MHCN supports BEING – Mental Health Consumer’s NSW, ‘BEING’, in its call for decision makers in NSW to reflect on recommendations in the final report by the Victorian Mental Health Royal Commission, released earlier this week.
MHCN also supports ‘Tandem’ the mental health carer peak body for Victoria, in its statement “The current Royal Commission into Victoria’s Mental Health System is a once-in-a-generation opportunity for us to truly transform mental health support for generations to come.”
With BEING and Tandem, we welcome the final report of the Victorian Royal Commission (‘VRC’) and acknowledge the courage of those consumers and carers sharing their personal stories. We thank the VRC for the robust and inclusive evaluation of the mental health system in that state.
Systemic problems that inquiry identified in Victoria are also relevant across Australia, including in NSW. We have an overburdened system that too often effectively denies access to many in need of support and only operates in a crisis mode. But care delayed is care denied. Yet the voices of people with lived experience of mental illness and of their families and carers do not seem to matter enough to provoke change, and nor do the disastrous outcomes that our system too often allows to befall them.
The VRC’s findings of the inadequacy of the system and its failure to live up to community needs or expectations are shocking, but not unexpected. There have been numerous inquiries into the adequacy of the Australian mental health system and other human services in various states and nationally that have made similar findings (see MHCN Human Rights Submission 2019 ).
Indeed in December 2017 the Review of Seclusion Restraint and Observation in NSW (‘RSRO’) made many similar recommendations. The VRC’s recommendation 9, for inclusion of ‘Safe Spaces’ and ‘crisis respite facilities’ (for pathways to urgent care for people experiencing a mental health crisis, including risk of suicide), seems similar in motive at least to RSRO’s recommendation 15 “all emergency departments should have clinical pathways for people presenting with mental health issues that are reflective of their needs. There needs to be a pathway that does not include the use of safe assessment rooms.”
The VRCs recommendation 28 ‘developing system-wide roles for the full and effective participation of people with lived experience of mental illness or psychological distress’ mirrors the RSRO’s recommendation 10 “the peer workforce should be developed and professionalised…”
There was no precise equivalent in the RSRO report to the VRC’s recommendation 29, for ‘the creation of a new agency led by people with lived experience of mental illness or psychological distress’. But the motive and at least part of the role of such an agency was reflected by the RSRO’s emphasis on the need to amplify the voice of lived experience in the mental health sector and services, and to address trauma in the design and delivery of services through co-design and co-delivery, “12. Consumer and carer co-design and systematic engagement should occur at all levels of the health service”. Both inquiries recommend working towards the elimination of seclusion and restraint.
We note that the RSRO in this state has prompted a lot of work by the Mental Health Commission and the Mental Health Branch, LHDs, services and agencies to address many of the defects identified, and many of the service reform objectives and outcomes articulated previously in “Living Well the Strategic Plan for Mental Health in NSW”. But at a system wide level it is also unclear exactly how effective this work has been, where it has failed (if anywhere), what. if any obstacles might exist to its success or further improvement and therefore what strategies might be needed to help?
Like the RSRO’s, the VRC’s excellent recommendations seem to have been taken up by the state government for vigorous implementation. But without sufficient transparency and thought as to how to measure and publicly report tangible progress towards their achievement, (with these measures built in right at the beginning), it may be hard to tell in four or five years time what real progress has been made, and what remains to be done.
However, MHCN endorses BEING and others in saying that empowering people with lived experience of mental illness and those who care for them over and within mental health services will help a great deal. Short of sophisticated data measures (and even with them), asking consumers and carers about their experience of the support received from services is the key and in some ways the only real measure of those service’s value. Our systems must become much more responsive to this. YES and CES are excellent general measures, but specific issues require specific measures to understand, monitor and resolve them.
MHCN also strongly endorses and echoes’ Tandem’s just demand, that Victorian’s and all Australian’s have the right to expect a mental health system to be delivered by their state and federal governments that is: Safe, Accessible, Fair and Funded!
It really seems like the very least an enlightened society could be expected to provide for its people when they are at their most vulnerable. In NSW MHCN will continue to build its Mental Health Carers Advocacy Network Register to empower mental health carers and their community to advocate for a system very similar to that which the VRC recommends here as well!