The Roadmap for National Mental Health Reform 2012 – 2020 is an interesting document for a number of reasons.
- It moves away from the neoliberal notion of self-responsibility to state that the nation’s mental wellbeing is a collective endeavour
- The government is committed to reducing stigma and discrimination
- Reducing suicide rates
- Individuals and their families have access to appropriate services, supports, stable and safe homes
- Individuals are able to participate successfully in education and employment.
Each and every one of the points listed are admirable and worthy of inclusion in a forward-thinking strategy to improve the nation’s mental health. I uphold the reform in general and applaud what appears a commitment to providing those with mental health issues a way to access the support they require.
The strategies it is in the process of implementing are to:
1. Increase opportunities for people with mental health issues, their families and carers, to determine the most appropriate services and supports, including through individualised funding mechanisms such as the National Disability Insurance Scheme, as well as their capacity to contribute to the design, implementation and evaluation of mental health policies, programs and services.
2. Increase the availability of prevention and intervention activities appropriate to each person’s life-stage and circumstances, including for children, young people, new parents and older people.
3. Support people to access natural supports, such as family and friends, community groups, and self-help groups, and provide services that assist people in accessing and maintaining these supports.
4. Support integrated and recovery-oriented approaches to service delivery, including through the Mental Health Recovery Framework, to help reduce the recurrence of mental illness and, where possible, prevent future episodes of such illness.
What a lovely list of good intentions. Pardon my cynicism but how are they intending to implement this lofty programme of strategies when funding has been so severely cut, jobs are moving from permanent to casual and contract work and services historically tightly knit into the health system are to be tendered out to the non-government and private sectors. I wonder what kind of services individuals with mental health issues will receive.
In contrast the Australian National Drug Strategy (NDS) 2010 – 2015 takes a different view to the problem of illicit substance use. Addiction has a mental health classification in the DSMIV which means addiction is as much a mental illness as bi-polar, schizophrenia, anxiety, panic disorder etc, and to my mind belongs in the domain of the health system. However, the NDS is a document that has a dominant focus on minimising the criminal harms of substance use. Apart from mentioning the needle syringe programmes, methadone programme or alcohol and drug clinics there is no talk of collective responsibility for supporting those with substance abuse issues to become well again – a very different document compared to the Mental Health Reform.
Has society, with no small help from the media, so stigmatised drug use that we can only discuss and remedy it in terms of a criminal approach. The combative stance taken by policy-makers and the media is disturbing when emotive language is used to portray this sector of the community. Sweeping generalisations that state the drug trade is linked to serious and organised crime, prostitution and trafficking of people and firearms. Our service works with people affected by illicit drugs every day of the week and I have to say I know of one drug dealer, one prostitute and a number who may have committed petty crimes.
Not for one moment am I condoning acts of violence while under the influence of an illicit substance, or alcohol for that matter, what I am pointing out is that almost the entire focus of the NDS is on the criminality of substance use rather than on the health issues it poses.