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