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!

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..)

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

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.

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.

(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".

The authors:
McGorry’s likeness to Geoffrey Edelstein is striking. Will he too one day fly a pink helicopter and own a football team; I wonder?
Surly to drag the GP kicking and screaming into the mental illness primary care role, as your article suggests, is a strategy bound for failure. His role is surely to treat physical illnesses with roots of pathology/organic origan.

Since very little mental illness (include here suicide) originates from the physical source, mental illness must therefore be categorised as a disease of philosophic or socially deviant nature. From this view the solutions are much simpler and raise the question “why should the tax payer fund treatment of any illness which has no physical origan”?

This view solves the problem of funding using the philosophical argument. Governments are correct to argue that all those in society should contribute to the economic wellbeing of the greater mass by avoiding the excuse of mental illness to justify malingering.

To diverdan...your knowledge of mental illness appears extremely poor; please examine the following facts to your satisfaction. The major illnesses classified as serious/severe in mental health are schizophrenia, bipolar 1 disorder and/or severe clinical depression. These are incurable and biological diseases of the brain which may now be seen in some scans and in post-mortem examinations. The areas of the brain exacerbated when voices are heard may also now be viewed. World Health Organization statistics show a global rate of severe mental illness as 3%. In Australia's 20 million this means we have some 600,000 seriously mentally ill people suffering a disease with the WHO suicide rate of 10-13%.
We do not care for our severely mentally ill and mental health reform is desperately needed.
I find it difficult to believe that you have had no contact, however tenuous, with a person who has severe incurable mental illness and/or
has completed suicide.

Another ludicrous situation in mental health....PEC Units...psychiatric assessment units attached to Accident & Emergency Units in most General Hospitals...the idea of a PEC Unit was to take pressure off triage and remove mentally unstable people from Accident and Emergency, due to the disruption they often create. Good idea. But the PEC Units won't accept anyone that is unstable!?!? Of course, this forces the mentally unstable patient to remain in Accident & Emergency until they "stabilize".

We don't have lunatics running the asylum...oh for it to be that good!! What we have is complete idiots ruining/running everything!

Diver Dan, "Since very little mental illness (include here suicide) originates from the physical source, mental illness must therefore be categorised as a disease of philosophic or socially deviant nature"...I'm afraid there's much more to it than that. There are numerous forms of depression in which suicidal ideation may feature. Some forms suggest genetic links, such as bi-polar, while others not, such as reactive depression. There's more, but we only have 350 words.

The affliction is more accurately categorized as psychological and emotional, not philosophical. Deviant only means minority, not in "normal" parameters, while "normal" only means averaged amongst the collective. There is no such thing as the "normal" or "average" person. These are statistical terms, not a human condition. For it is "normal" for ALL humans to experience the gamut of metal health symptoms and features at one time or other in their lives....for example, you only have to be awake for 24 hours to start experiencing some psychosis. Only need the death of a loved one to experience at least briefly, mild depression. We all have habits, and some may be "obsessions", and so fall under the neurotic umbrella, at times. It's only when these "features" overtake our lives so that we cannot function in a "normal" manner, that we can say that there is a "problem".

TBC...

The tax-payer funds health care. The source of poor health is not the concern of the tax-payer, but of the individual concerned, the medical staff, the researchers in the field(s), and ultimately, the government and insurance companies in funding most of it. Causes in both medical and mental health are rarely clear-cut and singular in nature...there's usually many contributing factors, and over-lapping features of other issues.

So in a "holistic" approach to health care, cause is the concern of the researcher, positive therapeutic regimes and outcomes the concern of the practitioners, and the will to make changes and adjustments to their lives is the concern for the individual(s) involved.

The tax-payer then may rest assured that regardless of the cause for them to be in need of whatever service, the service is there. If there's an individual tax-payer that never is in need of such services, then that is a very rare tax-payer indeed.

Agree with most of what written above by veritas, MindlessCruelty and Caroline93.

Tony Abbott's broadband misunderstanding presented as a plan horrifies self - suspect others also.

Wanting to see established and used on-line video-counseling services to assist assessment and treatment of many rural and remote areas people who suffer mental illness.

The NBN from ALP at least offers us chance an on call pool of trained, qualified, experienced and competent mental health people to assist in the diagnosis and treatment of mental illness sufferers

Caroline 93
There are many events in life that prompt one to feel the need to bail-out (suicide); let us be sensible in drawing conclusions about diagnosis of mental illness. As with schizophrenia, not a disease in itself, it can be argued, but more an aberration of the mind I would think; a conclusion based on the view historical facts of that classic “illness” (sic).
Another bleating argument often heard in support by weeping and wailing for the mentally ill is the incidence of mental illness amongst inmates of jails. I read recently that figure was at 40% of inmates. Well, here I extend the debate to cover this group. Surly if one breaks the law to the degree that incarceration becomes necessary, where is the problem? Should we release 40% of detainees as a gesture towards mental illness? Extending the logics of the argument put forward by the “industry” (again sic.) now looking for more taxpayers dollars in support of overpaid medical “experts” lounging back on the mental illness gravy train.

Polpak, thanks for your support. But the ALP has no answer to the problems either. Their proposal for "super clinics" is a facade...it sounds good to the general public, but it falls well short of the mark of making any meaningful impact. The clinics that already are out there can provide a superior service for less than half the cost, they just require some additional funding and show accountability for that funding...that the monies are used specifically for their designed purpose, and not just feeding some coffers.

Gillard announced 2,000 more nurses over the next 10 years. That's 200 nurses per year. I could place 200 nurses in Sydney, and still be 2,000 short. That's a single band-aid for a dog with three severed legs, and then calling him Lucky.

And even then, there has been a lowering of competency levels since the early 1990's, when Neville Wran was Premier, it was noted that there were 20,000 Registered Nurses that had the qualifications, but did not use them, creating a shortage. Rather than asking why, they then lowered the prerequisites to gain entry into the course, thereby lowering the quality of personnel.

Had they asked the 20,000 why they didn't use the qualification, they would have been told that it's just too damned legally dangerous, emotionally and physically taxing, with responsibilities and diversity of duties far outweighing the pay-scales, and risks of litigation, physical and psychological abuse. Lowering the calibre of personnel does not fix this. This is particularly the case in Mental Health, where people are unstable emotionally and physically violent, and every sort of accusation possible can be made...in a day! Let alone for a career, and the physical harm that is at risk to you. It's dangerous physically, emotionally, psychologically and legally, and made more so with a lower calibre of staffing prerequisites, less permanent jobs, and more jobs being made casual to avoid "unfair dismissal" laws, holidays, sick leave, etc.

MindlessCruelty:>> Had they asked the 20,000 why they didn't use the qualification, they would have been told that it's just too damned legally dangerous, emotionally and physically taxing, with responsibilities and diversity of duties far outweighing the pay-scales,<<

A factual post Mindless.

Both sides of politics at both state and federal level have allowed the health system to become administrator heavy. Further to that the job spec of the administrators has evolved to manipulating clinicians in matters medical through the implementation of admin systems and protocols that serve no practical purpose but to justify their positions, but these administrated impositions do affect the decision making process of the clinicians, a role that was previously the domain of the medicos. This usurping of the role of the clinician has also driven competent staff away from the system, as it has in the police and ambulance services.

When we talk about fixing the health system we talk in hundreds of millions and govt freaks out at the thought, yet we have just blown 16 billion on a bunch of portable sheds and taught the kids nothing.

They say you get the govt you deserve, but I know half of us don't deserve the shameful incompetent lying clowns we have, and the other half are too simple to comprehend. Ignorance is bliss and we have become a blissful nation.

diver dan:>> As with schizophrenia, not a disease in itself, it can be argued, but more an aberration of the mind I would think;<<

DD you would not be thinking like that if you were schizophrenic. I thought your post was an aberration, I was wrong you actually employ simplistic logic, no offense.

Sonofgloin,
No offence taken. However, the historic interpretation of a schizophrenic (prior to Freud and company who kicked off the cult of mental illness in the 1930’s) was imbecile. To this day no laboratory test for schizophrenia exists. So sonofgloin, do you still believe my description of the malady of schizophrenia as a “mental aberration” inappropriate?
My argument is as the first poster, estelles, lamented: There are much more deserving causes in the field of health looking for the tax dollar, you would surely have to agree.

DiverDan, “My argument is as the first poster, estelles, lamented: There are much more deserving causes in the field of health looking for the tax dollar, you would surely have to agree."

Estelle mourned the lack of resources within Disabilities, she did not suggest or imply that no resources should be thrown towards mental health, but lamented that both used to be associated with each other. She is perfectly correct. Under that circumstance, Disabilities received a lot more professional services than they currently do.

Regarding your comment about there not being a lab test... Psychology/psychiatry are "soft" sciences, meaning that no instruments can be made to do the testing for the dysfunctions...in schizophrenia, the dysfunctions are apparent in their behaviour and portrayal of attitudes, coupled with their experiences of auditory, visual or olfactory hallucinations, or delusions. It’s all relative to the individual, and unfortunately, relative to the observer too.

Just because a machine cannot be made to determine these events, doesn't mean they don't occur, aren't legitimate or are less than valid. No machine can be made that can track an abstract thought or idea, let alone the emotional content of any such thought. This leaves the industry in the unfortunate position of being far more subjective than most of the other "hard" sciences where instruments may be developed for measurement and detection.

And all this leads me to the point of “profiling the profilers”…we “profile” for terrorists, we “profile” serial killers, corporations “profile” executives for compliance to corporate philosophy as well as ability, but we don’t profile the people that do the profiling. We look at base qualifications, but not suitability in personality. It’s bizarre! Most people that work in my industry, shouldn’t. And the people who should, won’t, because there’s too many that shouldn’t, occupying positions.

Back to genetics, all this has a lot to do with why genetics is the holy grail for many researchers in being able to find a definitive cause for many mental health conditions. But mental health has as much to do with the person's personality and their environment as their genetics. Genetics, most of the time, can be overcome with good management (in mental health), but good diagnosticians and staff are a rarity indeed, these days, due to what I mentioned about lowering the prerequisites, but also and equally importantly, there is no training for mental health staff outside of the few institutions that exist (and there’s been an active winding-down or closure of most of them) except for a few private courses that are costly. Currently in the Nursing curriculum, only one hour in 3 years is dedicated to mental health. Probably about the same for Disabilities. And we wonder why these services are in disarray!?!

When I started in the industry 30 years ago, there were 3 year courses for both Mental Health and for Disabilities, or an 18 month "conversion" course if you already were qualified another field of nursing, and we were treated like the poor cousins to general nurses anyway back then. Now, there's no specialized course for either, and only a mere mention of the topics for nurses at university today. We're not poor cousins anymore; we've been completely exiled with the view to eradication.

I've already mentioned no qualified staff within Disabilities, but now with many psychiatric units attached to General (medical) Hospitals, most of the nurses that staff those areas are only general trained, not psychiatric trained. So again, regardless of the calibre of the personnel, they are not qualified nor experienced to staff the areas, and yet they do.

Bring back hospital-based training, but in conjunction with university. Bring back the training and qualifications to work within specific areas. And the contentious point for most, bring back institutions...I'll answer any questions pertaining to these points.

To diver dan: your views on severe mental illness (SMI) contribute to the miasmic stigma which surrounds the severely mentally ill. The biological/physiological evidence for SMI is freely available on the world wide web. I understand that you may not care to view it.

The figure of 40% SMI is correct for male prisoners; it approaches 50% for female prisoners. This is because, the processes of deinstitutionalization having been done so poorly by all states, with what should have been the first step never finished, prisons are now places of reinstitutionalization for the mentally ill. Since our legal system does consider persons may be of unsound mind, many should be in a forensic hospital for possible rehabilitation. Such placements are rare as beds are unavailable.

The life expectancy of the severely mentally ill is 25 years lower than that of other Australians (except for a majority of indigenous people)

Mindless cruelty/caroline93
There are factors to the argument that must be clarified.
1. Mental illness “the disease”?
This is the achilles heel of the profession: Its vagueness as a so called disease, and the innate ability of humans to imitate symptoms of mental illness on cue.
2. Resourcing
A Lack of scientific credibility verses the industry ability and willingness to petition for un-proportional resources.
3. Success of treatments:
The matching of vague illnesses to the unreliable credibility of patients.
4. Treatment verses care; the priority.
Are prisons the sensible and economic answer as outcomes to behaviour of the mentally ill?

DiverDan, "1. Mental illness “the disease”?
This is the achilles heel of the profession: Its vagueness as a so called disease, and the innate ability of humans to imitate symptoms of mental illness on cue.”

It’s unfortunate that in its beginnings, mental health was based upon a medical model, and a new model wasn’t created. However, we are stuck with that model and some of the terminological misgivings that it sometimes offers. That being said, if you can accept that different industries have differing jargon, and that differing sub-cultures use a differing vernacular, then it shouldn’t be too difficult to accept some of the terms used within mental health, and try to accept the connotations we apply to them. Disease in mental health cannot be thought of in the same context as disease in medical health.

What we must accept in something like psychology, is that these are conceptual terms that describe an affliction, and use a medical model to make that description. But that description cannot always be as clearly defined and determined as say, a broken bone, or a particular microbe.
For example, you cannot point to fear. You can point to a person that may appear to you to be fearful, but fear is a personal and a relative concept. Only the person suffering fear can tell you what they fear, and then attempt to substantiate some of the reasons why they believe it is so. So in point of fact, if there are 6.5 billion people on the planet, then there are 6.5 billion interpretations of what fear is, and what they fear. The Achilles heel of the industry is that, and the fact that few people truly understand and appreciate this! And yet we have only described one single facet of the human condition. We haven’t spoken of depression, joy, paranoia, neurosis, ad infinitum. Nor have we even begun to contemplate the myriad of manifestations that this fear may adopt.

Many emotional and psychological conditions have no singular cause, but are a culmination of many triggers over time.

TBC

The terminology of the industry must grapple with these facts, and then grapple with the personnel interested in the subject matter, that they are lateral thinkers, not black & white concrete thinkers, that the personnel has insight, emotional maturity, and life experience and understanding, as well as the academic knowledge and training. To have an understanding of some of the people that you encounter, you must also have an understanding of the society and that society’s sub-cultures at all levels, and some of the unique influences of those groups. It’s as much a path in personal growth as it is the study of the human condition and society. It is not only an intellectual pursuit. Some of the brightest people are poor at understanding some of the material, for you cannot always think of things in linear terms, nor take things on face value. Which brings us back to our inability to build a machine that can detect or determine levels of something as common in understanding conceptually, as fear. Which brings me back to insight and understanding….if you think you need a machine to make these determinations, then psychology/psychiatry is not the field for you. It can never work in such mechanical terms and parameters as “hard” sciences, for it is organic and dynamic, not static. Maths has little use other than as a statistic in this field.

TBC

The human condition is full of paradoxes and ironies, and terms like “reverse psychology” do not exist for nothing, but is a vague description of an application in psychological terms of an irony. Sometimes you have to walk backwards, to move forward. Sometimes, the very thing that you would normally expect to do, is the very thing you should not do. For example, the act of self-harming is an attention-seeking behaviour…it attracts attention to the act, that in turn for the observer, sparks the reaction of intervention. This in turn often sparks volatile conflict, with increased emotional and physical levels, for it is oppositional…it’s attention, albeit negative attention. So, the very thing TO do, is to ignore the act, but engage the person. This decreases the chances of escalation of emotions and volatility, and clearly, is not oppositional. They will cease the act after gaining your attention, not your intervention. But to the uninitiated, the first impulse is to intercede and attempt to disarm the person, creating conflict, therefore creating volatility due to its oppositional stance and the physical act of intervention. Don’t even look at, or talk about what they are doing, but talk about them and look them in the eyes. They’ll stop what they are doing and then volunteer the offending weapon in time, and then you may patch-up their wounds. There’s a lot more involved to stopping the behaviour permanently, but that will de-escalate the situation in the short term.

There are many such peculiarities.

“2. Resourcing
A Lack of scientific credibility verses the industry ability and willingness to petition for un-proportional resources.”
Resourcing…a valid point. Doing anything properly seems costly in financial terms, but it is not cost, but rather, investment. It’s a social attitude, as I have just demonstrated with use of the contrasting term of “investment”. While we view it as a cost, it will always be under-valued, whereas an investment reaps rewards.

No scientific credibility? Little understanding, and thus little credibility given, more to the point

“3. Success of treatments:
The matching of vague illnesses to the unreliable credibility of patients.”
Poor science is a reflection of poor practitioners, not the quality of the science and its success rates in particular conditions by better practitioners.

“4. Treatment verses care; the priority.
Are prisons the sensible and economic answer as outcomes to behaviour of the mentally ill?”
Yes…for you and your loved ones, it is. Or would you like to reconsider that statement? Or I could put it this way… I could call that statement indicative of a sociopathic tendency due its elitist and dispassionate suggestion for the management of people with certain afflictions, and its obvious lack of any sense of morality. So how should we deal with that sociopathic notion? Should we imprison you? Do you see the slippery slope that is easily created by such a suggestion? I don’t mean any of it to be personal, but a demonstration of how easily things can be made subject to interpretation, depending on what we like to emphasise. In this instance, I have manipulated understanding, but you never know when there is genuine misunderstanding, and when there is agenda, and how easily we may all fall under the receiving end of it. For example, it is not unusual to experience an acute psychotic episode from nothing more than a spike in body temperature . Would you like to be imprisoned under that circumstance? You had a bad inflammation of some sort and body temp spiked, got psychotic in a public place, and went to jail. You don’t have a mental illness, but for a few hours, possibly a day or two, you present as mentally ill.

It’s easy to need the service, but it’s hard to understand much of it, and even harder to implement good recovery programs, for we are returning people to the very environments that often are providing the triggers for many of their issues. It’s a lot tougher than most people realize to get positive outcomes. There is no such thing as a “clinical environment” for the study of human behaviour. We cannot put people in cages and mazes like mice, and study them. It sounds obvious, but you have to agree that it’s rather a large limitation in the study of something.

So in short, the limitations do not de-validate the science, but are additional challenges to those that pursue the science.

Could I just move this discussion back onto topic and inject a fresh breeze of common sense at the same time. I propose we step back and look at what REFORM really means, and at where the misleading claims are coming from.
This debate (not just this forum) has become more like a debate on capital punishment where all that is being discussed is "What music should we play in the background while we are connecting the electrodes?"
What about such questions as "Should the multi billion dollar pharmaceutical industry pull all the strings on government policy in this field?" or
“Should we accept the ‘expert opinion’ of McGory’s PR machine, or should we get back to grass roots and listen to people who care for individuals”
"Should we really be building a system to look for new and earlier opportunities to drug school children?"
Of course there are a lot of misleading claims being made in this debate because that's what happens when there is big money at stake.
So I put to you this question;
Have good Australians been railroaded into supporting a whole new “solution” to mental well being that is in fact the PROBLEM not the solution?
The more money we pour in, the more “mental problems” are being discovered.
The more anti-depressant and anti-psychotic prescriptions we write, the more sadness and violence there is.
The more spin we swallow from the “Experts” the more we stop looking for real answers to making people well.

@Cynix, Good questions. But every time I try to respond, it turns into 2 million words or more, not 350.

“Have good Australians been railroaded into supporting a whole new “solution” to mental well being that is in fact the PROBLEM not the solution?”

Not deliberately, but as a side effect of our greater emphasis and focus upon “bottom line” and the business orientation of society. “De-institutionalization” was the politically correct mantra to close down centralized resources, and place patients/clients into the community. But what does that mean? That means left in the care of families that cannot cope, or funding “group home “ accommodation at tax-payer expense, buying properties at market rates, and scattering the clients all over the city. That’s hundreds and thousands of houses to purchase, maintain, repair…which there’s a lot needed because of the client type. And with no centralized resource, now they go all over the city for appointments. But if they are in the care of employed carers, then that includes the carer now and their costs, being paid to be with one person only, but only to traverse the city all day. The carer costs less per hour as they have no qualifications, but they cost more because more are required to do less, further stretching the already short resources. And due to the lack of overall qualifications industry-wide, a lowering of overall standard of care and management of clients, staff, facilities, and of course, monies.

Yet they cried “professionalism” by sending nurses to university by taking them from hospital-based training. In 3 years of uni, the curriculum covers one hour of mental health, probably the same for disabilities. I can’t comment on the general nurses, but I presume in 3 years they learn something, but as far as mental health or disabilities is concerned, none have been trained since 1984. But it used to be three years full-time at a psychiatric hospital. They have closed most of these hospitals, and downgraded the ones that still exist.

TBC...

That means sucking money out, not putting money into both facilities and training/education of qualified personnel for mental health! One hour is not even much of an overview in mental health, let alone training and education. Trainee nurses were both the cheap labour, some of whom qualified to become skilled and even highly skilled professionals, and so also the more expensive labour. It was a perfect balance. So even in mental health units today, they are staffed by qualified Registered Nurses, but ones that have no formal education in mental health anymore. The ones that are around, are those of us that qualified prior to 1984, or the very few that worked in psychiatric hospitals that provided “conversion” courses, but not in the mental health units that now adorn all general hospitals, replacing the mental health institutions. It’s exactly the same for Disabilities. There’s no new blood, and the rest of us are getting too old, worn-out and crusty from the lower calibre and qualified/experienced staff.

Finally, comprehend this if you can, because I sure as hell can’t…I managed a dual diagnosis unit, which means it assessed people with both an intellectual disability and psychiatric diagnosis. The unique thing about this facility was that it was for the purpose of assessing the worst 350 odd clients in the State that had bounced between jails, juvenile detention centres, psychiatric facilities and other assorted welfare departments…the “unmanageable”. So we assessed, stabilized, managed and implemented management programs, and once those things were achieved, then placed them in appropriate accommodation with staffing. I’m formally qualified in both areas, but my immediate superior that wanted to make clinical and management decisions about all clients, was a drama teacher with no qualification or experience in either area. She is the reason that both I don’t work there, and the unit closed shortly after my departure, yet prior to her sinking her claws into the project, we were getting good results and had great personnel.

TBC...

On the basis of how many of the welfare agencies function in this country, I should run NASA, as I know absolutely nothing about cosmology, quantum physics or technology. The problem with the mental health industry is that there aren’t many people that know very much about it left working in it anymore, as it has been decimated by governments under the guise of “de-institutionalization”, when actually they’ve merely thrown the problem back at the families with the problems, and downgraded both access and quality of services. There is no perfect system, but a centralized system is superior in all ways than a scattering-to-the-wind system.


“The more money we pour in, the more “mental problems” are being discovered.”

We’re not pouring more money in, but the opposite. There aren’t so many more mental problems being discovered, as there are more people identifying a need for one reason or another, with our cities growing in population but 50 years behind in infrastructure, with no planning foreseeable.

“The more anti-depressant and anti-psychotic prescriptions we write, the more sadness and violence there is.”

I believe my two previous answers have addressed this issue, at least backhandedly.

“The more spin we swallow from the “Experts” the more we stop looking for real answers to making people well.”

Yes, but the spin we are listening to, is the spin of government officials that are merely relaying their spin of experts’ reports that they only glean the cost-cutting and political expediency out of. In NSW in the 1980’s, the Richmond Report is a wonderful example, where Richmond did a thorough and thoughtful investigation reporting on the four areas of aged, general, mental and disabilities health care and management, writing a paper on each. “Nifty” Neville Wran, using his hatchet-man Laurie Brereton, bastardized the reports and decimated the health system in NSW in the mid 80’s, from which it has never recovered, but slowly slid further into desperate disarray at high cost, under these two politically-charged headings…

TBC...

1.”De-institutionalization”: to put people back into the community and their families, thereby theoretically reducing costs, but in effect increasing strain on families, requiring further, not less assistance, and so now compounding problems, and;

2. “Professionalism”, by getting the support of the majority of the nursing fraternity to go to university, ceasing hospital based training shouting the mantra of nurses becoming “professionals at university, and in effect, ceasing training in disabilities and mental health, allowing the employment of unqualified cheaper labour that has come at a much higher cost in those areas, and the breaking-up of Disabilities and Aged care from the Health Department, to a new department based upon a non-medical model, for lower labour costs, but subsequent lowering of standards at increased costs through mismanagement and incompetent use of resources. I won’t even talk about the corruption.

Bring back hospital-based training, but couple it with university, and bring back some focus of centralized services with the economies of scale that it affords, rather than scattering clients and services across the countryside. I know “institution” is a dirty word, but it’s the only realistic form of care for a large number of clients and their families, that the State can afford and still provide a quality service. This of course coupled with community services, as I’m not advocating institutions alone, but a re-thinking of their positives, rather than the hysteria about some of their negatives that has been the focus of the last 25 years. I’ve been in the industry for just over 30, so have seen first-hand how both work.

Nurses from Third World countries are being employed because people from these countries do not buck the system, but are grateful for a job. A union is only as strong its membership, and these people do not speak out, let alone partake in any industrial action. Most staff, especially in Disabilities, are on contracts, not full-time, further making staff reluctant to speak-up about conditions for both staff and clients, for fear of loss of contract