The allocation of A$2.3 Billion for mental health and suicide prevention in the federal Budget will be welcomed news for those who have struggled to access adequate support and mental health services.
Recent reports on mental health by the Productivity Commission and Victorian Royal Commission have highlighted the impact of mental illness in Australia’s society. They also highlight the public’s concern about the inadequate service provision.
The large expenditure items for mental health announced in the Budget largely include increasing treatment services including:
Will more services mean better mental health?
It is logical to assume that increased expenditure on mental treatment services will improve the mental health of a population. It’s an unpleasant truth, however, that neither Australia nor any comparable country have managed to improve mental health by increasing mental health services.
Over the last 20 years, Australia has seen a significant increase in mental health services. Many more people are receiving GP, psychological, and allied services funded by Medicare. Headspace has also seen a significant expansion of youth services.
The Australian Bureau of Statistics, however, has tracked our mental health over the past decade — and hasn’t shown any improvement. In recent years, the has gotten worse for young people. The suicide rates have also been on the rise.
The 2021-2022 federal Budget was presented by Treasurer Josh Frydenberg. It includes A$2.3billion for mental health. Mick Tsikas/AAP
The right people may not always need the right services
Randomised controlled trials have shown that treatments work. A range of psychological therapies can be helpful for depression and anxiety disorders. Antidepressants are also helpful for those with severe anxiety or depression.
Clinical practice guidelines are not always consistent with what is evaluated in trials or what is actually delivered in the field.
People receive far less sessions of psychotherapy than recommended, despite the availability of more services. Antidepressant medication is often prescribed by GPs for milder cases, even though these people are unlikely to benefit.
Need for better quality services
We’ve seen in the past that increasing services results in progressively more people getting services that were too thinly distributed or poorly targeted to make a difference. We need to improve the services provided to people with severe mental illness and make self help options more available to people with less serious problems.
We do not know if the extra services that are funded by the Budget will have an impact. We should focus more on the long-term benefits that these services will have on mental health rather than the immediate services they will provide.
The Budget allocates A$117,000,000 for the establishment of a national database to track service delivery, performance, and outcomes in the mental health system. This will allow for a better focus on the impact of the services in improving mental health across the country.
Read more: Youth anxiety and depression are at record levels. Mental health hubs could be the answer
Some much-needed attention to prevention
prevention was neglected, and this is another reason why past government spending hasn’t improved mental health in the country.
The Budget makes some small but important steps forward in this area, focusing on children, as that is where problems with mental health often begin. A$46,000,000 is allocated for parenting support and education, while A$54,000,000 is used to create child mental health and wellbeing hubs.
It is important to prevent mental illness by establishing child mental health and wellbeing hubs. Shutterstock
spending in other areas will also reduce the risk factors of mental health problems such as sexual abuse, violence in families, unemployment and homelessness. Mental health expenditure is still largely focused on treatment and not prevention.
The Productivity Commission: a long-term vision
In its final report on mental healthcare, published in November of last year, the Productivity Commission outlined a vision for major reform. The report acknowledged that mental health was a problem that required a coordinated approach across the government.
It was inevitable that some of the Commission’s recommendations could be cherry-picked in budgets or election promises and that the grand vision would be lost. The grand vision for mental health is still not fulfilled, even though this Budget offers some promising initiatives.
