VICTORIA’S MENTAL HEALTH CRISIS – COMMUNITY SUPPORT SERVICES ARE KEY

It is true, Victoria’s mental health system is in crisis, but not solely because there is a lack of hospital beds (‘Beds run out for mentally ill’ - The Age 10/11).

The critical question is: why are many more people becoming so ill that they need a hospital bed? The support for their recovery is beginning far too late. If recovery begins earlier and in a community setting, we could in fact see a decline in the need for hospital admissions.

People with a mental illness sometimes need ready access to hospital, just as they may need access to good housing and support as soon as they are ready to leave – and in both of these areas the system is failing. Admitting people to hospital is at best a short-term solution which addresses an immediate need to contain a crisis but it doesn’t deal with the underlying issues. People don’t simply walk into hospital with a mental illness and walk out ‘recovered’.

Recovery is a journey, not a quick fix. It is living well, having a satisfying, productive life in the presence of a mental illness – it is not always about being ‘cured’.

Nearly 15 years have passed since the Human Rights and Equal Opportunity Commission’s Report (Burdekin Report) on mental health, which brought the human rights issues of abuse within institutions, and neglect in the wider community, to the attention of the general public.

In Victoria we have seen some significant reforms in mental health care, including the closure of its institutions. However, there is still an extremely long way to go.

In 2003 the report ‘Out of Hospital, Out of Mind’ by the Mental Health Council of Australia found that immediate action needed to be taken to “combat the current crisis, improve the spectrum of available services and promote genuine recovery.” It also concluded that an investment must be made in the long-term sustainability of a mentally healthy community.

We need to invest in community services that offer intensive support for people experiencing a mental illness. We need to identify mental illness earlier and address the individual needs of the person in a holistic way.

Like the rest of the community, people experiencing a mental illness aspire to lead lives that are fulfilling. Relationships, jobs, children and being a valued part of the community are things that most people want, and the same is true for people experiencing a mental illness.

Mental illness can take these things from people – people often experience stigma, isolation, discrimination, low self-esteem, serious physical ill-health and sometimes an inability to function at even the most basic levels.

Hospitals are not equipped, nor are they designed, to address issues of social inclusion.

This is not to underplay the importance of hospital psychiatric services. They are extremely important, but they are certainly not the sole answer to supporting people’s recovery.

Recovery is about addressing individual needs – people need to be active participants in their recovery – setting goals and being supported to achieve them. This is the role of community support services.

The community can be encouraged by the new PARC (Prevention and Recovery Care) supported residential services funded by the Department of Human Services, which aim to assist in averting acute inpatient admissions and facilitate earlier discharge from inpatient units.

These services acknowledge the need for a broader and more holistic approach to recovery, combining the clinical expertise of mental health services and the psychosocial expertise and recovery-focused care of organisations like Mind.

Mind is currently working with a number of Victorian hospitals, including Eastern Health that provides services through Maroondah Hospital (identified in The Age article), Bendigo Health Service, and Melbourne Health to set up PARC services.

The benefit of this type of service over hospital admission is that it offers individualised support and counselling to assist clients to develop and maintain a sustainable and meaningful lifestyle.

These and other collaborations between services create opportunities for the development of independent living skills and assist people to manage their mental illness in a way that reduces the need for hospital admissions. They also result in enhancement of personal growth and self-understanding, allowing people to pick up their lives again and get back to work or school.

As members of society we must also take responsibility for the role we play in the mental health of our community. We must ensure we encourage inclusive communities that support – not prevent ¬¬– recovery; communities that foster acceptance and education about mental illness, not discrimination and isolation.

Robyn Duff is the CEO of Mind (formerly Richmond Fellowship Victoria & South Australia), Australia’s largest not-for-profit NGO provider of mental health services.

Media contact – Katrina Wilkins 03 9455 7935 or 0412 659 928