Foreword
Time for governments to act on mental health care
Sev Ozdowski
Australian Human Rights Commissioner; Acting Disability Discrimination Commissioner
Human Rights and Equal Opportunity Commission
PP: 203 - 204
Article Text
In 1993 the Human Rights and Equal Opportunity Commission released the report of its National Inquiry into the Human Rights of People with a Mental Illness (the Burdekin Report). This followed agreement by all Australian Health Ministers in 1992 to a National Mental Health Strategy.
The National Inquiry found that although the movement towards community care and mainstreaming of mental health services had reduced the stigma associated with psychiatric care, in general governments had not redirected the money saved by deinstitutionalization into mental health and related services in the community.
Families and carers were found to be badly overstretched and insufficiently supported.
Specialist services for the many thousands of Australians affected both by mental illness and some other form of disability were found to be almost non-existent.
The Inquiry recommended improved crisis facilities, accommodation services and other community mental health services, and measures to promote improved employment opportunities for people affected by mental illness.
From the start of my term as Human Rights Commissioner in December 2000 I was hearing reports that most of the issues identified in the 1993 Burdekin Report remained of concern.
With this in mind, I decided in 2004 to join with the Mental Health Council of Australia (MHCA) and the Brain and Mind Research Institute (BMRI) and conduct national consultations on human rights and mental health issues. Twelve years after the Burdekin report, our 'Not for Service: Experiences of injustice and despair in mental health care in Australia' Report was launched - on 19 October 2005 just as this special issue of Health Sociology Review was being readied for press.
We wanted to provide a forum for the experience of people affected by mental illness, as patients, families, or carers, together with community and professional service providers; to seek to refocus debate in this area as involving matters of human rights; and to draw public and political attention to this experience as a means of promoting accountability and remedies where abuses or neglect of human rights were found.
Some key points from the consultations were these:
- Resources provided are simply inadequate to match the level of unmet needs and ensure access to treatment and services when they are needed. Accountability for money allocated to mental health services is also seriously lacking.
- The most frequently mentioned gap in mental health services was the absence of early intervention and other specialist services for young people. All too often people are being told, in effect, to come back when they are really ill. Australia leads the way in development of early intervention programs for mental illness - but not in their implementation.
- We still lack adequate mental health facilities to cope where a person also has an addiction - or other forms of dual diagnosis.
- In all States I received reports of children and young people being admitted to inappropriate adult facilities.
- Emergency services are overburdened and often inaccessible. Acute care services are too often simply missing, especially in regional Australia. This results in preventable death.
- Community supports likewise are seriously overburdened and unable to cope with the existing demand.
- Those with a mental illness are still being blamed for being sick.
- Criminal justice facilities are functioning as de facto large scale institutions for mentally ill people - but without adequate facilities for diagnosis and treatment.
The failure of adequate funding for mental health services, the failure by governments to address the issue and the resulting human right breaches and suffering of people with mental health problems and their carers have been well known for years.
Now it is a time for action
I am proud of the work that I have done with the Mental Health Council. I also look forward to the results of the Senate select committee inquiry on mental health services. But frankly, our greatest need is not for more inquiries and reports. We need our governments to act.
To achieve this we need to involve our civil society. We need opinion makers; media; those who have expertise through training or direct experience or both, to publicise the issues.
For this reason I most strongly welcome the publication by TASA (The Australian Sociological Association) of this special edition of the Health Sociology Review on the experience of deinstitutionalisation in practice, and the publisher's decision to release this issue separately for wider circulation as a book (Closing Mental Asylums: Consumer and Social Consequences edited by Pauline Savy - ISBN 0-9757422-1-3).
I commend the papers published in this title to the attention of everyone working to improve the position in Australian society of people affected by mental illness.
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