Spotlight
Making Mental Health a Priority
As an economist and carer , Prof Allan Fels is well placed to bring a balanced view to his role as chairman of the National Mental Health Commission .
As a carer to his daughter Isabella , the Chairman of the National Mental Health Commission ( NMHC ), Prof Allan Fels is well aware of the practical ramifications of policy decisions made within tight budgetary constraints . Given the finite nature of the health dollar , he stresses the importance of medical practitioners taking a broad approach to the mentally ill .
“ I went to school in Perth [ now John XXIII ] and it was a classic Jesuit education . There was a strong sense of the need for public service and most of my life I ’ ve worked in sectors with a focus on areas of community interest . My background in economics is rather unusual because mental health is usually the province of psychologists or psychiatrists . I think the Commission will overcome the culture shock and they ’ re beginning to understand my strange terminology .”
One of the principal aims of the NMHC is to ensure that mental illness receives the same priority and focus as any other part of the health system . Currently , 6 % of the national health budget is allocated to mental health . Patrick McGorry , Professor of Youth Mental Health at Melbourne University , has stated emphatically that the sector is being underfunded by 50 %.
“ I agree that mental health doesn ’ t receive the priority it should from either government or the community . There is an acute shortage of resources and that ’ s not going to change in a hurry . Admittedly , there are some ways the money could be better spent .”
“ It ’ s extremely important that we ’ re as open as possible about mental health issues . That ’ s why I went on the ABC program , Australian Story so that my daughter ’ s journey with schizophrenia could be told publicly . It ’ s only by continuing to talk about mental illness that we gain a better understanding and then stigma and discrimination will be broken down .”
“ There has been some improvement in this area but there ’ s still a considerable distance to go .”
The link between mental illness and homelessness is undeniably strong and Allan reinforces the importance of housing support and the need for the agencies involved to work cohesively .
“ Unless there is increased stability in housing the statistics on mental illness will
��Allan Fels
There are a large number of mentally ill patients who like to smoke and I ’ ve been extremely tolerant of that because it ’ s a form of relief for them . But , on reflection , given the statistics on life expectancy we have no choice but to address these issues ..
only improve slowly , particularly for young people . And this must be addressed from a whole of life perspective that embraces not just accommodation but also medical issues , counselling and employment . This area is even more notorious than other parts of the health sector in that it ’ s divided into countless autonomous groups that aren ’ t always efficient in their interaction with one another .”
“ Fragmentation is a problem , particularly when working with government agencies that usually prefer to work in a more concentrated way .”
Allan underscores the point that GPs are a crucial point of first contact and it ’ s vital that they address both the physical and the mental needs of patients .
“ It ’ s important that GPs take a broad interest in the physical health of these patients . I ’ ve had to rethink this aspect myself . There are a large number of mentally ill patients who like to smoke and I ’ ve been extremely tolerant of that because it ’ s a form of relief for them . But , on reflection , given the statistics on life expectancy we have no choice but to address these issues . That should form part of every consultation with a GP .”
In relation to Men ’ s Health , the numbers don ’ t bear close scrutiny when it comes to the mentally ill . And , if you ’ re looking at young men as a subset , they ’ re even worse .
“ There ’ s no doubt that many men are reluctant to seek medical help , particularly in relation to mental health . The statistics aren ’ t impressive . Between the ages of 12-25 , there ’ s about $ 3.27b in lost productivity every year .”
“ One aspect that ’ s relevant for medical practitioners is what ’ s called the ‘ overshadowing effect ’. There ’ s some evidence that when an individual with a mental illness sees a doctor and talks about side issues , physical problems included , that those areas are clouded by the banner of mental illness .”
There is a strong correlation between Aboriginal people and higher comparative rates of mental illness , particularly in WA , this is reflected in a disproportionate number of indigenous people incarcerated in our prison system .
“ Prof Pat Dudgeon from the School of Indigenous Studies at UWA is a commissioner on the NMHC and she brings a strong background to our discussions . On all measures the mental health outcomes for Aboriginal people are worse compared with the remainder of the population . This area needs high priority and that ’ s why we devoted a special section to Indigenous issues in our first report .”
The WA Minister for Mental Health , Helen Morton , recently reiterated the importance of allowing family members and carers to be fully involved in the treatment and recovery journey . Prof Fels couldn ’ t agree more . And , as far as the Commission is concerned , there are two carers , including Allan , on the NMHC .
“ Family members have a huge contribution to make . They ’ re the ones with the best knowledge of that person and a lifelong commitment to their welfare . We must make sure that privacy laws don ’ t obstruct this too much and we also have to train health workers to become more adept at working with families .” �
By Mr Peter McClelland
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