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

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

Reading from the states... quite wonderful article! Things ain't so different here... Dr. Peterson

Dear Bob,
If only we could roll out your therapy Australians would be a whole lot healthier...
Thanks!

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.

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.

rancitas

Thank you for your post. What a horrible story. I am very sorry that your friends were the victim of such negligence.

I am proud of my commitment to people with mental health problems and their families (and other loved ones).

I am also pleased to say that 90% of mental health professionals I have worked alongside have been as dedicated as myself. The other 10% are usually into power and control, and have no empathy - let alone compassion. Sadly that is the real world. But I can say even worse for aged care. In my last position I was apalled by the way that our senior citizens were treated by most nurses and doctors. It was as if they were an irritating lump of baggage. Thank God that I no longer work in that field. There are always excuses. But there is no valid reason for blatant patient/client abuse - and that's what it is, bloody abuse!

I can't talk about it any more. Makes me ashamed to be a health professional.

Cheers
Kay

PS - and it's on the cards that it will get much worse before there is a turn in the fork of the road.

Kalweb, I think it was remiss of me not to mention all the very supportive, professional and helpful people who have assisted us through this crisis (seven years and continuing). We think and hope that the worst is over. It is easy to let the anger at this treatment and situation blind one (that was only a bit of it) to all the good, caring workers in the system. They need and deserve support.

The suggestions I make would not last one second in the mind of a politician - too expensive.

Keep 'em separated. Youngsters picked up by the cops and dumped at mental wards need to be kept away from drug-induced mentally ill. Group gatherings such as CBT need to be reconsidered as do any group activity. This is where the kids can get their drugs. Some people who are border-line mental cases usually from resolvable stresses/issues of some sort are easily influenced by older scamming types. I know of one fellow who used to follow his girlfriend to CBT to score. I know one girl who never touched drugs and was introduced to them (speed)while in the care of the hospital. When we alerted the staff to this no action was taken by the hierarchy. The person dealing the drugs was mentally ill himself. Staff were outraged but what could they do?

Also, I tend to think that kids need to be with normal people to get an idea of appropriate behaviour. My friend made huge improvements when she started mixing with the local youth group mob (Christian). She also has a male friend who is interested in her for her own sake(nearly all men are predatory bastards).

I don't regard our situation as hardcore. There are plenty of people in the system and pre-system who are neglected and have had far worse treatment by virtue of the fact that they are on their own - abandoned. On the other hand, I acknowledge that there are caring health care workers who do what they can with what they have.