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The Forum > Article Comments > Abandoning the mentally ill > Comments

Abandoning the mentally ill : Comments

By Bob Montgomery, published 24/10/2005

Bob Montgomery argues Australian governments have not been spending enough on mentally ill people.

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Dr Montgomery

Thank you for an excellent article. It marries nicely with Dr Morgan's article. As a psych/mental health nurse of long standing (see my response to Dr Morgan)I fully concur with your views.

I have had the privilege of working with clinical psychologists in the community mental health sector. Great team work, great collaboraation, and great sharing of views. I used to really enjoy joint case management.

I particularly agree that mental health services seem to be paying lip service to people with mental health problems - especially when they employ "quassi" mental health professionals. Sadly, I think it will get worse.

And I strongly support your stance that clinical psychologists should be recognised re Medicare. Clinical psychology is a science and a pure discipline. The same cannot be said for complimentary therapies.

I loved your point about GPs. I taught into a GP mental health education program some years ago. They loved it, but most did not want to engage in counselling or therapy. They just wanted to know early warning signs and the best way to refer. Counselling in 15 mins? Gotta be joking.

Yes, early intervention and health promotion is the way to go. I have written and taught into community mental health promotion projects. A hard slog, but extremely beneficial for all participants (including myself).

I wish you well in your endeavours
Cheers
Kay
Posted by kalweb, Monday, 24 October 2005 6:45:24 PM
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Thanks for this Bob. Psychologists have been ignored for decades. The pharmaceutical industry and professional jealousy from doctors has seen to that. However, in your article where you see the word psychologist you could add in social worker and psychiatric nurse.
I would like to make two points: Firstly, politicians were sold the idea that mandatory injectable drugs would solve the mental illness problem. State governments brought in forced medication orders then ordered mental illness services to send their patients to GP's. In the meantime services were run down and cut.
Secondly, The lost services cannot be re-built. Our current governments will not put back the funding. They canot replace the old mental hospitals because they have been sold. All present governments absolutely refuse to do anything other than expand prisons to house mentally people because to do so would admit they made a mistake - a big mistake and they won't be shamed. Therefore we have to look at alternatives to government. Until we start to do this nothing effective will happen.
Barfenzie
Posted by Barfenzie, Tuesday, 25 October 2005 8:06:05 AM
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Reading from the states... quite wonderful article! Things ain't so different here... Dr. Peterson
Posted by catsongs, Tuesday, 25 October 2005 9:55:49 PM
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Dear Bob,
If only we could roll out your therapy Australians would be a whole lot healthier...
Thanks!
Posted by aramis1, Wednesday, 26 October 2005 8:34:02 PM
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I agree that "we are saddled with a health system that is overwhelmingly biomedical in its focus and expenditure, paying scant attention to the psychosocial factors involved" That the saddest fact is that more than half the Australians with a psychological disorder will receive "no treatment at all", for their disorder, within the near future.

It’s about time governments and NGOs took a better look at the evidence suggesting we utilise and integrate preventive, psychological resources, through sustainable health and development policies and practice, in human social development.

Throughout Australia we find, there is no serious evaluation of the effectiveness of cheap mental health services, only the jestings on crisis provision. Alongside the honorable "gaze" of the otherwise sightless pychiastrists, we have, as Bob Montgomery puts it, the "penny-pinching program of converting psychologists’ positions to generic mental health worker positions".

Australia fails to effectively meet the needs of people struggling with real psychological problems, or who are "mentally ill" because Australia, and especially Queensland, has inadequate community health resources, at all regional and local levels.

Through the health system, there is a poor recognition of the causal elements, associated with declining life-quality indices, contributing to mental health, where there is a great need to fund community enterprising programs, at miro-levels, within regions, to alleviate this growing phenomenon.

The consequence has meant that there is a large number of people, from all sectors, becoming entangled in a arduous social drift, whereby we net large numbers of people, who have absolutely "no access to adequate community support and services". There is little, if any support to help people who suffer from "psychological" problems or indices contributing to possible "mentally illness", and therefore these people have little opportunity to; "adhere to their illness management plans" and enjoy a reasonable quality of life, within a supportive sustainable environment.

We require a commitment from government, to fund "mental illness prevention" and "mental health promotion programs", with the view necessary to focus on "respect for the beneficial results of sustainable human development", of future generations, and the growth of whole neighbor communities.
Posted by miacat, Wednesday, 26 October 2005 10:05:56 PM
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Mental illness not only affects the person who is hearing voices, having extreme mood swings, self-harming (cutting, alcohol, drugs, dangerous sexual practices, suicide, etc, but it also disrupts the lives of family and friends. They usually get zero support, zero understanding.

Reading some of these articles on mental illness - I feel like I
have died and gone to heaven (or a parallel world).

Parents know their children better than anyone and yet are often left on the sideline. The public system often contributes to a patient's mental illness because parents and other concerned people have no way of criticising psychiatrist without some theory on parental behaviour being espoused to explain away parents' concerns.

I know a case where the ignorant attitude of a high-ranking doctor in the public system led to an attempt at suicide. It was as if the doctor was trying drive this girl to suicide. For instance: he changed her medication (which a private psychiatrist thinks she never needed) while she was living alone (both Affexa and Solarian); refused to shift an appointment so she could stay on a day after burying her grandma; he told her father (in front of her), when the father pointed out that it would help her to stay on and grieve with family and the doctor needed to be more flexible, that if he didn't like the public system he should take her to a private doctor. (The father and daughter had travelled half the night on bus to get to appointment on time and the doctor thought she was only 17 - she was 21.)

The girl tried to kill herself not long after. She was then taken out of a much-needed CBT program because she missed a meeting because when she tried to top herself the police took her to the psych ward where she was too heavily sedated to keep an appointment- CBT staff refused to allow her to continue. This triggered another downward spiral.

There needs to be more top-flight pyschiatrists employed and the public systems'de-sensitised-careerist and incompetent psychiatrists to wake up to themselves.
Posted by rancitas, Thursday, 27 October 2005 2:58:24 PM
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