Last Monday, I flew to Canberra to represent the shared perspectives of consumers and mental health professionals to the federal senators involved in the current Senate Inquiry on Commonwealth funding and administration of mental health services. Thankfully, the senators provided an extended period of time, which allowed some of the complexities of the issues at stake to be explained in some detail. For those of you who would like to know how this hearing went in detail, you can read the Hansard transcript in full (page 91 of PDF file, page 87 of main text). Otherwise, please feel free to read the summary below.
The first issue I raised with the senators was about the need for the system to identify all of our skilled practitioners in mental health care, for the sake of expanding consumer choice. I explained to the senators that some of the tensions between mental health professionals right now were actually caused by problems with the way that the system had been structured. Earlier in the day there had been some confusion about who advised the government to design the system in the way it had been. I pointed out some of the absurdities with the system that resulted from this and suggested ways to rectify the problem.
The second point I made to the senators was that 10 sessions of psychological treatment isn’t enough. It was explained to the senators that there have been controlled studies for decades, replicated all over the world, showing that people typically need between 16 and 20 sessions to show long-term improvement, even for relatively mild symptoms of depression. I pointed out that the 10 session limit being proposed was going to be a major problem for people with moderate to severe levels of distress, who we know represent over 80% of those who use psychological services in the Better Access program.
It seemed to me that some of the senators had formed a rather peculiar view that the Better Access program was not intended to provide services for people with severe distress. Notes from the 2006 COAG meeting make no reference to the program being intended for mild problems, and nor does former Prime Minister John Howard’s announcement of the scheme, which repeatedly makes reference to programs being developed to tackle ‘severe mental illness’ in Australian society. Likewise, both the Better Access program orientation manual for GPs, and the orientation manual for psychologists and other mental health practitioners, refer to the program as targeting high prevalence mental health disorders (notably anxiety and depression). There is no reference made across any of these documents stating that the program is not intended to serve the needs of severely depressed or severely anxious people. I came away from the hearing thinking that perhaps some politicians believe (falsely) that depression and anxiety are not severe conditions, and instead, reserve the term ‘severe’ to psychosis and bipolar disorder. This would certainly be consistent with some of the stigmatising rhetoric coming from the few vocal commentators who are against the scheme.
So where does this leave us now? The Senate Committee will be writing up their findings in a summary, which usually takes the form of a thick book which few people ever end up reading. From there, the ball will be in the court of the federal government. Our decision makers may choose to take this feedback on board, or they may choose to dig their heels in and proceed as planned regardless. The Australian people have done their part in making their views known and I think that for the most part, the professional groups have made sure that sensible information is available. Let’s wait and see what comes of this by November!
Want to help?
Oppose the cuts to psychological services by signing our petition at at CommunityRun and Change.org. You can also join in discusison about this important issue on our Facebook Group.
If you would like to email your concerns to a politician, you might start by taking this directly to Prime Minister Julia Gillard: http://www.pm.gov.au/contact-your-pm/. You can also send an eail to the Mark Butler, the Minister for Mental Health, or Concetta Fierravanti-Wells, the Shadow Minister for Mental Health, or Senator Penny Wright, senator for The Greens on Mental Health. Make your message loud and clear – ten sessions is not enough. Every voice makes a difference!
Your comments are welcome below