Victoria suggest that about 75 per cent of mental illness first occurs in people aged between 15 and 24 years old. One in four people in that age group will suffer a mental illness in any 12-month period. Startling figures, yet when the illness emerges many of these young people are denied basic treatment and care - they are simply told to go home and sort themselves out.

This is especially the case for those youth who are dependent on alcohol or drugs. Medical research has now irrefutably proved that mental illness can cause drug and alcohol dependency, and drugs and alcohol can trigger and exacerbate mental illness. Despite the prevalence of this ' 'dual diagnosis ' ', mental health services often tell these young people to take themselves to rehab, and rehab services send them to mental health services.

They are left in limbo, with the likely outcome anything from suicide, permanent brain disease or destroyed families resulting in huge economic and social costs for society as a whole. But it gets even worse. Not only are Australia 's mentally ill being turned away from the health services that they need, they often end up in jails instead.

The South Australian public advocate recently described one example of two brain- damaged men who were placed in a Port Augusta Prison because there was no room in a secure mental health facility. Then there was the Cornelia Rau case which showed that if you are mentally ill and have a foreign- sounding name or accent, you can end up in a jail and an immigration detention centre for an indefinite period of time. The magnitude of the problem is clear, and so is the solution.

Commonwealth, State and Territory governments need to work together to address the issues rather than play the age- old game of shifting blame and responsibility. Change is possible if the will is there. More than 20 per cent of Australians are counting on their governments to make mental health a priority - now.

Dr Ozdowski is the Federal Human Rights Commissioner.

Last updated 7 November 2005