I rise tonight to mark the celebration on 10 October 2008 of World Mental Health Day. This is an area of public policy about which I am especially passionate, and it is one area I intend to focus on during my term in this place. As a member of the Senate Standing Committee on Community Affairs, I was pleased to be involved in the inquiry whose report was entitled Towards recovery: mental health services in Australia, even though much of the committee’s inquiry was conducted prior to my entering this place.
My interest in mental health began with my first full-time job. I was employed with an eminent psychiatrist, Dr Eric Cunningham Dax, who worked in Hobart for a few years with the Mental Health Services Commission of Tasmania, having been asked by the Tasmanian government to assist in developing community mental health services and other health and welfare services. Dr Dax established a new psychiatric research centre to focus on social aspects of health. I consider myself very fortunate to have been not only employed by but able to work with Dr Dax in the late 1970s, as he was so dedicated to his patients and his work. He was the loveliest of men and shared his work passion with his staff.
I remember that he would run art classes for patients at the site where we worked. The Old Vicarage was a beautiful old building and had a sunroom that Dr Dax set up with easels, and he would bring patients in from nearby John Edis Hospital and encourage them to express their feelings through art. The next day, as we catalogued it together, he would talk to me about the artwork and its representation. To me as an 18-year-old, just out of college, it was truly amazing.
During the 1940s, Dr Dax had initiated art as mainstream psychiatric treatment. While he was quite aware of the recreational and healing value of art making, he was more interested in how the art could illustrate some aspects of a person’s experience of mental health. Earlier in his career, he was able to use his pioneering research to convince the British National Health Service to employ artists in hospitals.
Alongside developing community treatment, as opposed to institutionalisation, Dr Dax was among the first to appreciate the detrimental effects of stigma. He thought that the stigma of mental illness was a result of fear, a fear that was fed by ignorance—as is so often the case. He was quick to see that the artwork of his patients could offer a most interesting and accessible form of public education about mental health, and with this in mind he set out to establish a psychiatric art collection. The Cunningham Dax Collection, based in Victoria, with more than 12,000 works, is now one of the largest of its type in the world, and I am proud to be a Friend of the Cunningham Dax Collection.
Although I had not seen Dr Dax for many years, I had kept up to date from time to time with his activities through his son, who still lives in Hobart. It was with great sadness that I learned of his death earlier this year. He had lived a full life and died in his 100th year. The world has lost a true gentleman, a man who never sought to grandstand—although he could have, with his great works—and a great advocate for those suffering from mental illness.
But I digress. Around one in five Australians will experience a mental illness at some stage of their lives. Many will suffer with more than one mental illness, due to the interrelationships between many mental health conditions. Mental illness impacts not only upon the sufferer but also upon their family, friends and work colleagues. The potential disruption to the individual’s capacity to participate in and contribute to the social and economic life of our country is immense. Of course, this becomes a vicious circle, as recognition of this incapacity on the part of the sufferer will, in many cases, and depending upon the specific condition, only add to a sense of helplessness and reduced self-esteem.
It has been estimated by the Victorian government that the annual cost of mental illness in Australia is approximately $20 billion, a figure which includes the costs of a loss of productivity and participation in the workforce. It is clear that policy intervention in this domain not only is essential but must seek to balance the need for action to rectify past neglect.
It is important when considering the report of the community affairs committee to examine the context against which it is framed. When we examine the recent history of national approaches to mental health policy development, the overriding concern that is present is the need to undertake the shift from an institution based mental health system towards community based approaches. This was one of Dr Dax’s greatest beliefs.
Historically, this shift had commenced in the 1990s, beginning with the 1992 Mental Health Strategy, and 2006 marked the year in which two significant events occurred which have come to recently influence the development of mental health policies in Australia. In its April 2006 report, A national approach to mental health—from crisis to community, the then Senate Select Committee on Mental Health noted that the focus on deinstitutionalisation had been accepted as a recognised priority but had been restricted by the slow development of community based services. As a direct result, those vulnerable individuals in society, whether homeless, in prisons, or living in poverty, were considered highly unlikely to seek or receive treatment until the advanced stages of their particular illness were apparent. The Senate select committee made a large number of recommendations which were directed towards refocusing policy development and funding priorities towards the role of community partnerships and policy solutions.
The second major development which took place at this time occurred at the political level. In February 2006, Australian leaders recognised, like their predecessors, that mental health is a major problem for the Australian community and committed to reform the mental health system in Australia. As a direct outcome of these concerns, the COAG National Action Plan on Mental Health 2006-2011 was adopted to provide a strategic framework for coordinating cross-jurisdictional policy and program responses within the context of a federal model.
The national action plan outlined a series of initiatives to be implemented over a five-year period. These new initiatives required a significant investment from all governments. The national action plan was directed at achieving four outcomes: reducing the prevalence and severity of mental illness in Australia; reducing the prevalence of risk factors that contribute to the onset of mental illness and prevent longer term recovery; increasing the proportion of people with an emerging or established mental illness who are able to access the right health care and other relevant community services at the right time, with a particular focus on early intervention; and increasing the ability of people with a mental illness to participate in the community, employment, education and training, including through an increase in access to stable accommodation.
The national action plan recognised that, from a consumer perspective, a need existed for greater clarity and transparency in service delivery and responsibility. Only by achieving this requirement would a significant investment by both Commonwealth and state and territory governments achieve optimal health outcomes on a cost-efficient basis. The plan concentrated on identifying policy and program responses which would enable more effective connections to be made both between the different levels of government and also across state and territory borders.
I do not intend to detail all of the initiatives contained in the national action plan this evening but will note that, when the individual state and territory plans were added to that of the Commonwealth, over 100 initiatives were identified, bringing the total funding commitment in the COAG plan to approximately $4 billion. It is against the background of these developments that the recent report was framed. The Senate Standing Committee on Community Affairs identified that there existed a lack of a compelling national vision regarding an Australian mental health strategy. Rather, there was a tendency for governments at both levels to list their responses and demonstrate how they had sought to meet any identified gaps. The other major theme, which was supported by evidence supplied to the committee and which is reflected in the title of the committee’s report, relates to the need to adopt a recovery orientation in service delivery.
Before I run out of time, I would like to mention a couple of initiatives that have taken place in my home state of Tasmania recently. The Tasmanian government recently announced the establishment of a new initiative in the area of mental illness and its impacts upon ethnic communities. The launch of the Tasmanian Transcultural Mental Health Network aims to link up consumers, carers and relevant community organisations with an interest in transcultural mental health. The Tasmanian government has combined with Multicultural Mental Health Australia to provide funding support for this initiative. A second initiative was also announced in late October and concerns the expansion of the Hobart community’s mental health activity program to include a particular focus on young people in the central city area. The focus will be on the implementation of recovery based programs targeted to be responsive to youth needs. This program will commence in January 2009 and, according to Mr Paul Mayne, CEO of the service provider Langford Support Services, it provides an excellent example of the collaborative partnership between government and the community sector.
These initiatives are but two illustrations of the many existing innovative programs that focus on community needs by providing community based solutions with a recovery focus. It is my hope and expectation that future initiatives continue to address the recommendations of the report. (Time expired)