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Serious reform needed to address growing Australian mental health crisis

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Through inaction, the Australian Government is failing those in need (Image via Pexels)

With the Federal Election being two years ago today, this is the mental health reform we should demand going into an election year, Simon Katterl writes.

HOW LONG must a crisis persist before crisis is seen as government policy? Not a week goes by that we don’t hear about Australians taking their lives or being harmed by an imperfect mental health system.

And while there are complex arrangements between different levels of government, it is fair to say the Commonwealth has never stepped up to a leadership role.

As we are a year out from an election, Australians need governments, oppositions and cross-bench leaders to step up and put mental health on the map. Many topics deserve discussion, such as stigma, discrimination and contested debates around Medicare rebates.

However, for real change, we should focus on the structural problems and the structural solutions.

Here are five structural policies any prospective politician should have a position on.

Tax them and support us

Many parts of the economy represent a tax on our mental health. Whether extractive digital platforms like Facebook, Instagram and Twitter/X, or gambling companies that are implicated in our suicide crisis, their commercial gain is our psychological loss.

Subsidise things you do want and tax things you don’t. That is a common maxim of economic policy, and it should apply to how we address the corporate drivers of mental distress and suicide, including gambling.

A Commonwealth mental health levy that complements existing revenue will support new and better mental health and addiction support services nationally.

Protecting psychosocial disability under the NDIS

The National Disability Insurance Scheme (NDIS) Review has led to real concerns amongst people with lived experience of psychosocial disability that they are being sacrificed for budgetary reasons.

The early intervention pathway proposed by the Government would mean that many people with psychosocial disability are moved from the core NDIS model to one with significantly shorter support.

Rather than segregate people with lived experience from a scheme that, though imperfect, has been valuable to have choice and control, governments should identify ways to create sustainability for all NDIS psychosocial disability participants, equally.

Co-designing that solution in the next term of government, rather than ram through discriminatory reforms that disadvantage people with lived experience, is a commitment we should look for.

Give us a strong and independent national mental health commission

Every year, we hear more questions about our mental health commissions. At their heart, Commissions should be important in balancing the different interests of industry bodies, governments – at Commonwealth and other levels – and mental health services, while articulating the public interest. It is also crucial to getting the states and territories to pay their share on national mental health reform.

For the National Mental Health Commission to be effective, it has to be empowered and authorised to monitor governments and their promises, so that people in Brisbane and people in Brusselton each have their mental health needs met.

Young people amidst a youth mental health crisis, First Nations communities grappling with suicide and other under-served communities rely on a Commission that goes in to bat for them.

The recent Commonwealth Budget spoke about reforming the Commission. Urgent changes to create an independent and powerful Commission will be key.

Respect for lived experience requires funding

People experience mental health discrimination across virtually all aspects of our society. This happens in schools, in the media, in workplaces and in mental health services.

This is also seen in the lack of funding for lived-experience-led mental health services.

People with lived experience, including peer workers, have a long history of supporting one another while in distress. Positively, the Commonwealth has committed to an association to represent peer workers, like exists for other workforces.

Future governments should be prioritising lived-experience-led and controlled mental health services, including early support, crisis and post-suicide support services.

A National Human Rights Inquiry and act

In every state and territory, we permit human rights abuses against people with lived experience that we would not for others. Inside locked wards, the use of seclusion, restraint, forced medication and forced electroconvulsive treatment remains disturbingly high.

That this operates as shared national policy is an affront to our liberal principles of freedom and equality.

Any government wishing to embark on mental health reform should do two things: establish a restorative justice process to identify that harm, and hear from people with lived experience and invite government and system representatives to respond. Similar processes have been called for in Victoria and in Queensland, with governments yet to act.

While this occurs, the Commonwealth Government should prioritise a national human rights act, with specific elements designed closely with people with lived experience. This will enhance the human rights of all Australians, not just those with lived experience.

There are no quick fixes to structural mental health reform in this country. There are only structural solutions.

They are difficult. But if our lives are on the line, then it is too important not to try.

Simon Katterl (he/him) is a mental health and human rights advocate with lived experience of mental health issues. He has advised government ministers and legal and mental health services. You can follow Simon on Twitter @simonkatterl.

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