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The Forum > Article Comments > Misleading claims in the mental health reform debate > Comments

Misleading claims in the mental health reform debate : Comments

By Melissa Raven and Jon Jureidini, published 9/8/2010

GetUp! and mental health: not only is there a high degree of spin in the rhetoric on mental health but also there is misrepresentation of evidence.

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How do we go about getting this degree of community awareness for Intellectual Disability? Once tied to Mental Illness, and still sometimes confused with it, intellectual disability remains the great forgotten of the Australian social landscape. What we would give for a bandwagon and a high-profile advocate! Get-Up won't have a bar of it. I guess it's because the sufferers of mental illness used to be OK and with help maybe OK again, while those with intellectual disability are always just disabled. We have 55,000 people with dependent disability over the age thirty who are living at home with ageing parents - sooner rather than later the tsunami is going to strike - and I am not fudging the figures!
Posted by estelles, Monday, 9 August 2010 12:18:46 PM
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Congratulations to the authors of this article for doing the background digging I didn't have time for. I am a member of GetUp, and attended one of the initial meetings. The following is excerpted from the email I sent around subsequently to explain why I was withdrawing from this particular campaign :

I am sure something does need to be done about mental health. I am not at all sure that bandaid measures are any use at all.

Social policy in this country has a strong tendency to respond to the demands of professional groups for more and more funding for problems that predictably never diminish but only grow larger. The logic by which this operates is explained quite nicely in Daniel P Moynihan’s small monograph, “Maximum Feasible Misunderstanding”. While the ostensible purpose of Moynihan’s essay is to explain the failure of Lyndon Baines Johnson’s War On Poverty, way back in the 1960’s. I have found it profoundly useful as a template upon which to map the failure of many, or most, other attempts to ‘solve’ what appear to be intransigent social problems.

Talcott Parsons, the leading American sociologist of the 1950’s, spent a great deal of time explaining, in somewhat more convoluted ways, a parallel phenomenon – the tendency of professional groups to invade and appropriate the private domains of life, and in the guise of helping, actually destroy the capacity of individuals and families to take on the responsibilities that properly belong to them. Part of the fallout of this is the effective infantilisation of whole populations, the creation of dependencies that should not exist, and other negatives.

My trite answer to the ‘mental health’ problems (that do indeed confront this country) is that we should try and create a society that does not systematically drive half the population to swallow anti-depressants on a daily basis.(Continued in next post..)
Posted by veritas, Monday, 9 August 2010 12:51:35 PM
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Continued:

[we should try create a society that does not systematically drive half the population to swallow anti-depressants on a daily basis.] I have heard the flippant answer to this proposal that runs along the lines that if you are confronted with a road accident you try and provide immediate help without redesigning either the automobile or the road system. This may be true, but our biggest efforts should go into trying to redesign our social relationships, which are the primary cause of the explosion of the so-called “mental health” figures.

The very phrase “mental health” commits the sin of misdirecting our attention, which should be firmly focussed on the SOCIAL origins of personal distress. Why are our young boys committing suicide in such horrendous numbers? Let us fix that, and we will not have to check in a third of our young men to have psychiatric counseling.

Anyway....

The other thing that is a little worrying....I do believe that direct action is one of the best ways to change entrenched patterns... But if we don’t discuss ideas before we jump into action at the behest of HQ, then we are little more than a rent-a-crowd mob available to do what we are told, and nothing else.

I think that for myself I might have to ... determine my response one issue at a time. I certainly wanted David Hicks freed. He was portrayed as slightly retarded by the press. Yet he had the courage to do what the great majority of us did not have the courage to do, namely to put his body on the line to resist an unjust war – which we are now trying to get out of with all kinds of ‘face-saving’ explanations that can be categorised as spin, pure and simple.

This vigil is not in the same league as the vigil for Hicks
Posted by veritas, Monday, 9 August 2010 1:00:38 PM
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The mental health reform debate...how debate suicides when indeed there is no benchmark deathrate for the mental health services, as there is for every other health service.
Nothing has changed in the four years since the Victorian Department of Human Services published (I have always felt, by mistake) these stark horrific words; "There is a well-acknowledged need for timely systemic data collection for suicide and attempted suicide...To date most suicide prevention strategies, including Victoria's, have not been determined by a solid evidence base and rely largely on assumed efficacy with little or no research." Assumed efficacy=anecdotal evidence. How many health services with a high (10-13%)death rate do we run on "anecdotal evidence"?
Misleading claims occur when professionals refuse to accept the WHO statistics of 2.5-3% global serious mental illness rate with an 10-13% suicide rate. Even though we have only false under-estimated suicide rates from all states (ABS, 2008, MHCA, 2009) we should value and accept the WHO global rates, which show we have some 600,000 Australians with the severe, incurable mental illnesses of schizophrenia, bipolar 1 disorder and/or severe clinical depression and who suffer the WHo global death rates.
As for research into suicides; a never finished (of course) study of nearly 2000 suicides in Victoria, 1992-2002, showed that discharge from hospital increases suicide risk, with the greatest risk in the first five weeks after leaving care...one in five committed suicide in this period of, presumably, premature discharge and almost half within a year.
These figures have no connection with that of around 1% presented by the writers.
One of the people who committed suicide and is a number in that unfinished study is my daughter, Anne. She died 30 hours after release on leave from the Alfred Psychiatric Unit...without a risk assessment.
God help the seriously mentally ill. NO person can shout loudly enough to get help for them...but at least some people try.
Posted by Caroline93, Monday, 9 August 2010 4:06:21 PM
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Disabilities used to be attached to mental health, and was staffed by professionals. Now, it is staffed by totally unqualified people, most of whom would not have a job higher than that of waitress, cleaner or clerk. Now they are called "accommodation managers".

D.A.D.H.C. serves two purposes...it employs the unemployable, while manages people with disabilities at a lower staffing cost.

Unfortunately, what monies are saved in staffing, is lost with interest to incompetence.

I'm qualified to work in both systems of mental health and disabilities, and I assure you all that compared to when the two were under the Dept of Health umbrella, the older system provided a superior service with greater dignity. Now it's a facade of paperwork assuring that all is well, when it is actually collapsing in a convoluted disorganisation of costly incompetence.

DOCs and DADHC should be decommissioned, with all responsibilities returning to the Dept of Health.

There's a lot that the general public do not know nor understand about Disabilities as a department. To enlighten those that are interested briefly, it was set-up on a non-medical model, thus eliminating trained and qualified personnel such as doctors and nurses. Secondly, it was based upon the premise that there is no such thing as "dual diagnosis"...meaning that if you have a disability, you CANNOT have psychosis, depression and every other mental health affliction.
Posted by MindlessCruelty, Monday, 9 August 2010 7:40:01 PM
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(Continued from above)

People also forget that DOC's originally started as Youth and Community Services, then due to continued allegations of incompetence, changed their name to Family and Community Services, with allegations continuing, and so changed their name to Department of Community Services, with DADHC being a further permutation of that monster. The name changed, but the incompetent managers and premises remained the same.

It is now such a large white elephant, that to decommission them would create employment figures problems, as such is the size of these departments of cumbersome and inept administrators, overseeing areas that they have no understanding of, but make all the policy pertaining to people with disabilities, and/or people with disabilities with additional mental health issues.

It's a travesty sold as a "service".
Posted by MindlessCruelty, Monday, 9 August 2010 7:53:28 PM
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