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Mental health policy dreams?

By astrojax - 3 October 2013 13

Hi hive mind,

I have a discussion coming up soon on the way forward for mental health policies in this country and, while i of course have my own ideas on some of the current paucities and some of the ideals we should strive towards, i thought i’d ask my goodly friends here to provide their own thoughts on how a new policy, if we could start from scratch, or from where we are, might be developed.

What are some fundamentals missing from the current policy?

What are some critical outcomes not being achieved?

I’d welcome your thoughts…

What’s Your opinion?


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13 Responses to
Mental health policy dreams?
jcat 1:31 pm 16 Oct 13

IrishPete said :

Then there’s the lack of prevention. Prevent child abuse and neglect and you’ll almost eradicate many mental illnesses. Control psychoactive drugs, and you will almost eradicate most of what’s left. (Ice and cannabis are big contributors to schizophrenia and bipolar, and current drug policies have FAILED – stop pursuing failed policies).

IP

It seems to me after reading these comments that there is not enough public information about the nature and causes of mental illness. People generally only become interested in the topic when someone they know is affected. Mental illness is not ’caused’ by child neglect, poverty, drugs or socio economic background. Many mental illnesses such as depression and anxiety can be exacerbated by negative environmental circumstances. Depression caused through these events is called exogenous depression and the severity can be affected by the reaction to the stressful events. There is another category of depression called endogenous depression which is primarily biological and genetic in nature. Whilst stressful events may precipitate both forms of depression, it is the people with endogenous depression that are most likely to relapse rather than the person whose depression is reactive in nature. Bipolar is a good example of this kind of genetic illness. Whilst the illness may be precipitated by a stressful event, it is a disease like an other that is passed down primarily through the maternal genes. You can’t get ‘rid’ of it, adverse lifestyle choices may exacerbate the severity of it but ultimately it is a disease that you have no choice about getting. Schizophrenia is a much used and misunderstood term. It is a generic term used to generalize many forms of the disease such as paranoid, catatonic and disorganized schizophrenia. Causes of this disease are though to be genetic, infection in the womb, serious childhood diseases and social or psychological factors. Again, it is just a disease, can be exacerbated by lifestyle choices and you have no choice about getting it.

We need to stop thinking of people with mental health issues as being dangerous, weird, scary, or second class citizens and start thinking of them as people with a disease that needs treatment. More money needs to be put into community health so that people who are unable to access the private system will not fall through the cracks and become outcasts with no life expectancy.

Canberra is probably one of the worst places to have a mental illness. There are not enough local bulk billing doctors that can help people and even the private psychiatrists in Canberra have their books closed and are not taking new patients. The mental health staff at the hospitals try to help as much as they can within the system and give over and above of what is expected of them, but ultimately lack of staffing numbers and beds don’t help the situation.

I have had Bipolar type 1 all my life. I inherited it from my mother and it is certainly not something that I would wish on my worst enemy. There are times of incredible brilliance and creativity, some of the greatest minds in the world have Bipolar, but for every good time there are a hundred bad times waiting to drag you down into the depths of hell. I have had a great career and have a beautiful family and grandchildren, but as I get older the fight is harder and the drugs don’t really work any more. I am one of the lucky ones who have access to the private health system but I have worked in the community sector and seen the pain and misery of those who cannot procure help.

Society needs to be more positive about these issues. 1 in 5 people in Australia have some form of mental illness. Look around you and react positively to this. If someone has a disease such as cancer it is seen as acceptable and everyone understands and accepts it. Most mental illnesses are just a disease, they are NOT something you can catch! Accept that the person might be displaying some aberrant behavior associated with the illness, but have compassion for that person not contempt. No one wants to be like that. It hurts like hell. As the old saying goes…..before you judge someone, walk a mile in their shoes and see what it feels like.

Mental health acceptance starts right here, right now with anyone who reads this. Think before you judge, ask if you can help, listen with an open mind and offer what you can of yourself. The world would be a much better place if we all take responsibility for ourselves, our thoughts and our actions!

Enough of my rant.

kea 2:55 pm 08 Oct 13

Getting help in the instance of a first episode, is probably where I would put my money. In our situation, it took several days and about 19 phone calls to get someone to listen to me when I said my partner was not well.. Lifeline, Beyond Blue et al was no help at all when it came to helping me identify what the issue could be exactly.. I didn’t have the vocabulary then to say “My partner seems to be experiences schizophrenic phenomena, is distressed and needs an urgent assessment”.. in fact, it’s not for me to “diagnose” anyway.. It was only when I reached out to a friend who worked in the hospital system that I found out that you had to drop the right phrases to get noticed.. He was well and truly stuck in a psychotic episode and they weren’t interested in coming out to help until I told them that he was a risk to himself or to others.. And it was only under that pretence that we found assistance..

astrojax 2:24 pm 08 Oct 13

IrishPete said :

PoQ said :

Mental health care costs money. A lot of money. The afflicted (not trying to be sarcastic) can barely keep their own act together, let alone organise to lobby the government. Their carers are usually health department employees, and have hard enough time maintaining their own funding. The wider population don’t care/don’t want to know and so the government knows that it can – without penalty of any sort – throw the mentally ill out on the streets, forget to fund the “community care” and sell Callan Park to the developers.

You are generalising and stereotyping. You seem to be imaging people with Schizophrenia, not people with anxiety or depression. And people with Bipolar are often very productive members of society in between episodes (which can be decades apart)

Like most health care, good mental health care can save money, by helping people be productive (earning) members of society rather than languishing on the DSP or in hospitals, on the streets or in prison.

IP

I took the original sarcasm, but you make some good points, ip.

poq’s point about ‘the broader community’ is telling – the. broader community is affected by mental illness every day and very often within a fairly close circle. interesting beyond blue study reported today on the incidence of mental health issues in the medical profession, some four to five times higher than the general population – in a profession with very high stress levels. no coincidence. I’d be keen to see some version of this study done on, say serving armed forces, emergency services (police, firies, etc) and the like.

YeahBuddy 11:51 am 08 Oct 13

Early intervention. How do you do that? I have no idea. I think starting from scratch is the way to go, the current system APPEARS to be too broken to fix and would probably take longer than just wiping it and starting fresh.
Oh, and support the bloody Mental Health workers!! I

LSWCHP 10:49 pm 07 Oct 13

Education.

If money is to be spent somewhere, it should be on education, starting in early high school. Let’s start spreading the word about what mental illness is, how to recognise it, and how it can be fixed.

I was married for seven hellish years to a person with a severe personality disorder, and it almost wrecked me. I went from being a tough, fit, happy and well adjusted man to being a physically and emotionally shrunken wreck contemplating suicide. And because I was so intimately involved in that transition I didn’t know that my wife’s mental disturbance was messing with my head and slowly making me mentally ill. I was log the frog in the pot of water being warmed on the stove. The slowness of the process meant that I almost got boiled, but luckily I survived.

Kids in school need to be told “Hey…if ever in your life you’re really unhappy and thinking of killing yourself, then this really isn’t a good solution…this isn’t a reasonable way of solving your problems. There is lots of help available, and no matter how bad things may seem to you, life will get better”.

I think if those plain words had been spoken to me at some point, I might have recognised my own problems sooner, and saved myself a lot of grief. And those words spoken to a young family friend of ours may have prevented her from taking her life last year, and causing almost unbearable heartache to her family and friends.

BimboGeek 10:48 pm 07 Oct 13

From personal experience, psychiatrists need to learn when to back the hell off. I’ve seen them make things worse for people who just wanted help getting through some drama. They encourage people to wallow in their misery and prescribe drugs that have not been proven to work beyond a short trial period. Well guess what, there are any number of drugs on the streets that make you feel pretty good for a little while.

For people with bigger problems there needs to be real life support. A fortnightly visit is not good enough for someone with serious paranoia, delusions, dissociation or other super scary symptoms. Agree with the residential care comment.

Finally, crime and punishment. Punishment won’t work. These people need those symptoms treated, not left to fester and become infected. We have generations of criminal behaviour because we refuse to treat the problems that cause it.

IrishPete 9:01 pm 07 Oct 13

PoQ said :

Mental health care costs money. A lot of money. The afflicted (not trying to be sarcastic) can barely keep their own act together, let alone organise to lobby the government. Their carers are usually health department employees, and have hard enough time maintaining their own funding. The wider population don’t care/don’t want to know and so the government knows that it can – without penalty of any sort – throw the mentally ill out on the streets, forget to fund the “community care” and sell Callan Park to the developers.

You are generalising and stereotyping. You seem to be imaging people with Schizophrenia, not people with anxiety or depression. And people with Bipolar are often very productive members of society in between episodes (which can be decades apart)

Like most health care, good mental health care can save money, by helping people be productive (earning) members of society rather than languishing on the DSP or in hospitals, on the streets or in prison.

IP

PoQ 3:33 pm 07 Oct 13

Mental health care costs money. A lot of money. The afflicted (not trying to be sarcastic) can barely keep their own act together, let alone organise to lobby the government. Their carers are usually health department employees, and have hard enough time maintaining their own funding. The wider population don’t care/don’t want to know and so the government knows that it can – without penalty of any sort – throw the mentally ill out on the streets, forget to fund the “community care” and sell Callan Park to the developers.

poetix 10:46 am 07 Oct 13

I think that there is still a very long way to go in removing the stigma from mental illness, despite the fact that it (in all its delightful manifestations) is probably as common as cancer, if not more so.

Deref 9:32 am 07 Oct 13

I’d have thought that adequate provision of residential care, when appropriate, would be fundamental.

astrojax 3:09 am 07 Oct 13

thanks, some good issues in these responses.

I thought there’d be more of you with strong feelings on this topic. perhaps that in itself is another point to make…

IrishPete 7:37 pm 06 Oct 13

Like many areas of government, the fragmentation of pubic and private, State and Federal, is really unhelpful. The feds want it all done by private practitioners, but that almost inevitably means a “gap” fee, which then excludes the poor (who, oddly enough, are over-represented in mental illnesses). They also fund a lot of non-government, even private sector, providers, who tend to pay poorly and employ less-qualified practitioners. Some of them (like religious organisations) even have their own agendas.

Then there’s the lack of joined up government. I have had clients who have been on Disability Support Pension. What’s your disability? Schizophrenia. But when talking to me you won’t accept you have it and you won’t accept treatment for it…? (Has even happened with people on TPI pensions too… pensioned out of a job because of schizophrenia, but won’t accept treatment for it.)

And States/Territories just grossly inadequately fund their services, such that many people can’t get help at all.

And then there’s the lack of joined-upness between States – someone moves across a state border, they just disappear. Even happens within States, if they don’t have computerised records (like NSW last time I looked). I’ve seen some really tragic cases, of people who move and just fall through the enormous cracks, even when moving from one government house to another in a different area (so a government department knew they’d moved, and knew they had a serious mental illness, but didn’t tell the other government department).

There there’s the extreme negative attitudes of most mental health professionals to people with personality disorders.

Then there’s the lack of prevention. Prevent child abuse and neglect and you’ll almost eradicate many mental illnesses. Control psychoactive drugs, and you will almost eradicate most of what’s left. (Ice and cannabis are big contributors to schizophrenia and bipolar, and current drug policies have FAILED – stop pursuing failed policies).

And there’s the lack of suicide prevention. Suicide prevention and mental illness treatment are correlated but not 100%. Many people who commit suicide (or attempt it) do not have a mental illness, not even a personality disorder. I don’t have an easy answer to this one, but perhaps there should be mental illness and suicide awareness taught in high schools.

IP

unclebill 3:05 pm 06 Oct 13

Discussing it is a good start. As with most health matters prevention of crises is better than trying to cope with emergency, ambulance at the top of the cliff instead of the bottom.Most of the Govt dollars are going to hospital services like our AMHU instead of trying to prevent people reaching that stage. We need to hook everyone up with a bulk billing GP where possible so that medication & general health is being monitored not just by half an hour with a psych every so often. Currently there is a life expectancy gap of 10 to 15 years between the mentally ill & the general population.A new model of supported accommodation would be good, something like hostels with support staff instead of sticking them in houso estates where they are prey to crooks & druggos.
Generally mentally ill people just want the same opportunities as any one else in such things as employment, education, housing, sports, fitness, arts, music, hobbies, romance, sex, pet ownership & freedom of choice. Taking any of these away can lead to frustration, boredom, anger or self medicating with alcohol & illegal drugs or misuse of prescribed ones. Thus the crises happen.
The NDIS is a good start with people having choice of what services that they want to utilise instead of being told what others think is good for them. The current rounds of enhanced service offer grants have shown that most people just want simple things like a comfortable bed, fitness programs or education choices.
Mental Health week is a good time for a rant. Check out some of the events like the Mindscapes Festival to see what the mentally ill can achieve.

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