The needs of four million Australians suffering from mental illness and their families have been pushed to the side by other policy issues. The $2.2bn announced by the Federal Government last year – a modest beginning – has been stalled or delayed. We need to find a new approach that does not require COAG’s lowest common denominator. The Federal Government must assume control and leadership of community-based mental healthcare.

Louise Newman, Professor of Developmental Psychiatry at Monash University

The 10-year road map combines vision, values, and wishful thought. This is a risky exercise if it’s not realized.

The vision and goals are hard to dispute. It is important to focus on the inclusion of individuals and families affected by mental illness, as well as the improvement of their mental health. Mental health services must be reformed. Families and individuals affected by mental illness need support and social inclusion.

It’s less clear how to get there and if the road map represents more than just a restatement of what mental health advocates have been saying for years. Leading change requires more than stating that change is needed. It also takes leadership and will.

It is important to pay attention to mental illness prevention, but the plan does not give it enough detail. The program mentions the importance of trauma and abuse in relation to mental disorders. Still, it does not say the need for a comprehensive approach to the prevention of child abuse and the treatment of survivors.

The vision is noble, but it lacks details on reforms that can be achieved and time frames.

Professor Ian Hickie is Executive Director of the Brain and Mind Research Institute

Two major documents have been released in the past few weeks that are crucial to the future mental health reform in Australia. The 2012 report card of the National Mental Health Commission documents our major failures in the disorganized health care, community support, and social services for individuals and families who are affected by mental illness.

This report continues a tradition of independent pieces that date back to the Burdekin inquiry in 1993. It stands out, along with the rest of the independent news, as a contrast to how governments continue to report progress.

Unfortunately, despite more than two decades of national efforts to coordinate improvements in federal and state services, many people in need, including young people and those without the means to pay, as well as those living outside major urban centers, struggle to get the help they would normally receive if they suffered from a serious heart condition or chronic illnesses like cancer.

The lives of our citizens are ruined, and the nation suffers from lost productivity and social disruption.

The second document, Roadmap to National Mental Health Reform, is our collective government’s response to the challenge posed by Prime Minister Gillard after her investment of $2.2 billion of new and redirected funding in the 2011 budget. One would have expected a document that clearly defined the destination and set out a timeline for reaching milestones on the way to this destination. It would also have defined key measures that could be used to assess substantive change, as well as real targets in line with national goals. It would model the amount of investment necessary to achieve real changes (as was done for the National Disability Insurance Scheme).

Unfortunately, we have been given another excellent policy and planning document that continues a long tradition that dates back to 1992’s national mental health strategies. The paper picks up on themes that have been dormant for the past few years since the last major COAG accord in 2006. It also tries to define key success indicators. It proposes a collaborative and prolonged dialogue with states that may or may no result in actual success targets.

It’s not enough for those who waited patiently to see real improvements in their access to health and social services. They also deserve stable housing, respect for basic human dignity, and employment and education opportunities. It will not be enough to stop a major campaign in the lead up to the federal election of 2013 – as we saw with the Labor Party before the 2010 elections when they were forced to adopt ad hoc, poorly thought out policy options.

At the moment, specialist services are concentrated mainly around acute care hospitals or prisons. Mental and general health care services in the community are still largely focused on chronic and persistent illnesses. We haven’t taken any action to address the physical illness and premature death that those with mental disorders experience.

We have yet to implement the national system of early intervention that was so important for the community during the tenure Pat McGorry, 2010 Australian of the Year. The current discourse is a serious blow to the commitment made to ensuring an appropriate balance between early intervention services and continuing care, through new investments that will create novel pathways for care.

The dysfunctional political system that has derailed any serious reform agenda for this country continues to work. This is especially frustrating in the health sector, as good health is essential to our ability to live a “contributing” life – an idea central to our nation’s values and social contract. Australia is proud of its history of responding quickly to health emergencies such as HIV/AIDS, which arrived in Australia 30 years ago. However, our response to persistent inequality has been much less successful. Look at dental care, Indigenous health, chronic disease management, and mental health.

The message is very clear. Expect no real changes if reform is left up to a bureaucratic panel – which will be convened both by the states and commonwealth. We will instead see more finger-pointing and blaming. What’s clear from history is also that national leadership, i.e., the actions of a federal government and a determined Prime Minister, can make a difference.